A trial of cediranib and saracatanib for kidney cancer that has spread to other parts of the body (COSAK)

Cancer type:

Kidney cancer
Renal cell carcinoma

Status:

Results

Phase:

Phase 2

This trial looked at 2 drugs called cediranib (pronounced sed-ih-ran-ib) and saracatanib (pronounced sah-rah-cat-an-ib) for a type of kidney cancer. It was for people with a type of kidney cancer called renal cell cancer that is clear cell type. To enter the trial, their cancer must have come back after having other treatment.

Doctors often use biological therapy to treat kidney cancer that has spread to other parts of the body (metastatic cancer). This treatment can help, but the cancer may come back. Researchers are looking for new treatments to help people in this situation. In this trial they looked at 2 drugs called cediranib (also known as AZD2171) and saracatanib (also known as AZD0530).

A cancer can only grow if it can develop its own blood supply. This process is called angiogenesis and involves growth factors such as vascular endothelial growth factor (VEGF). The people who took part in this trial had already had treatment that targets VEGF such as the drugs sunitinib or bevacizumab.

Cediranib stops VEGF from telling cancer cells to grow new blood vessels, and may stop the cancer growing.

Sometimes a drug can stop working, even though cancer responded to it at first. Doctors call this resistance. Some trials have shown that saracatanib may help to stop cancer cells becoming resistant to other drugs.

The aims of this trial were to

  • Find out if a combination of cediranib and saracatanib worked better than cediranib alone for clear cell renal cancer that had spread
  • Learn more about the side effects

Summary of results

The trial team found that saracatanib alongside cediranib didn’t work as well as cediranib on its own.

This was a phase 2 trial that was randomised and recruited 138 people. They were put into 1 of 2 treatment groups. Neither they nor their doctor chose which group they were in.

  • 69 people had cediranib and a dummy drug (placebo)
  • 69 people had cediranib and saracatanib

The researchers looked at the average length of time people were living free of their cancer. They found that it was

  • Just under 5½ months for those who had cediranib and the dummy drug
  • Just under 4 months for those who had cediranib and saracatanib

The average length of time people lived after treatment was

  • Just over 14 months for those who had cediranib and the dummy drug
  • 10 months for those who had cediranib and saracatanib

The average overall length of time that people lived after treatment was a year.

The most common side effects reported in both groups were

  • Tiredness and a lack of energy
  • Sore mouth
  • Feeling or being sick
  • Numbness, tingling and painful hands and feet
  • Diarrhoea

More people who had cediranib and saracatanib had their treatment reduced or stopped because of side effects than those who had cediranib and the dummy drug.  

The trial team concluded that adding saracatanib to cediranib didn’t work as well as cediranib alone for people who had clear cell renal cancer that had spread and was resistant to other VEGF treatments.  

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed) but may not have been published in a medical journal.  The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Prof Thomas Powles

Supported by

AstraZeneca
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
ISD Cancer Clinical Trials Team
Edinburgh
National Institute for Health Research Cancer Research Network (NCRN)

Other information

This is Cancer Research UK trial number CRUKE/09/031. 

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 5110

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Over 60,000 cancer patients enrolled on clinical trials in the UK last year.

Last reviewed:

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