Neoadjuvant Sitravatinib in Combination With Nivolumab in Patients With Clear Cell Renal Cell Carcinoma

Sitravatinib is a receptor tyrosine kinase inhibitor (TKI) that targets multiple closely
related receptor tyrosine kinase pathways including VEGFR, PDGF receptor (PDGFR), c-KIT, MET,
and the TAM family of receptors (TYRO3, AXL, and MER). Nivolumab is a monoclonal antibody
directed against PD-1 and blocks the interaction between PD-1 and its ligands, thereby
releasing PD-1-mediated inhibition of T-cell proliferation (including cytotoxic CD8+ T-cells)
and cytokine production. Together, sitravatinib and nivolumab may cooperate to elicit greater
anti-tumor activity than either agent alone, as sitravatinib is predicted to enhance several
steps in the cancer immunity cycle that may augment the efficacy of nivolumab.

Inclusion Criteria:

1. Imaging results consistent with locally-advanced RCC

2. Candidate for partial or complete nephrectomy as part of treatment plan.

3. Measurable disease as per RECIST version 1.1.

4. ECOG performance status 0 or 1.

5. Adequate bone marrow and organ function.

Exclusion Criteria:

1. Prior systemic anti-tumor treatment for RCC.

2. Patients who are receiving any other investigational agents.

3. Clinical status indicating that immediate surgery (within 6 weeks) is warranted
regardless of whether neoadjuvant therapy is to be administered, as assessed by the
treating surgeon.

4. Inability to undergo baseline tumor biopsy.

5. Active or prior documented autoimmune or immunocompromising conditions.

6. Uncontrolled hypertension.