Description:
Abiraterone is approved in the United States by the U.S. Food and Drug Administration (FDA)
to treat metastatic prostate cancer at 1000 mg daily.
The purpose of this study is to find out if an on and off schedule of taking abiraterone
would prolong the participant's cancer's response to this drug and maintain their
functionality to perform their daily activities.
Title
- Brief Title: Adaptive Abiraterone Therapy for Metastatic Castration Resistant Prostate Cancer
- Official Title: A Pilot Study of Adaptive Abiraterone Therapy for Metastatic Castration Resistant Prostate Cancer
Clinical Trial IDs
- ORG STUDY ID:
MCC-17981
- NCT ID:
NCT02415621
Conditions
Interventions
| Drug | Synonyms | Arms |
|---|
| Abiraterone Acetate | Zytiga | Abiraterone Acetate Therapy |
Purpose
Abiraterone is approved in the United States by the U.S. Food and Drug Administration (FDA)
to treat metastatic prostate cancer at 1000 mg daily.
The purpose of this study is to find out if an on and off schedule of taking abiraterone
would prolong the participant's cancer's response to this drug and maintain their
functionality to perform their daily activities.
Detailed Description
In this pilot study, 10 black participants and 15 non-black participants will be enrolled
after achieving 50% or more decline of their prostatic specific antigen (PSA) while on
abiraterone for asymptomatic or minimally symptomatic metastatic castration resistant
prostate cancer (mCRPC). Abiraterone will be stopped and will not be re-initiated until there
is 50% or more increase of the PSA. Each time abiraterone is stopped, it will be defined as
the start of a new adaptive therapy cycle. Participants who cannot achieve a 50% decline of
their PSA after restarting abiraterone will continue abiraterone until they develop
radiographic disease progression. If the decline in performance status does not occur at the
time of radiographic disease progression, participants will be followed until they develop
radiographic disease progression.
The study will be terminated early if less than 3 of the first 10 enrolled participants can
complete 2 cycles of the adaptive abiraterone.
Trial Arms
| Name | Type | Description | Interventions |
|---|
| Abiraterone Acetate Therapy | Other | Study schedule involves stopping FDA Approved abiraterone after participants achieve a good PSA response (50% or more decline of pre-abiraterone PSA) and then restarting abiraterone after their PSA reaches the level of pre-abiraterone PSA. | |
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed adenocarcinoma of the prostate (the
availability archival prostate tumor sample is preferred not required)
- Asymptomatic or minimally symptomatic (not requiring opioids for cancer related pain)
metastatic castration resistant prostate cancer (CRPC) patients on abiraterone as
standard of care and achieved at least 50% decline of their pre-treatment prostatic
specific antigen (PSA)
- Performance status Eastern Cooperative Oncology Group (ECOG) 0-2
- Adequate organ function
- Stable medical condition, including the absence of acute exacerbations of chronic
illnesses, serious infections or major surgery within 28 days prior to study
enrollment
- Prior surgical castration or concurrent use of gonadotropin-releasing hormone (GnRH)
analogue (i.e. medical castration) with testosterone at screening <50 ng/dL.
- Ability to give written informed consent
Exclusion Criteria:
- Except GnRH analogue therapy, any other therapies for prostate cancer (excluding
bisphosphonate and denosumab) must be discontinued 3 weeks before the first dose of
study drugs.
- Prior treatments with Cyp 17 inhibitors like TAK-700/Orteronel, ketoconazole, radium
223 or docetaxel (up to 6 cycles of docetaxel given in the non CRPC setting is
allowed). Prior treatment with Sipuleucel-T is allowed.
- Documented central nervous system (CNS) metastases or liver metastasis
- Treatment with any investigational compound within 30 days prior to the first dose of
study drugs
- Diagnosis or treatment for another systemic malignancy within 2 years before the first
dose of study drugs, or previously diagnosed with another malignancy & have any
evidence of residual disease. Potential participants with non-melanoma skin cancer or
carcinoma in situ of any type are not excluded if they have undergone complete
resection.
- Uncontrolled hypertension despite appropriate medical therapy (blood pressure of
greater than 160 mmHg systolic and 90 mmHg diastolic at 2 separate measurements no
more than 60 minutes apart during the Screening period). Note: May be rescreened after
adjustments of antihypertensive medications
- Unstable symptomatic ischemic heart disease, ongoing arrhythmias of Grade > 2
[National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events
(CTCAE), version 4.03], New York Heart Association (NYHA) Class III or IV heart
failure
- Known human immunodeficiency virus (HIV) infection, active chronic hepatitis B or C
not contained with anti-viral therapy, life threatening illness unrelated to cancer,
or any serious medical or psychiatric illness that could, in investigator's opinion,
potentially interfere with participation in this study.
- Known gastrointestinal (GI) disease or GI procedure that could interfere with the GI
absorption or tolerance of study drugs, including difficulty swallowing tables
- Delayed healing of wounds, ulcers, and/or bone fractures
- Inability to comply with protocol requirements
| Maximum Eligible Age: | N/A |
| Minimum Eligible Age: | 18 Years |
| Eligible Gender: | Male |
| Healthy Volunteers: | No |
Primary Outcome Measures
| Measure: | Prostatic Specific Antigen (PSA) Response Rate |
| Time Frame: | End of cycle 2: 2 months per participant |
| Safety Issue: | |
| Description: | PSA response rate (defined as 50% decline of pre abiraterone PSA) at cycle 2. Rate in black participants, non-black participants, and participants overall. |
Secondary Outcome Measures
| Measure: | Median Radiographic Progression-Free Survival (rPFS) |
| Time Frame: | Up to 36 months |
| Safety Issue: | |
| Description: | Radiographic progression defined by any of the following: 1.) Progression of measureable lesions per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria. 20% increase in the sum of appropriate diameters of target measurable lesions over smallest sum observed (over pretreatment baseline if no decrease during therapy) using the same imaging techniques as baseline, as well as an absolute increase of at least 0.5 cm. 2.) Progression on bone scan is defined as 2 or more new lesions on radionuclide bone scans. 3.) Unequivocal progression evidenced by appearance of 2 or more new measurable lesions at least 2 cm in short axis. Rate in black participants, non-black participants, and participants overall. |
| Measure: | Median Time to Performance Status Deterioration |
| Time Frame: | Up to 36 months |
| Safety Issue: | |
| Description: | Median Time to Eastern Cooperative Oncology Group (ECOG) Performance status in deterioration. 0 - Fully active, able to carry on all pre-disease performance without restriction; 1 - Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light housework, office work; 2- Ambulatory and capable of self-care but unable to carry out any work activities; up and about more than 50% of waking hours; 3 - Capable of limited self-care, confined to bed or chair more than 50% of waking hours; 4 - Completely disabled; cannot carry on any self-care; totally confined to bed or chair. Rate in black participants, non-black participants, and participants overall. |
Details
| Phase: | Early Phase 1 |
| Primary Purpose: | Interventional |
| Overall Status: | Active, not recruiting |
| Lead Sponsor: | H. Lee Moffitt Cancer Center and Research Institute |
Trial Keywords
- metastatic
- castration resistant
- abiraterone therapy
Last Updated
May 24, 2021
