Description:
This study will attempt to determine the efficacy of checkpoint inhibitor immunotherapy with
nivolumab and ipilimumab combination therapy followed by nivolumab monotherapy in patients
with metastatic prostate cancer harboring loss of CDK12 function.
Title
- Brief Title: Immunotherapy in Patients With Metastatic Cancers and CDK12 Mutations
- Official Title: IMPACT: Immunotherapy in Patients With Metastatic Cancers and CDK12 Mutations
Clinical Trial IDs
- ORG STUDY ID:
UMCC 2018.050
- SECONDARY ID:
HUM00145104
- NCT ID:
NCT03570619
Conditions
- Metastatic Castration Resistant Prostate Cancer
- Metastatic Cancer
Interventions
Drug | Synonyms | Arms |
---|
Nivolumab | | Metastatic CRPC |
Ipilimumab | | Metastatic CRPC |
Purpose
This study will attempt to determine the efficacy of checkpoint inhibitor immunotherapy with
nivolumab and ipilimumab combination therapy followed by nivolumab monotherapy in patients
with metastatic prostate cancer harboring loss of CDK12 function.
Detailed Description
This study investigates the efficacy of checkpoint inhibitor immunotherapy in patients with
metastatic cancer with CDK12 mutations. The study includes two cohorts of patient groups:
castration resistant metastatic prostate carcinoma and other solid tumor histologies. Both
cohorts receive the same treatment with the combination of nivolumab and ipilimumab followed
by nivolumab.
Trial Arms
Name | Type | Description | Interventions |
---|
Metastatic CRPC | Experimental | Patients with metastatic castration resistant prostate cancer (mCRPC) will be enrolled in cohort A. | |
Solid Tumors (non-prostate) | Experimental | Patients with all other metastatic subtypes will be enrolled in cohort B | |
Eligibility Criteria
Inclusion Criteria:
- Be ≥18 years of age as of date of signing informed consent.
- Be willing and able to provide written informed consent for the study.
- ECOG Performance Status of 0, 1 or 2 (Eastern Cooperative Oncology Group scoring
system used to quantify general well-being and activities of daily life; scores range
from 0 to 5 where 0 represents perfect health and 5 represents death.
- Subjects must have a histologic or cytologic diagnosis of metastatic adenocarcinoma of
the prostate without small cell histology OR another type of metastatic carcinoma.
- All subjects, regardless of cancer type, must have a documented CDK12 aberration in
tumor tissue.
- Subjects with prostate cancer must have documented prostate cancer progression within
six months prior to screening with PSA progression defined as a minimum of three
rising PSA levels ≥ 1; 1 week between each assessment with a baseline PSA value at
screening of ≥ 2 ng/mL.
- Subjects with prostate cancer must have ongoing androgen deprivation with total serum
testosterone < 50 ng/dL (or ≤ 0.50 ng/mL or 1.73 nmol/L)). If the subject is currently
being treated with LHRH agonists (subjects who have not undergone an orchiectomy),
this therapy must have been initiated at least 4 weeks prior to registration. This
treatment must be continued throughout the study.
- Subjects with non-prostate histologies must have RECIST 1.1-measurable cancer on
computed tomography (CT) or magnetic resonance imaging (MRI) scans.
- Subjects must have recovered to baseline or ≤ grade 1 toxicities related to any prior
treatments unless AE(s) are clinically non-significant and/or stable.
- Patients must be ≥ 2 weeks from most recent systemic therapy or most recent radiation
therapy.
- Women of childbearing potential must have a negative serum or urine pregnancy test
within 28 days prior to registration.
- Female and male subjects of reproductive potential must agree to use an adequate
method of contraception starting with the first dose of study therapy through 5 months
(for women) and 7 months (for men) after the last dose of study therapy.
- Adequate organ and marrow function
Exclusion Criteria:
- Prior treatment with anti-PD-1/PD-L1 and anti-CTLA-4 is NOT allowed. Prior
intravesical BCG therapy is allowed.
- Treatment with any investigational agent or on an interventional clinical trial within
28 days prior to registration.
- Prior or concurrent malignancy except for: adequately treated basal cell or squamous
cell skin cancer, in situ cervical cancer, localized or locally advanced prostate
cancer definitively treated without recurrence or with biochemical recurrence only, or
any other cancer fully treated or from which the subject has been disease-free for at
least 2 years.
- Autoimmune diseases such as rheumatoid arthritis. Vitiligo, mild psoriasis (topical
therapy only) or hypothyroidism are allowed.
- Need for systemic corticosteroids >10mg prednisone daily or equivalent alternative
steroid (except physiologic dose for adrenal replacement therapy) or other
immunosuppressive agents (such as cyclosporine or methotrexate) Topical and inhaled
corticosteroids are allowed if medically needed.
- Any history of organ allografts
- Any history of HIV, hepatitis B or hepatitis C infection
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | The proportion of patients with CDK12 loss of function metastatic CRPC (Cohort A) that respond to treatment. |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | The primary objective is overall response rate (ORR) of patients with metastatic CRPC. Response will be defined as a 50% decline in PSA (prostate specific antigen) from baseline as determined by PCWG3 criteria. |
Secondary Outcome Measures
Measure: | The proportion of patients that respond to treatment in Cohort B. |
Time Frame: | Up to 52 weeks after start of therapy |
Safety Issue: | |
Description: | Overall response will be defined as patients that achieve either a partial response or complete response using RECIST 1.1 criteria.
Complete response (CR) is defined as disappearance of all target lesions, determined by two separate observations conducted not less than 4 weeks apart. There can be no appearance of new lesions.
Partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. There can be no appearance of new lesions. |
Measure: | Radiographic progression free survival time (rPFS) |
Time Frame: | Up to 52 weeks after start of therapy |
Safety Issue: | |
Description: | Radiographic progression-free survival (rPFS) is defined as the duration of time from start of treatment to time of radiographic progression. Progression is defined as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started, or the appearance of one or more new lesions. |
Measure: | Progression free survival time (PFS) |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | Progression is defined as the duration of time from start of treatment to time of progression. Progression is defined as:
Either, Radiographic progression: At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started, or the appearance of one or more new lesions OR, PSA Progression: For rising PSA after an initial decline from baseline, the PSA is recorded from the start of therapy to first PSA increase that is ≥ 25% and ≥ 2ng/mL above the nadir, which is confirmed by a second value 4 or more weeks later, confirming a rising trend. If there is no initial decline from baseline, PSA progression is defined as ≥ 25% increase and ≥ 2 ng/mL increase from baseline beyond 12 weeks. |
Measure: | Duration of Therapy (DOT) |
Time Frame: | Up to 52 weeks after start of therapy |
Safety Issue: | |
Description: | Defined by the time interval from the start of treatment to the day of permanent discontinuation of treatment (including death). |
Measure: | Time to Progression (TTP) |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | Progression is defined as the duration of time from start of treatment to time of progression. Progression is defined as:
Either, Radiographic progression: At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started, or the appearance of one or more new lesions OR, PSA Progression: For rising PSA after an initial decline from baseline, the PSA is recorded from the start of therapy to first PSA increase that is ≥ 25% and ≥ 2ng/mL above the nadir, which is confirmed by a second value 4 or more weeks later, confirming a rising trend. If there is no initial decline from baseline, PSA progression is defined as ≥ 25% increase and ≥ 2 ng/mL increase from baseline beyond 12 weeks. |
Measure: | Overall survival Time |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | Defined as the time from the start of treatment until death from any cause. Patients alive or lost to follow-up at the time of analysis will be censored at their last date of follow-up. |
Measure: | PSA progression free survival time |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | PSA Progression: For rising PSA after an initial decline from baseline, the PSA is recorded from the start of therapy to first PSA increase that is ≥ 25% and ≥ 2ng/mL above the nadir, which is confirmed by a second value 4 or more weeks later, confirming a rising trend. If there is no initial decline from baseline, PSA progression is defined as ≥ 25% increase and ≥ 2 ng/mL increase from baseline beyond 12 weeks. |
Measure: | Time to PSA progression |
Time Frame: | Up to 24 months post treatment |
Safety Issue: | |
Description: | PSA Progression: For rising PSA after an initial decline from baseline, the PSA is recorded from the start of therapy to first PSA increase that is ≥ 25% and ≥ 2ng/mL above the nadir, which is confirmed by a second value 4 or more weeks later, confirming a rising trend. If there is no initial decline from baseline, PSA progression is defined as ≥ 25% increase and ≥ 2 ng/mL increase from baseline beyond 12 weeks. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Michigan Rogel Cancer Center |
Trial Keywords
- Metastatic Cancer
- Metastatic Castration Resistant Prostate Cancer
- mCRPC
- Immunotherapy
- CDK12
Last Updated
August 18, 2020