Description:
This is a phase II clinical trial in patients with metastatic castration sensitive prostate
cancer. The objective of the study is to determine the efficacy and further define the safety
of the treatment combination. This study will evaluate dose levels of carboplatin AUC 4 with
cabazitaxel 20 mg/m2. Patients will be treated with the combination of ADT and carboplatin
and cabazitaxel for 6 cycles. After 6 cycles of chemotherapy, they will start abiraterone
with ADT. The primary objective is to determine the percent of subjects that have no PSA or
radiographic progression at 1 year. Secondary objectives will include determining the
progression-free survival, time to PSA nadir and time to PSA progression of carboplatin and
cabazitaxel in combination with ADT.
Title
- Brief Title: CASCARA: Castration Sensitive Carboplatin, Cabazitaxel and Abiraterone
- Official Title: A Phase II Study of Carboplatin, Cabazitaxel and Abiraterone in High Volume Metastatic Castration Sensitive Prostate Cancer
Clinical Trial IDs
- ORG STUDY ID:
2018LS158
- NCT ID:
NCT03934840
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Cabazitaxel | | Carboplatin, Cabazitaxel and Abiraterone |
Carboplatin | | Carboplatin, Cabazitaxel and Abiraterone |
Abiraterone | | Carboplatin, Cabazitaxel and Abiraterone |
Prednisone | | Carboplatin, Cabazitaxel and Abiraterone |
Purpose
This is a phase II clinical trial in patients with metastatic castration sensitive prostate
cancer. The objective of the study is to determine the efficacy and further define the safety
of the treatment combination. This study will evaluate dose levels of carboplatin AUC 4 with
cabazitaxel 20 mg/m2. Patients will be treated with the combination of ADT and carboplatin
and cabazitaxel for 6 cycles. After 6 cycles of chemotherapy, they will start abiraterone
with ADT. The primary objective is to determine the percent of subjects that have no PSA or
radiographic progression at 1 year. Secondary objectives will include determining the
progression-free survival, time to PSA nadir and time to PSA progression of carboplatin and
cabazitaxel in combination with ADT.
Trial Arms
Name | Type | Description | Interventions |
---|
Carboplatin, Cabazitaxel and Abiraterone | Experimental | | - Cabazitaxel
- Carboplatin
- Abiraterone
- Prednisone
|
Eligibility Criteria
Inclusion Criteria:
- Willing and able to provide, or have a legally authorized representative provide,
written informed consent and HIPAA authorization for the release of personal health
information. A signed informed consent must be obtained before screening procedures
are performed.
- Histologically confirmed prostate cancer.
- High volume metastatic disease (defined as the presence of visceral metastases or ≥3
bone lesions).
- ADT for ≤3 months by day 1 of study chemotherapy; Prior episodes of ADT are allowed
(i.e. ADT used previously in courses of radiation).
- Testosterone <50 ng/dL. Patients must continue primary ADT with an LHRH analogue if
they have not undergone orchiectomy.
- ECOG Performance Status 0 or 1 (see Appendix A)
- Patient has adequate bone marrow and organ function as defined by the following
laboratory values:
- Absolute neutrophil count ≥ 1.5 × 10^9/L
- Platelets ≥ 100 × 10^9/L
- Hemoglobin ≥ 9 g/dl
- Serum creatinine ≤ 1.5mg/dL or estimated creatinine clearance ≥ 50 ml/min
- In the absence of liver metastases, alanine aminotransferase (ALT) and aspartate
aminotransferase (AST) <2.5 x ULN. If the patient has liver metastases, ALT and
AST <5 x ULN
- Total bilirubin < ULN; or total bilirubin ≤3.0 x ULN or direct bilirubin ≤1.5 x
ULN in patients with well-documented Gilbert's Syndrome.
- Sexually active males must use a condom during intercourse while taking study drugs
and for 30 days after stopping treatment and should not father a child in this period.
A condom is required to be used also by vasectomized men in order to prevent delivery
of the drug via seminal fluid. Fertile males must use a condom with spermicide (double
barrier method).
- Age ≥ 18 years
Exclusion Criteria:
- Prior exposure to any chemotherapy, PARPi, or immunotherapy for prostate cancer.
- Prior abiraterone or enzalutamide, unless therapy was for < 2 weeks
- Radiation therapy (including palliative radiotherapy to a metastatic lesion) within 14
days or major surgery (e.g., open abdominal, pelvic, thoracic, orthopedic or
neurosurgery) within 28 days of the date of the first dose.
- Other systemic therapies for prostate cancer within 28 days or 5 half-lives, whichever
is shorter, prior to day 1 of chemotherapy (with the exception of anti-androgens like
bicalutamide).
- PSA <2.0 ng/mL at diagnosis.
- If present, peripheral neuropathy must be ≤ Grade 1
- Patients with an active second malignancy that could, in the investigator's opinion,
potentially interfere with the patient's ability to participate and/or complete this
trial.
- Patients with central nervous system (CNS) involvement unless they meet ALL of the
following criteria:
- At least 4 weeks from prior therapy completion (including radiation and/or
surgery) prior to starting the study treatment
- Clinically stable CNS tumor at the time of screening.
- Baseline screening for CNS metastases is not required unless presence of signs
and/or symptoms of involvement
- Patients with severe psychiatric illness/social situations that would limit compliance
with study requirements in the judgment of treating investigator.
- Patient has a history of non-compliance to medical regimen or inability to grant
consent.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Male |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Prostate-Specific Antigen (PSA) or Radiographic Progression |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Proportion of patients who have no PSA or radiographic progression as determined by RECIST 1.1 or PCWG3 criteria |
Secondary Outcome Measures
Measure: | Progression-Free Survival (PFS) |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Incidence of PFS |
Measure: | PSA Nadir |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Time to time to PSA nadir |
Measure: | Incidence of adverse events |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Safety and Tolerability |
Measure: | Incidence of Homologous Recombination Deficiency (HRD) |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Incidence of HRD |
Measure: | PSA Complete Response Rate |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | PSA complete response rate (PSA <0.2 ng/ml) in patient with mutations in DNA repair genes |
Measure: | PSA Complete Response Rate |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | PSA complete response rate (PSA <0.2 ng/ml) in patient without mutations in DNA repair genes |
Measure: | PSA Progression |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | Time to PSA progression |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Masonic Cancer Center, University of Minnesota |
Last Updated
May 28, 2021