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Prostate Cancer MetastaticPhase 2PRIMCABNCT02379390

Cabazitaxel Versus the Switch to Alternative AR Targeted Therapy Enzalutamide or Abiraterone in Metastatic Castration-Resistant Prostate Cancer (mCRPC) Primary Resistant Patients to Abiraterone or Enzalutamide

A Phase 2 study testing Cabazitaxel XRP6258, Ezalutamide and Abiraterone acetate in people with Prostate Cancer Metastatic, run by Sanofi at 24 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Primary Objective: To demonstrate the superiority in term of radiographic Progression-Free Survival (rPFS) of cabazitaxel at at 25 milligram per meter square (mg/m^2) plus prednisone (Arm A) versus either enzalutamide at 160 milligram (mg) once daily or abiraterone acetate at 1000 mg once daily plus prednisone (Arm B)… Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Prostate Cancer Metastatic
What is being tested?
Cabazitaxel XRP6258, Ezalutamide and Abiraterone acetate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
8 participants
Where
24 sitesin 2 countries
Study dates
17 Jun 2015to 10 May 2018
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of histologically or cytologically confirmed prostate adenocarcinoma.
  • Metastatic disease.
  • Progressive disease (PD) while receiving AR targeted therapy with abiraterone acetate or enzalutamide within 12 months of treatment initiation (≤12 months) by at least one of the following:
  • Progression in measurable disease Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.
  • Appearance of 2 or more new bone lesions according to Prostate Cancer Working Group 2 (PCWG2).
  • Rising PSA defined (PCWG2) as at least two consecutive rises in PSA to be documented over a reference value (measure 1) taken at least one week apart.
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  • A PSA value of at least 2 nanogram/milliliter (ng/mL) is required at study entry.
  • Effective castration (serum testosterone levels ≤0.5 ng/mL).
  • Prior AR targeted therapy (abiraterone acetate or enzalutamide) must be stopped at least 2 weeks before study treatment.
  • Signed written informed consent.

Who cannot join

  • Prior chemotherapy for prostate cancer, except estramustine and except adjuvant/neoadjuvant treatment completed >3 years ago. No further anti-cancer therapy after the previous AR targeted therapy and before inclusion. Prior docetaxel in hormone sensitive setting is allowed if completed >1 year before randomization. Prior immunotherapy is allowed.
  • Less than 28 days elapsed from prior treatment with immunotherapy, radiotherapy, or surgery to the time of randomization.
  • Adverse events (excluding alopecia and those listed in the specific exclusion criteria) from any prior anticancer therapy of grade >1(National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] v4.0) at the time of randomization.
  • Eastern Cooperative Oncology Group (ECOG) performance status >1.
  • History of brain metastases, uncontrolled spinal cord compression, or carcinomatous meningitis, or new evidence of brain or leptomeningeal disease.
  • Prior malignancy. Adequately treated basal cell or squamous cell skin or superficial (pTis, pTa, and pT1) bladder cancer are allowed, as well as any other cancer for which treatment has been completed ≥5 years ago and from which the patient has been disease-free for ≥5 years.
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  • Participation in another clinical trial and any concurrent treatment with any investigational drug within 30 days prior to randomization.
  • Acquired immunodeficiency syndrome (AIDS)-related illnesses or known Human immunodeficiency virus (HIV) disease requiring antiretroviral treatment.
  • Any severe acute or chronic medical condition including uncontrolled diabetes mellitus, severe renal impairment, history of cardiovascular disease (uncontrolled hypertension, arterial thrombotic events in the past 6 months, congestive heart failure, severe or unstable angina pectoris, recent myocardial infraction within last 6 months or uncontrolled cardiac arrhythmia), which could impair the ability of the patient to participate to the study or interfere with interpretation of study results, or patient unable to comply with the study procedures.
  • Participants with reproductive potential who do not agree to use accepted and effective method of contraception during the study treatment period and up to 6 months after the last administered dose. The definition of "effective method of contraception" will be based on the Investigator's judgment.
  • Known allergies, hypersensitivity or intolerance to prednisone or excipients of abiraterone acetate or enzalutamide. History of hypersensitivity to docetaxel or polysorbate 80.
  • Known history of mineralocorticoid excess or deficiency (not applicable to participants who have already been treated with abiraterone acetate in first line before inclusion).
  • History of seizure, underlying brain injury with loss of consciousness, transient ischemic attack within the past 12 months, cerebral vascular accident, brain arteriovenous malformation or the use of concomitant medications that may lower the seizure threshold (not applicable to participants who have already been treated with enzalutamide in first line before inclusion).
  • Unable to swallow a whole tablet or capsule.
  • Inadequate organ and bone marrow function as evidenced by:
  • Hemoglobin <10.0 g/dL.
  • Absolute neutrophil count <1.5 x 10^9/L.
  • Platelet count <100 x 10^9/L.
  • Aspartate aminotransferase (AST) and/or Alanine aminotransferase (ALT) >1.5 x Upper limit of normal (ULN).
  • Total bilirubin >1.0 x ULN.
  • Potassium <3.5 mmol/L.
  • Serum albumin <3.0 g/dL.
  • Child-Pugh Class B and C.
  • Contraindications to the use of corticosteroid treatment.
  • Symptomatic peripheral neuropathy grade ≥2 NCI CTCAE v4.0.
  • Concomitant vaccination with yellow fever vaccine.
  • The above information was not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Trial locations and contacts

24 sites in 2 countries.

24 sites in 2 countries

United States14 sites
  • Investigational Site Number 840028

    Anaheim, California, 92801

  • Investigational Site Number 840024

    Anchorage, Alaska, 99508

  • Investigational Site Number 840002

    Boca Raton, Florida, 33486

  • Investigational Site Number 840022

    Canton, Ohio, 44718

  • Investigational Site Number 840001

    Covington, Louisiana, 70433

  • Investigational Site Number 840027

    Lakeland, Florida, 33805

  • Investigational Site Number 840017

    Metairie, Louisiana, 70006

  • Investigational Site Number 840030

    Muscle Shoals, Alabama, 35661

  • Investigational Site Number 840016

    Myrtle Beach, South Carolina, 29572

  • Investigational Site Number 840026

    Omaha, Nebraska, 68198

  • Investigational Site Number 840015

    Ottawa, Illinois, 61350

  • Investigational Site Number 840006

    Port Saint Lucie, Florida, 34952

  • Investigational Site Number 840012

    Rockville, Maryland, 20850

  • Investigational Site Number 840004

    Sacramento, California, 95817

Other trials in United States

Canada10 sites
  • Investigational Site Number 124003

    Edmonton, T6G 1Z2

  • Investigational Site Number 124010

    Greenfield Park, J4V2H1

  • Investigational Site Number 124005

    Hamilton, L8V 5C2

  • Investigational Site Number 124004

    London, N6A 4L6

  • Investigational Site Number 124002

    Montreal, H2L 4M1

  • Investigational Site Number 124006

    Montreal, H2W1S6

  • Investigational Site Number 124007

    Ottawa, K1H8L6

  • Investigational Site Number 124009

    Québec, G1R 2J6

  • Investigational Site Number 124008

    Saskatoon, S7N4H4

  • Investigational Site Number 124001

    Vancouver, N5Z4E6

Other trials in Canada

About this study

Official title: Phase II, Randomized, Open-label, Multicenter Study in Chemotherapy-naïve Metastatic Castration-Resistant Prostate Cancer (mCRPC) Patients Who Have PRIMary Resistance to Abiraterone Acetate or Enzalutamide Treatment Comparing the Anti-tumor Effect of CABazitaxel to Alternative Androgen Receptors (AR) Targeted Therapy

Primary Objective:

To demonstrate the superiority in term of radiographic Progression-Free Survival (rPFS) of cabazitaxel at at 25 milligram per meter square (mg/m^2) plus prednisone (Arm A) versus either enzalutamide at 160 milligram (mg) once daily or abiraterone acetate at 1000 mg once daily plus prednisone (Arm B) in chemotherapy-naïve participants with metastatic Castration-Resistant Prostate Cancer (mCRPC) who have disease progression while receiving androgen receptor (AR) targeted therapy (abiraterone plus prednisone or enzalutamide) within 12 months of treatment initiation (≤12 months).

Read more

Secondary Objective:

  • To compare efficacy for:
  • Prostate-specific antigen (PSA) response rate and Time to PSA progression (TTPP).
  • Progression Free Survival (PFS).
  • Overall Survival (OS).
  • Tumor response rate in participants with measurable disease (RECIST 1.1)
  • Pain response and time to pain progression.
  • Symptomatic skeletal events (SSE) rate and time to occurrence of any SSE.
  • To analyze messenger ribonucleic acids (mRNAs) including androgen-receptor splice variant 7 messenger RNA (AR-V7) as a biomarker in Circulating Tumor Cells (CTCs).
  • To evaluate safety in the 2 treatment arms.
Read the detailed description

The duration of the study per participant was approximately 2 years. Each participant was treated until radiographic disease progression, unacceptable toxicity, or participants refusal of further study treatment, and each participant was followed after completion of study treatment until death, study cutoff date, or withdrawal of participant consent.

Being tested
Cabazitaxel XRP6258, Ezalutamide, Abiraterone acetate, Prednisone

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cabazitaxel XRP6258Drug

    Also called Jevtana

  • EzalutamideDrug

    Also called Xtandi

  • Abiraterone acetateDrug

    Also called Zytiga

  • PrednisoneDrug

Study groups in NCT02379390
Study groupRoleWhat they receive
CabazitaxelExperimentalParticipants received Cabazitaxel 25 mg/m^2, intravenously for 1 hour along with prednisone 10 mg orally on Day 1 of every treatment cycle (each cycle was of 3 weeks) until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
Receives: Drug: Cabazitaxel XRP6258; Drug: Prednisone
Abiraterone acetate or EnzalutamideActive comparatorParticipants received abiraterone acetate 1000 mg (4 tablets of 250 mg), orally once daily along with prednisone 5 mg, orally twice daily from Day 1 to 21 in each treatment cycle (each cycle was of 3 weeks) or enzalutamide 160 mg, orally, until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
Receives: Drug: Ezalutamide; Drug: Abiraterone acetate; Drug: Prednisone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Radiographic Progression-Free Survival (rPFS)

    rPFS was defined as the time from randomization to the first occurrence of radiological tumor progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 or progression of bone lesions using prostate cancer working group 2 (PCWG2) criteria or death due to any cause.

    Measured: Baseline until tumor progression or bone lesion progression or death due to any cause (maximum duration: 1059 days)

Secondary outcomes (10)
  1. Number of Participants With Prostate Specific Antigen (PSA) Response

    PSA response was defined as decline of serum PSA from baseline by >= 50 percent (%).

    Measured: Baseline up to PSA progression or death due to any cause (maximum duration: 1059 days)

  2. Progression-free Survival (PFS)

    PFS: time interval between date of randomization to first documentation of tumor progression as per RECIST 1.1.

    Measured: Baseline upto progression or death due to any cause (maximum duration: 1059 days)

  3. Overall Survival

    Overall Survival was defined as the time interval from the date of randomization to the date of death due to any cause.

    Measured: Baseline until death or study cut-off date, whichever was earlier (maximum duration: 1059 days)

  4. Time to PSA Progression

    Time to PSA progression was defined as the time interval between the date of randomization and the date of first documented PSA progression as per PCWG2 criteria.

    Measured: Baseline up to PSA progression or death due to any cause (maximum duration: 1059 days)

  5. Number of Participants Achieving Tumor Response

    Tumor response was defined as either a partial response (PR) or complete response (CR) according to the RECIST 1.1.

    Measured: Baseline up to disease progression or death due to any cause (maximum duration: 1059 days)

  6. Duration of Tumor Response

    Duration of tumor response was defined as the time between the first evaluation at which the tumor response criteria were met and the first documentation of tumor progression.

    Measured: Baseline up to disease progression or death due to any cause (maximum duration: 1059 days)

  7. Pain Response Using Brief Pain Inventory-Short Form (BPI-SF) for Pain Intensity Score

    Pain response was analyzed using the brief pain inventory-short form (BPI-SF).

    Measured: Baseline until the end of study (maximum duration: 1059 days)

  8. Time to Pain Progression

    Time to pain progression was defined as the time interval between the date of randomization and the date of the first documented pain progression.

    Measured: Baseline until disease progression, start of another anticancer therapy or study cut off, whichever came first (maximum duration: 1059 days)

  9. Percentage of Participants With Symptomatic Skeletal Event (SSE)

    SSE was the occurrence of a new symptomatic pathological fracture, or the use of external beam radiation to relieve bone pain, or the occurrence of spinal cord compression, or tumor-related orthopedic surgical intervention.

    Measured: Baseline until the end of study (maximum duration: 1059 days)

  10. Time to Occurrence of Any Symptomatic Skeletal Events (SSE)

    Time to SSE was defined as the time interval between the date of randomization and the date of the occurrence of the first event defining a SSE, whichever is earlier.

    Measured: Baseline up to occurrence of the first event defining a SSE (maximum duration: 1059 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Mar 2015 (estimated)
  2. Study start17 Jun 2015
  3. Primary completion10 May 2018
  4. Study completion10 May 2018

Why it stopped: Unsatisfactory patient accrual

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
8 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02379390
Sponsor's protocol ID
LPS14022
Other IDs
U1111-1160-6008
Acronym
PRIMCAB
Status last verified
Jun 2019
First submitted
27 Feb 2015
Last updated
21 Jun 2019
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Cabazitaxel XRP6258, Ezalutamide and Abiraterone acetate in people with Prostate Cancer Metastatic, run by Sanofi at 24 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 21 Jun 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Jun 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Radiographic Progression-Free Survival (rPFS) (time frame: Baseline until tumor progression or bone lesion progression or death due to any cause (maximum duration: 1059 days)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jun 2019.

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