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Prostate Cancer MetastaticPhase 2NCT04028388

ModraDoc006/r vs Docetaxel IV in Metastatic Prostate Cancer

A Phase 2 study testing Docetaxel in Parenteral Dosage Form and ModraDoc006/r in people with Prostate Cancer Metastatic and Castration-resistant Prostate Cancer, run by Modra Pharmaceuticals at 28 sites in 6 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a multicenter phase 2b study to evaluate the efficacy and tolerability of ModraDoc006 in combination with ritonavir (denoted ModraDoc006/r) in patients with metastatic castration-resistant prostate cancer, suitable for treatment with a taxane. Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
Docetaxel in Parenteral Dosage Form and ModraDoc006/r
Could I receive a placebo?
No, everyone receives an active treatment
How many people
135 participants
Where
28 sitesin 6 countries
Study dates
17 Jul 2019to 29 Nov 2021
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

  • Age ≥ 18 years
  • Histologically or cytologically proven prostate cancer with evidence of progressive mCRPC, defined as:
  • Castrate levels of testosterone, defined as ≤ 50 ng/dL (or ≤ 0.50 ng/mL or 1.73 nmol/L)
  • Evidence of progressive metastatic disease as defined by radiographic disease progression or Prostate Specific Antigen (PSA) progression
  • With an indication for systemic treatment with docetaxel according to the standard of care
  • Measurable tumour lesions, defined as pelvic and/or extra-pelvic nodal lesions ≥1.5 cm in the short axis or visceral lesions ≥1.0 cm in the longest dimensions and measurable according to RECIST v1.1, bone metastasis as evaluated with 99mTc-methylene diphosphonate (MDP) radionuclide bone scintigraphy
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  • Resolution of toxicity of prior therapy to < grade 2 (except for alopecia), as defined by CTCAE v5.0
  • Adequate haematological, renal and hepatic functions:
  • Hemoglobin ≥ 6.0 mmol/l (>9.6 g/dL)
  • Absolute Neutrophil Count (ANC) ≥ 1.5 x 109 /L
  • Platelet count ≥ 100 x 109 /L
  • Hepatic function defined by serum bilirubin ≤ Upper Limit of Normal (ULN), Alanine Amino Transferase (ALAT) and Aspartate Amino Transferase (ASAT) ≤ 1.5 x ULN concomitant with alkaline phosphatase ≤ 2.5 × ULN.
  • Renal function defined by serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 50 ml/min (by Cockcroft-Gault formula, or MDRD).
  • World Health Organisation Performance Status (WHO-PS) of 0-2
  • Estimated life expectancy of at least 12 weeks
  • Able and willing to swallow oral medication
  • Able and willing to undergo radiologic scans (CT scan)
  • Able and willing to give written informed consent according to local guidelines

Who cannot join

  • Any treatment with investigational drugs, chemotherapy or immunotherapy within 4 weeks prior to receiving the first dose of investigational treatment. Palliative radiotherapy (1x8 Gy dose) is allowed before and during the study, but not in the week prior to start of study treatment.
  • Subjects who have had prior treatment with taxanes.
  • Subjects with symptomatic brain metastases. Subjects asymptomatic in the absence of corticosteroids and anticonvulsant therapy for ≥6 weeks are eligible. Radiotherapy for brain metastasis must have been completed ≥6 weeks prior to start of trial. Brain metastasis must be stable with verification by imaging (e.g. brain MRI or CT completed at screening, demonstrating no current evidence of progressive brain metastases). Subjects are not permitted to receive anti-epileptic drugs or corticosteroid treatment indicated for brain metastasis. Subjects with a history of leptomeningeal metastases are not eligible.
  • Current malignancies other than mCRPC with exception of adequately treated basal or squamous cell carcinoma of the skin, or adequately treated non-muscular invasive bladder cancer.
  • Absence of highly effective method of contraception as of cycle one day one (C1D1). Men enrolled in this trial must agree to use a highly effective contraceptive method throughout the study.
  • Uncontrolled hypertension (systolic > 150 mm Hg and/or diastolic > 100 mm Hg)
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  • Unresolved (>grade 0 as defined by CTCAE version 5.0) gastrointestinal toxicities (pre-existing mucositis, diarrhea or nausea/vomiting)
  • Grade ≥ 2 motor ≥ 2 motor or sensory neuropathy symptoms (as defined by CTCAE version 5.0)
  • Known hypersensitivity to any of the study drugs or excipients or taxanes
  • Concomitant use of P-glycoprotein (P-gp , MDR), Cytochrome P450 (CYP)3A, Organic Anion-Transporting Polypeptide (OATP)1B1, OATP1B3 and Multidrug resistance-associated protein 2 (MRP2) modulating drugs such as Ca+- entry blockers (verapamil, dihydropyridines), cyclosporine, quinidine and grapefruit juice, concomitant use of HIV medications, other protease inhibitors, (non) nucleoside analogues, or St. John's wort
  • Bowel obstruction or motility disorder that may influence the resorption of drugs as judged by the treating physician
  • Major surgical procedures within 21 days prior to providing informed consent
  • Active acute or chronic infection, which is not controlled by appropriate medication (at the discretion of the treating physician)
  • Known positivity for Human Immunodeficiency Virus HIV-1 or HIV-2 type
  • Patients with known active infection of hepatitis B/C (HBC), or E (patients who are anti-HBC positive but HBsAg negative are eligible to participate in this study)
  • Clinically significant (i.e. active) cardiovascular disease defined as stroke, transient ischemic attack (TIA), myocardial infarction, unstable angina, or congestive heart failure within ≤ 6 months prior to first trial treatment
  • Evidence of any other medical conditions (such as treatment-resistant peptic ulcer disease, erosive oesophagitis or gastritis, infectious or inflammatory bowel disease, diverticulitis, or pulmonary embolism within 4 weeks of randomization, or psychiatric illness, drug or alcohol abuse, physical examination or laboratory findings) that may interfere with the planned treatment, affect subject compliance or place the subject at high risk of treatment-related complications
  • Legal incapacity

Trial locations and contacts

28 sites in 6 countries.

28 sites in 6 countries

Russia12 sites
  • Regional State Budgetary Healthcare Institution "Altai regional oncology dispensary"

    Barnaul

  • Limited Liability Company "EVIMED

    Chelyabinsk

  • Regional State Budget Institution "Krasnoyarsk Territorial Clinical Hospital n.a. A.I.Kryzhanovskogo"

    Krasnoyarsk

  • Federal State Institution "Russian Cancer Research Center named after N. N. Blokhin" RAMS

    Moscow

  • CJSC Medical Center "AVICENNA"

    Novosibirsk

  • Federal state budget institution "National medical research radiological center " of the Ministry of healthcare of the Russian Federation, branch - A. Tsyb Medical Radiological Research Center

    Obninsk

  • Clinical Oncological Dispensary of Omsk Region

    Omsk

  • Leningrad Region Onco Dispensary

    Saint Petersburg

  • Limited Liability Company "Klinika Andros [Andros Clinic]"

    Saint Petersburg

  • National medical research center of oncology n.a. N.N. Petrov

    Saint Petersburg

  • Pavlov First Saint Petersburg State Medical University

    Saint Petersburg

  • Sverdlovsk Regional Clinical Hospital No. 1

    Yekaterinburg

Other trials in Russia

United States4 sites
  • Karmanos Cancer Institute

    Detroit, Michigan, 48201

  • Comprehensive Cancer Centers of Nevada

    Las Vegas, Nevada, 89119

  • Carolina Urologic Research Center

    Myrtle Beach, South Carolina, 29572

  • Providence Cancer Institute

    Portland, Oregon, 97213

Other trials in United States

Hungary4 sites
  • Orszagos Onkologiai Intezet (National Institute of Oncology)

    Budapest, 6000

  • Debreceni Egyetem Klinikai Központ

    Debrecen

  • Petz Aladár Megyei Oktató Kórház

    Győr

  • Jasz-Nagykun-Szolnok Megyei - Hetenyi Geza Korhaz - Rendelointezet - Onkologiai Kozpont

    Szolnok, 9700

Other trials in Hungary

Germany3 sites
  • Universitätsmedizin Göttingen

    Göttingen

  • Studienpraxis Urologie

    Nürtingen

  • Universitätsklinikum Tübingen

    Tübingen

Other trials in Germany

Poland3 sites
  • Przychodnia Lekarska "KOMED"

    Konin

  • Instytut Centrum Zdrowia Matki Polki

    Lodz

  • Centrum Onkologii - Instytut im. Marii Skłodowskiej-Curie

    Warsaw

Other trials in Poland

Czechia2 sites
  • Nemocnice Liberec

    Liberec

  • Urologicke oddeleni FTN

    Prague

Other trials in Czechia

About this study

Official title: A Multicentre Phase 2b Trial to Evaluate the Efficacy and Tolerability of ModraDoc006/r in Subjects With Metastatic Castration Resistant Prostate Cancer (mCRPC), Suitable for Treatment With a Taxane

This is a multicenter phase 2b study to evaluate the efficacy and tolerability of ModraDoc006 in combination with ritonavir (denoted ModraDoc006/r) in patients with metastatic castration-resistant prostate cancer, suitable for treatment with a taxane.

Read the detailed description

This is an open label 1:1 randomized Phase 2b trial to determine the efficacy and tolerability of oral ModraDoc006/r versus i.v. docetaxel in mCRPC subjects. Cohort 1 will receive i.v. docetaxel at 75 mg/m2 every 3 weeks (Q3W). Cohort 2 will receive 30 mg ModraDoc006 in combination with 200 mg ritonavir in the morning and 20 mg ModraDoc006 in combination with 100 mg ritonavir in the evening (7-12 hours after the morning dose), on Day 1, 8 and 15 of a 21-day cycle (BIDW). All patients will also receive 5 mg oral prednisone twice daily. Treatment in both cohorts will continue until disease progression, unacceptable toxicity, or discontinuation for any other reason. The end of the trial is defined as the time point when all subjects have discontinued trial treatment and have been given follow-up for safety measurements according to the trial assessment schedule.

Being tested
Docetaxel in Parenteral Dosage Form, ModraDoc006/r

What participants receive

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

  • Docetaxel in Parenteral Dosage FormDrug

    Also called Taxotere

    Treatment with IV docetaxel at 75 mg/m2 given as a one-hour infusion on day 1 every 21 days plus 5 mg oral prednisone twice daily

  • ModraDoc006/rDrug

    Also called oral docetaxel formulation

    Treatment with twice daily once weekly (BIDW) ModraDoc006 (oral docetaxel) 10mg tablets in combination with ritonavir 100mg tablets

Study groups in NCT04028388
Study groupRoleWhat they receive
Docetaxel IVActive comparatorThis study arm will receive docetaxel at 75 mg/m2 given i.v. as a one-hour infusion on day 1 every 21 days plus 5 mg oral prednisone twice daily.
Receives: Drug: Docetaxel in Parenteral Dosage Form
ModraDoc006/rExperimentalThis cohort will receive ModraDoc006/r 30 mg oral docetaxel in combination with 200 mg ritonavir in the morning and 20 mg oral docetaxel in combination with 100 mg ritonavir in the evening (7-12 hours after the morning dose), on Day 1, 8 and 15 of a 21-day cycle, plus 5 mg oral prednisone twice daily.
Receives: Drug: ModraDoc006/r

What is being measured

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

  1. Radiographic Progression Free Survival (rPFS)

    Evaluation of rPFS that will be observed as measured by Prostate Cancer Clinical Trials Working Group 3 (PCWG3) criteria, in patients with metastatic prostate cancer after treatment with ModraDoc006/r or docetaxel IV.

    Radiographic disease progression was defined by the local assessment of:

    • Progressive disease by RECIST v1.1. for soft tissue disease
    • Or the appearance of 2 or more new bone lesions on bone scan (PCWG3)

    Measured: Time from the date of randomization to the date of the first radiologic progression (per PCWG3 criteria) or death from any cause, whichever occurred first, an average of 1 year.

Secondary outcomes (9)
  1. Adverse Event Profile (Safety)

    The hematological and non-hematological safety profile of ModraDoc006/r will be assessed by clinical and laboratory evaluations according to CTCAE v5.0.

    Measured: Evaluation of all adverse events during the complete study treatment until 28 days after the last intake, an average of 1 year.

  2. Overall Response Rate (ORR)

    Percentage of patients evaluable for radiological response (ERR) per Prostate Cancer Working Group 3 (PCWG3)-modified Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT/MRI with best overall response of either Complete Response (CR), i.e. disappearance of all target lesions, or Partial Response (PR), i.e. ≥30% decrease in the sum of the longest diameter of target lesions. PCGW3-modified RECIST 1.1 criteria implements the requirement for confirmation of progression at least 6 weeks later for bone lesions at all measurement time points, and for soft tissue lesions after the first measurement (after 2 months) only. Tumor measurements were scheduled after every 8 treatment weeks for the first 24 weeks (i.e. during Week 9, Week 17 and Week 25) and every 12 weeks thereafter.

    Measured: From baseline during the complete study treatment, including follow-up visit 28 days after the last treatment, an average of 1 year.

  3. Disease Control Rate (DCR)

    Disease control rate is calculated by the percentage of patients with Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), ≥30% decrease in the sum of the longest diameter of target lesions; and Stable Disease (SD), ≤20% increase to <30% decrease in the sum of the longest diameter of target lesions per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT/MRI. Disease control rate is presented by treatment group for patients that were evaluable for radiological response for the overall study.

    Measured: From baseline through study completion, an average of 1 year

  4. Duration of Response (DOR)

    DOR is defined as the median time in months from documentation of first tumor response to the first objective evidence of radiologic progression, as measured per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by CT/MRI, in the subpopulation of patients experiencing a Complete Response (CR), i.e. Disappearance of all target lesions; and Partial Response (PR), i.e. ≥30% decrease in the sum of the longest diameter of target lesions.

    Measured: From baseline through study completion, an average of 1 year

  5. Time to Progression (TTP)

    Time to Progression is defined as the time from the date of randomization to the date of the first radiologic progression per PCWG3 criteria.

    Measured: Time from the date of randomization to the date of the first radiologic progression, an average of 1 year.

  6. PSA Response Rate

    PSA decline of >50% from baseline with confirmatory read ≥3 weeks later, based on the Prostate Cancer Working Group 3 (PCWG3) criteria recommendations.

    Measured: From baseline through study completion, an average of 1 year

  7. PSA-PFS

    Prostate-Specific Antigen Progression-Free Survival (PSA-PFS) according to Prostate Cancer Working Group 3 (PCWG3) guidance.

    Prostate-specific antigen progression was defined as per PCWG3 guidance:

    • If a patient presented first a decline from baseline, progression was defined as the first PSA increase that was ≥25% and ≥2 ng/mL above the nadir, and which was confirmed by a consecutive second value ≥3 weeks later that fulfilled the same criteria (i.e., a confirmed rising trend)
    • If a patient did not present a decline from baseline, progression was defined as the first PSA increase that was ≥25% and ≥2 ng/mL increased from baseline beyond 12 weeks.

    Measured: Time from the date of randomization to the date of the first prostate-specific antigen progression or death from any cause, whichever occurred first, an average of 1 year.

  8. Time to PSA Progression

    Time to PSA progression was defined as the time from the date of randomization to the PSA progression as defined by Prostate Cancer Working Group 3 (PCWG3).

    Prostate-specific antigen progression was defined as per PCWG3 guidance:

    • If a patient presented first a decline from baseline, progression was defined as the first PSA increase that was ≥25% and ≥2 ng/mL above the nadir, and which was confirmed by a consecutive second value ≥3 weeks later that fulfilled the same criteria (i.e., a confirmed rising trend)
    • If a patient did not present a decline from baseline, progression was defined as the first PSA increase that was ≥25% and ≥2 ng/mL increased from baseline beyond 12 weeks.

    Measured: From baseline through study completion, an average of 1 year

  9. Number of Participants Who Experienced a First Skeletal-Related Event

    Number of Participants who Experienced a first Skeletal-Related Event (SRE), i.e. the occurrence of the first skeletal-related event (i.e. radiation therapy or surgery to bone, clinically apparent pathological bone fracture, spinal cord compression, or change of antineoplastic therapy to treat bone pain); from the time of randomisation to the first occurrence.

    Note: Due to small number of SREs the median time to SRE was not evaluable in this patient population.

    Measured: From baseline through study completion, an average of 1 year

Timeline

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

  1. First posted22 Jul 2019
  2. Study start17 Jul 2019
  3. Primary completion29 Nov 2021
  4. Study completion29 Nov 2021

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
Model description
One-hundred RECIST 1.1 evaluable patients will be randomized 1:1 to treatment with ModraDoc006/r versus standard i.v. docetaxel. The treatment outcome will be estimated and used as the basis for the design of the future pivotal phase 3 trial. The sample size of 50 evaluable patients per cohort will provide a sufficiently precise point estimate of the primary endpoint radiographic Progression Free Survival (rPFS) in both groups to calculate the sample size for the pivotal study.
Masking
None (open label)
Enrolment
135 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04028388
Sponsor's protocol ID
M18MDP
Status last verified
Jan 2024
First submitted
17 Jul 2019
Last updated
17 Apr 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Docetaxel in Parenteral Dosage Form and ModraDoc006/r in people with Prostate Cancer Metastatic and Castration-resistant Prostate Cancer, run by Modra Pharmaceuticals at 28 sites in 6 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 18 inclusion and 18 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: finished, as of the sponsor's last update on 17 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in Russia, United States, Hungary, Germany, Poland and 1 more country. 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 17 Apr 2024). 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: Time from the date of randomization to the date of the first radiologic progression (per PCWG3 criteria) or death from any cause, whichever occurred first, an average of 1 year.). 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 17 Apr 2024.

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