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Metastatic Castration-resistant Prostate CancerPhase 1NCT04629781

Open-label Dose Escalation Phase 1b Trial of a New Micellar Docetaxel Compound in Patients With mCRPC

A Phase 1 study testing Docetaxel micellar in people with Metastatic Castration-resistant Prostate Cancer, run by Swiss Cancer Institute at 3 sites in Switzerland.

Terminated

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

Official record
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Trial summary

Treatment with polysorbate 80-solved Docetaxel (Taxotere®) is hampered by the requirement to co-administer steroids. Chronic (intermittent) steroids are negatively impacting bone health and have well known immunosuppressive effects. Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
Docetaxel micellar
Could I receive a placebo?
No, everyone receives an active treatment
How many people
11 participants
Where
3 sitesSwitzerland
Study dates
28 May 2021to 29 Jan 2024
Phase
Phase 1
Are there results?
None posted in the registry

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

  • Written informed consent according to Swiss law and ICH GCP E6(R2) regulations before registration and prior to any trial specific procedures.
  • Histologically confirmed adenocarcinoma of the prostate
  • Metastatic castration resistant, progressive disease as defined as per PCWG3 criteria
  • Ongoing concurrent use of GnRH agonist or antagonist is required if the patient has not been surgically castrated
  • Measurable or evaluable disease per Recist 1.1 and as per PCWG3
  • Patients with treated and stable CNS metastases are eligible, provided they meet the following criteria:
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  • No ongoing requirement for corticosteroids as therapy for symptomatic CNS disease; anticonvulsants at a stable dose allowed
  • No stereotactic radiation or whole-brain radiation within 7 days prior to registration,
  • No evidence of progression for at least 4 weeks after completion of CNS-directed therapy as verified by clinical examination and brain imaging (MRI or CT) during the screening period
  • Patients with a previously treated malignancy are eligible, when the risk of the prior malignancy interfering with either safety or efficacy endpoints is very low.
  • Age ≥ 18 years
  • ECOG performance status 0-1
  • Adequate bone marrow function: (patient must not have received any growth factor or blood transfusion within 7 days prior to registration): neutrophil count ≥ 1.5 x 109/L , platelet count ≥ 100 x 109/L, hemoglobin ≥ 80 g/L
  • Adequate hepatic function: total bilirubin ≤ 1.5 x ULN (except for patients with Gilbert's disease 3.0 x ULN), AST and ALT ≤ 2.5 x ULN
  • Adequate renal function: estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 (according to CKD-EPI formula)
  • Willingness to have a central venous line inserted (PICC or Porth-a-Cath) if not already present.
  • Men agree not to donate sperm or to father a child during trial treatment and until 6 months after the last dose of investigational drug. Sexually active patients must agree to have an effective contraception during study treatment and for 6 months after the last dose.

Who cannot join

  • Clinical or radiological evidence of spinal cord compression
  • Known predominant small cell or neuroendocrine component on histological diagnosis
  • Prior chemotherapy including docetaxel for the treatment of prostate cancer (previous administration of chemotherapy concomitant with ADT is not allowed )
  • Prior use of taxane-based chemotherapy for any other previous cancer
  • Prior systemic treatment, immunotherapy, hormonal therapy (with the exception of GnRH agonists or antagonists) or investigational agents within 21 days before registration, with the exception of palliative radiotherapy (within 2 weeks)
  • Concomitant or within 28 days of registration treatment with any other experimental drug (enrollment in another clinical trial except participation in SAKK 96/12 and/or 63/12]
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  • Concomitant use of other anti-cancer drugs (other than GnRH agonists or antagonists). Bone-modifying agents (such as bisphosphonates or denosumab) are allowed before study entry and during treatment.
  • Patients who have not recovered to CTCAE grade ≤1 from clinically relevant adverse events of prior therapies, except for residual toxicities, such as alopecia, which do not pose an ongoing medical risk.
  • Peripheral neuropathy > CTCAE grade 1
  • Localized or general edema > CTCAE grade 1
  • Severe or uncontrolled cardiovascular disease (congestive heart failure NYHA III or IV; unstable angina pectoris, history of myocardial infarction within the last six months, serious arrhythmias requiring medication (with exception of atrial fibrillation or paroxysmal supraventricular tachycardia), known significant QT-prolongation, uncontrolled hypertension.
  • Major surgery within 4 weeks prior to registration
  • Known history of human immunodeficiency virus (HIV) or active chronic Hepatitis C or Hepatitis B Virus infection or any uncontrolled active systemic infection requiring intravenous (iv) antimicrobial treatment.
  • Concomitant or prior use of immunosuppressive medication within 28 days before registration, with the exceptions of intranasal and inhaled corticosteroids, or systemic corticosteroids which must not exceed 10 mg/day of prednisone or a dose equivalent corticosteroid)
  • Concomitant treatment with strong CYP3A inducers or inhibitors
  • Any concomitant drugs contraindicated for use with the trial drugs according to the approved product information
  • Known hypersensitivity to trial drug(s) or to any component of the trial drug(s)
  • Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications.

Trial locations and contacts

3 sites in 1 country.

Switzerland3 sites

  • IOSI - Ospedale Regionale Bellinzona e Valli

    Bellinzona, 6500

  • Kantonsspital Graubuenden

    Chur, CH-7000

  • Kantonsspital St. Gallen

    Sankt Gallen

Other trials in Switzerland

About this study

Official title: Open-label Dose Escalation Phase 1b Trial of a New Micellar Docetaxel Compound in Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC)

Treatment with polysorbate 80-solved Docetaxel (Taxotere®) is hampered by the requirement to co-administer steroids. Chronic (intermittent) steroids are negatively impacting bone health and have well known immunosuppressive effects. Despite steroid premedication, polysorbate 80-solved Docetaxel (Taxotere®) results in occasional infusion reactions due to the solvent polysorbate 80. Docetaxel micellar is a promising alternative to polysorbate 80-solved Docetaxel (Taxotere) as it avoids the mandatory need for steroid administration pre and post infusion, and thus avoids immunosuppressive and bone-damaging effects.

There is an unmet medical need to develop steroid-free taxane regimens for patients with advanced cancer to avoid the need for steroid administration pre and post infusion (as outlined above). The unique Docetaxel micellar formulation suggests an improved safety profile compared to polysorbate 80-solved Docetaxel (Taxotere®).

Read the detailed description

Docetaxel, a semi-synthetic analogue of paclitaxel, is one of the most widely used human anti-cancer agents. Docetaxel and paclitaxel belong to a group of cytotoxic agents called taxanes. Docetaxel has been marketed worldwide by Sanofi-Aventis under the trade name Taxotere® and its use is approved for different types of solid tumors. The efficacy of docetaxel has been proven in two different phase 3 trials in metastatic castration resistant prostate cancer (mCRPC) and is a standard of care option for patients with prostate cancer. In Taxotere®, polysorbate 80 is used as surfactant. Fluid retention and hypersensitivity reactions are reported, and the patients are pre-treated with corticosteroids, e.g. dexamethasone, to avoid or at least reduce the frequency and the severity of both hypersensitivity reactions and fluid retention.

Oasmia Pharmaceutical AB (Uppsala, Sweden) has developed a novel formulation of docetaxel (Docetaxel micellar) with N-(all-trans-retinoyl)-L-cysteic acid methyl ester sodium salt (XMeNa) as excipient, thus reducing adverse reactions caused by polysorbate 80. XMeNa forms micelles into which docetaxel can be incorporated thus increasing its aqueous solubility and keeping it dissolved.

Rational Treatment with polysorbate 80-solved Docetaxel (Taxotere) is hampered by the requirement to co-administer steroid pre and post Taxotere infusion. Chronic (intermittent) steroids are hurting bone health and have well known immunosuppressive effects. Despite steroid premedication, polysorbate 80-solved Docetaxel (Taxotere) results in occasional infusion reactions due to the solvent polysorbate 80. The new micellar formulation of docetaxel is a promising alternative to polysorbate 80-solved Docetaxel (Taxotere) as it avoids the mandatory need for steroid administration pre and post infusion, and thus avoids immunosuppressive and bone-damaging effects.

Safety and pharmacokinetics (PK) of Docetaxel micellar have been assessed in 2 clinical studies, but only in breast cancer patients. This is the first clinical trial to assess the safety and tolerability of 3-weekly intravenous Docetaxel micellar infusions in patients with mCRPC.

The primary objective of this study is to determine the maximum tolerated dose (MTD) and the recommended phase II dose (RP2D) for Docetaxel micellar in patients with mCRPC.

Being tested
Docetaxel micellar
Keywords
metastatic castration-resistant prostate cancer, micellar docetaxel compound, anti-cancer agent, Docecal, Docetaxel

What participants receive

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

  • Docetaxel micellarDrug

    There will be three dose levels, 1-3, with each level consisting initially of a cohort containing 3 patients. One additional dose level, dose level -1, shall be allowed in the event that dose level 1 is considered too toxic

Study groups in NCT04629781
Study groupRoleWhat they receive
Docetaxel micellarExperimentalTrial Treatment with Docetaxel micellar
Receives: Drug: Docetaxel micellar

What is being measured

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

  1. Dose-limiting toxicity (DLT)

    DLT is defined as the occurrence of any of a set of specified hematological, hepatic, gastro-intestinal, nervous systems disorders, fluid retention or other adverse events (AEs) which:

    • occur during cycle 1 of the trial treatment defined as the DLT monitoring period
    • is considered by the Investigator or the Sponsor to be at least possibly related to the IMP.

    Measured: at the end of Cycle 1 (each cycle is 21 days)

Secondary outcomes (6)

  1. Radiographic progression-free survival (rPFS)

    rPFS is defined as the time from treatment start to radiographic progression, or death due to any cause, whichever occurs first. The assessment of radiographic disease progression is based on local evaluations.

    Measured: from date of treatment start to date of radiographic progression, or death due to any cause, whichever occurs first, assessed up to 36 months

  2. Time to PSA progression

    Time to PSA progression is defined as the time from treatment start to the time point of PSA progression. The PSA progression date is defined as the date of

    • ≥ 25% increase AND ≥ 2 ng/mL increase above the nadir, confirmed by a second value ≥ 3 weeks later, if there is PSA decline from baseline (last PSA measurement before treatment start), or
    • ≥ 25% increase AND ≥ 2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline Time to PSA progression is defined as the time from treatment start to the time point of PSA progression. The PSA progression date is defined as the date of
    • ≥ 25% increase AND ≥ 2 ng/mL increase above the nadir, confirmed by a second value ≥ 3 weeks later, if there is PSA decline from baseline (last PSA measurement before treatment start), or
    • ≥ 25% increase AND ≥ 2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline

    Measured: from date of treatment start to date of PSA progression, or start of a subsequent anticancer treatment, whichever occurs first, assessed up to 36 months

  3. PSA response

    PSA response is defined as a PSA decline of ≥ 50% from baseline measured twice at least 3 weeks apart during treatment.

    Measured: from date of treatment start to date of end of treatment, assessed up to 30 weeks

  4. Partial (PR) or complete (CR) radiological soft tissue response according to RECIST 1.1

    Partial (PR) or complete (CR) radiological soft tissue response achieved according to RECIST 1.1 criteria. Patients without any response assessment during trial treatment will be considered as having a non-evaluable response (NE) and thus will be regarded as failure for this endpoint.

    Measured: from date of treatment start to date of end of treatment, assessed up to 30 weeks

  5. Duration of response (DoR) according to RECIST 1.1

    DoR is defined as the time from the earliest date of the first documented evidence of complete response (CR) or partial response (PR) until earliest date of disease progression according to RECIST 1.1 or death due to any cause, whichever occurs first.

    Patients not experiencing an event at the time of the analysis, as well as patients starting a subsequent anticancer treatment in the absence of an event, will be censored at the date of their last available tumor assessment before starting a subsequent anticancer treatment, if any.

    Measured: from date of response to date of disease progression according to RECIST 1.1 or death, whichever occurs first, assessed up to 36 months

  6. Adverse Events

    AEs will be assessed according to the NCI Common Terminology Criteria for Adverse Events (CTCAE v5.0).

    Measured: From registration until 28 days after last dose of trial treatment

Timeline

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

  1. First posted16 Nov 2020
  2. Study start28 May 2021
  3. Primary completion29 Jan 2024
  4. Study completion29 Jan 2024

Why it stopped: SAKK decided to premature terminate this trial as additional follow-up visits do not further contribute to the efficacy data. This decision does not adversely impact the patients.

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is an open-label, multicenter, single-stage phase 1b trial in patients with mCRPC. A 3+3 design is used
Masking
None (open label)
Enrolment
11 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04629781
Sponsor's protocol ID
SAKK 67/20
Status last verified
Jul 2024
First submitted
22 Oct 2020
Last updated
1 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Colombo I, Rietveld PCS, Fischer S, Merlo S, Vogl U, Cathomas R, Koolen SLW, Zoelly D, Gobat K, Micheloud C, Eckhardt K, Sessa C, Stathis A, Omlin A, Joerger M. Safety and preliminary efficacy results of a new micellar formulation of docetaxel in patients with metastatic castration-resistant prostate cancer - SAKK 67/20 trial. Cancer Chemother Pharmacol. 2026 Aug 29;96(1):95. doi: 10.1007/s00280-026-04933-6.

    PubMed 42667368

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Docetaxel micellar in people with Metastatic Castration-resistant Prostate Cancer, run by Swiss Cancer Institute at 3 sites in Switzerland.

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 17 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: stopped early, as of the sponsor's last update on 1 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Switzerland. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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

Are results available for this study?

The study was stopped early (reason given: SAKK decided to premature terminate this trial as additional follow-up visits do not further contribute to the efficacy data. This decision does not adversely impact the patients.). Results are not available in the source record.

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?

Dose-limiting toxicity (DLT) (time frame: at the end of Cycle 1 (each cycle is 21 days)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04629781, which also lists 1 linked publication.

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 1 Aug 2024.

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