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An Observational Study of Continuous Oral Dosing of Abiraterone Acetate in Castration-Resistant Prostate Cancer Patients Evaluating Androgens and Steroid Metabolites in Bone Marrow Plasma

Primary Purpose

Prostate Neoplasms

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Abiraterone acetate
Prednisone
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Neoplasms focused on measuring Prostate neoplasms, Prostate cancer, Castration-resistant prostate cancer, Abiraterone acetate, CB7630, Prednisone, Testosterone, Bone marrow

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically proven adenocarcinoma of the prostate
  • Eastern Cooperative Oncology Group (ECOG) performance status <=2 (Karnofsky Performance Status >=50%)
  • Serum testosterone levels <50ng/ml
  • Ongoing gonadal androgen deprivation therapy with luteinizing hormone-releasing hormone (LHRH) analogues or orchiectomy (patients, who have not had an orchiectomy, must be maintained on effective LHRH analogue therapy for the duration of the study)
  • Progression of disease despite androgen ablation (either documented osseous or soft tissue metastatic disease progression or by prostate specific antigen [PSA] criteria progression)
  • Progressive disease is defined by PSA evidence (PSA level of at least 5 ng/ml which has risen on at least 2 successive occasions, at least 2 weeks apart)
  • Presence of metastatic bone disease
  • Discontinue diethylstilbestrol or steroids treatment for >=4 weeks and for antiandrogens >6 weeks
  • Antiandrogen withdrawal: patients who are receiving an antiandrogen as part of primary androgen ablation must demonstrate disease progression following discontinuation of antiandrogen (disease progression after antiandrogen withdrawal is defined as 2 consecutive rising PSA values, obtained at least 2 weeks apart, or documented osseous or soft tissue progression)
  • For patients receiving flutamide, at least one of the PSA values must be obtained 4 weeks or more after flutamide discontinuation
  • For patients receiving bicalutamide or nilutamide, at least one of the PSA values must be obtained 6 weeks or more after antiandrogen discontinuation
  • Adequate adrenal function
  • Laboratory values within protocol -defined parameters
  • No evidence of chronic or acute disseminated intravascular coagulation or bleeding tendency and no angina at rest
  • Agrees to protocol-defined use of effective contraception

Exclusion Criteria:

  • Histologic variants other than adenocarcinoma in the primary tumor
  • More then 2 different prior chemotherapeutic regimens for metastatic prostate cancer
  • Abnormal liver function
  • Therapy with other hormonal therapy, including any dose of megestrol acetate (Megace), Ketoconazole, finasteride (Proscar), dutasteride (Avodart) any herbal product known to decrease PSA levels (eg, Saw Palmetto and PC-SPES), or any systemic corticosteroid within 4 weeks prior to first dose of study drug
  • Active infection or intercurrent illness that are not controlled
  • Unstable angina, myocardial infarction within the previous 6 months, or use of ongoing maintenance therapy for life-threatening ventricular arrhythmia, uncontrolled hypertension, New York Heart Association (NYHA) Class III or IV congestive heart failure
  • Prior radiation therapy completed <4 weeks or single fraction of palliative radiotherapy within 14 days prior to first dose of study drug
  • Any currently active second malignancy, other than non-melanoma skin cancer
  • Active psychiatric illnesses/social situations that would limit compliance with protocol requirements
  • Active or uncontrolled autoimmune disease that may require corticosteroid therapy during study
  • Severely compromised immunological state, including being positive for the human immunodeficiency virus (HIV)
  • Acute or chronic hepatitis B or C
  • Initiation of bisphosphonate therapy within 4 weeks prior to first dose of study drug
  • Long QT syndrome or bundle branch block or hemiblock or other history of life-threatening arrhythmia (unless the patient has been effectively treated for it and is considered stable)
  • Known brain metastasis
  • History of pituitary or adrenal dysfunction
  • History of gastrointestinal disorders (medical disorders or extensive surgery) which may interfere with the absorption of the study drug
  • Prior therapy with abiraterone acetate
  • Any acute toxicities due to prior chemotherapy and/or radiotherapy that have not resolved to a NCI CTCAE (version 3) grade of <=1
  • Condition or situation which, in the investigator's opinion, may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Abiraterone acetate plus prednisone

Arm Description

Patients will be treated orally with abiraterone acetate 1000 mg daily and prednisone 5 mg twice a day until clinical disease progression.

Outcomes

Primary Outcome Measures

Number of Participants With Detectable Bone Marrow Testosterone Level (>1 Picograms/Mililiter)
Number of Participants With Detectable Bone Marrow Dihydrotestosterone (DHT) Level (>9 Picograms/Mililiter)
Difference in Bone Marrow Testosterone Levels Between Participants With and Without Serum Prostate Specific Antigen Decline

Secondary Outcome Measures

Number of Participants With Change in Markers of Bone Metabolism

Full Information

First Posted
October 15, 2007
Last Updated
July 3, 2014
Sponsor
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00544440
Brief Title
An Observational Study of Continuous Oral Dosing of Abiraterone Acetate in Castration-Resistant Prostate Cancer Patients Evaluating Androgens and Steroid Metabolites in Bone Marrow Plasma
Official Title
An Observational Study of Continuous Oral Dosing of an Irreversible CYP17 Inhibitor, Abiraterone Acetate (CB7630), in Castration-Resistant Prostate Cancer Patients Evaluating Androgens and Steroid Metabolites in Bone Marrow Plasma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
October 2007 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to investigate the effect of abiraterone acetate on levels of androgens and steroid metabolites in bone marrow plasma of patients with metastatic castration-resistant prostate cancer (CRPC).
Detailed Description
This is a single-center, open-label (identity of assigned study drug will be known) study investigating the effect of abiraterone acetate on levels of testosterone and dihydrotestosterone (DHT) in bone marrow plasma of patients with metastatic CRPC and evaluating the difference in bone marrow androgen levels between patients with and without serum prostate specific antigen (PSA) decline. Approximately 60 medically or surgically castrated male patients with metastatic CRPC will be enrolled. The study will consist of screening, treatment, and follow-up periods. Patients will be treated orally (by mouth) with abiraterone acetate 1000 mg daily and prednisone 5 mg twice a day until clinical disease progression. Follow-up will continue until the patient dies, is lost to follow-up or withdraws informed consent. Bone marrow aspirates will be collected at Week 1 (predose), Week 9, and the final study visit. Safety will be monitored throughout the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Neoplasms
Keywords
Prostate neoplasms, Prostate cancer, Castration-resistant prostate cancer, Abiraterone acetate, CB7630, Prednisone, Testosterone, Bone marrow

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
57 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Abiraterone acetate plus prednisone
Arm Type
Experimental
Arm Description
Patients will be treated orally with abiraterone acetate 1000 mg daily and prednisone 5 mg twice a day until clinical disease progression.
Intervention Type
Drug
Intervention Name(s)
Abiraterone acetate
Intervention Description
Abiraterone 1000 mg (4 x 250 mg tablets) taken orally once daily
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
Prednisone 5 mg tablet taken orally twice daily
Primary Outcome Measure Information:
Title
Number of Participants With Detectable Bone Marrow Testosterone Level (>1 Picograms/Mililiter)
Time Frame
Baseline (predose Week 1 Day 1) and Week 8
Title
Number of Participants With Detectable Bone Marrow Dihydrotestosterone (DHT) Level (>9 Picograms/Mililiter)
Time Frame
Baseline (predose Week 1 Day 1) and Week 8
Title
Difference in Bone Marrow Testosterone Levels Between Participants With and Without Serum Prostate Specific Antigen Decline
Time Frame
Week 8
Secondary Outcome Measure Information:
Title
Number of Participants With Change in Markers of Bone Metabolism
Time Frame
Week 8

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically proven adenocarcinoma of the prostate Eastern Cooperative Oncology Group (ECOG) performance status <=2 (Karnofsky Performance Status >=50%) Serum testosterone levels <50ng/ml Ongoing gonadal androgen deprivation therapy with luteinizing hormone-releasing hormone (LHRH) analogues or orchiectomy (patients, who have not had an orchiectomy, must be maintained on effective LHRH analogue therapy for the duration of the study) Progression of disease despite androgen ablation (either documented osseous or soft tissue metastatic disease progression or by prostate specific antigen [PSA] criteria progression) Progressive disease is defined by PSA evidence (PSA level of at least 5 ng/ml which has risen on at least 2 successive occasions, at least 2 weeks apart) Presence of metastatic bone disease Discontinue diethylstilbestrol or steroids treatment for >=4 weeks and for antiandrogens >6 weeks Antiandrogen withdrawal: patients who are receiving an antiandrogen as part of primary androgen ablation must demonstrate disease progression following discontinuation of antiandrogen (disease progression after antiandrogen withdrawal is defined as 2 consecutive rising PSA values, obtained at least 2 weeks apart, or documented osseous or soft tissue progression) For patients receiving flutamide, at least one of the PSA values must be obtained 4 weeks or more after flutamide discontinuation For patients receiving bicalutamide or nilutamide, at least one of the PSA values must be obtained 6 weeks or more after antiandrogen discontinuation Adequate adrenal function Laboratory values within protocol -defined parameters No evidence of chronic or acute disseminated intravascular coagulation or bleeding tendency and no angina at rest Agrees to protocol-defined use of effective contraception Exclusion Criteria: Histologic variants other than adenocarcinoma in the primary tumor More then 2 different prior chemotherapeutic regimens for metastatic prostate cancer Abnormal liver function Therapy with other hormonal therapy, including any dose of megestrol acetate (Megace), Ketoconazole, finasteride (Proscar), dutasteride (Avodart) any herbal product known to decrease PSA levels (eg, Saw Palmetto and PC-SPES), or any systemic corticosteroid within 4 weeks prior to first dose of study drug Active infection or intercurrent illness that are not controlled Unstable angina, myocardial infarction within the previous 6 months, or use of ongoing maintenance therapy for life-threatening ventricular arrhythmia, uncontrolled hypertension, New York Heart Association (NYHA) Class III or IV congestive heart failure Prior radiation therapy completed <4 weeks or single fraction of palliative radiotherapy within 14 days prior to first dose of study drug Any currently active second malignancy, other than non-melanoma skin cancer Active psychiatric illnesses/social situations that would limit compliance with protocol requirements Active or uncontrolled autoimmune disease that may require corticosteroid therapy during study Severely compromised immunological state, including being positive for the human immunodeficiency virus (HIV) Acute or chronic hepatitis B or C Initiation of bisphosphonate therapy within 4 weeks prior to first dose of study drug Long QT syndrome or bundle branch block or hemiblock or other history of life-threatening arrhythmia (unless the patient has been effectively treated for it and is considered stable) Known brain metastasis History of pituitary or adrenal dysfunction History of gastrointestinal disorders (medical disorders or extensive surgery) which may interfere with the absorption of the study drug Prior therapy with abiraterone acetate Any acute toxicities due to prior chemotherapy and/or radiotherapy that have not resolved to a NCI CTCAE (version 3) grade of <=1 Condition or situation which, in the investigator's opinion, may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
City
Houston
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.cancer.gov
Description
NATIONAL CANCER INSTITUTE
URL
http://www.nlm.nih.gov/medlineplus/prostatecancer.html
Description
NATIONAL INSTITUTE OF HEALTH

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An Observational Study of Continuous Oral Dosing of Abiraterone Acetate in Castration-Resistant Prostate Cancer Patients Evaluating Androgens and Steroid Metabolites in Bone Marrow Plasma

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