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PK in Pts With HRPC & Skeletal Metastes

Primary Purpose

Prostatic Neoplasms

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Radium-223 chloride (Xofigo®, BAY88-8223) injection
Sponsored by
Bayer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Prostatic Neoplasms

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the prostate
  • Hormone refractory with evidence of rising prostate-specific antigen (PSA): Subject must be maintained on androgen ablation therapy with luteinizing hormone-releasing hormone agonist or have undergone bilateral orchiectomy
  • Serum testosterone level required to be ≤50 ng/dL
  • Subjects who have received prior antiandrogen drug therapy: Flutamide, nilutamide, or cyproterone acetate must have stopped at least 4 weeks prior to study drug administration and progression, as defined by rising PSA as defined below, must have been demonstrated since cessation; bicalutamide must have stopped at least 6 weeks prior to study drug administration and progression, as defined by rising PSA as defined below, must have been demonstrated since cessation
  • PSA progression: Progressive rise in PSA, defined as two consecutive increases in PSA documented over a previous reference value (measure 1). The first increase in PSA (measure 2) should occur at a minimum of 1 week from the reference value (measure 1). This increase in PSA should be confirmed (measure 3) after a minimum of 1 week. If the confirmatory PSA value (measure 3) is less than the previous value, the subject will still be eligible provided the next PSA measure (measure 4) is found to be greater than the second PSA value (measure 2)
  • Skeletal metastases confirmed by bone scintigraphy within the last 6 weeks
  • Performance status: Eastern Co-operative Oncology Group (ECOG) 0-2
  • Life expectancy: ≥6 months
  • Laboratory requirements: Neutrophil count ≥1.5 x 109/L, platelet count ≥100 x109/L, haemoglobin ≥95 g/L, total bilirubin level within normal institutional limits, aspartate aminotransferase and alanine aminotransferase ≤2.5 times upper institutional limit of the normal range, S Creatinine ≤1.5 times upper institutional limit of the normal range

Exclusion Criteria:

  • Has received an investigational drug within 4 weeks prior to the administration of radium-223, or is scheduled to receive one during the treatment and post-treatment period
  • Has received chemo-, immunotherapy, or external radiotherapy within the last 4 weeks prior to administration of study drug, or has not recovered from adverse events due to agents administered more than 4 weeks earlier
  • More than one regimen of previous cytotoxic chemotherapy
  • Has received prior hemibody external radiotherapy
  • Has a need for immediate external radiotherapy
  • Has received systemic radiotherapy with radium-223, strontium-89, samarium-153, rhenium-186 or rhenium-188 for the treatment of bony metastases within the last year prior to administration of study drug
  • Has started treatment with bisphosphonates less than 3 months prior to administration of study drug. Patients are allowed to be on bisphosphonates provided patient is on a stable dose for >/= 12 weeks before administration of study drug
  • Patients who are </= 4 weeks (6 weeks for bicalutamide) post withdrawal of antiandrogen therapy
  • Patients who have started or stopped systemic steroids, within a week prior to study drug administration, or are expected to be subject to changes in the systemic steroid medication
  • Other currently active (relapse within the last 3 years) malignancy (except non-melanoma skin cancer) that are not prostate cancer metastases
  • Visceral (e.g. liver, lung) metastases from prostate cancer as assessed by abdominal/ pelvic CT or chest radiograph within six weeks before administration of study drug
  • Lymph node metastases with short-axis diameter greater than 2 cm
  • Bulky loco-regional disease
  • Any other serious illness or medical condition, for example: any uncontrolled infection, any patient who has clinical heart failure severe enough to cause marked limitation of activity, and who is only comfortable at rest; or any patient who has heart failure more severe than this (NYHA Heart Failure Class III or IV), Crohns disease or ulcerative colitis

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Radium-223 chloride

Arm Description

IV administrations of 100 kBq/kg b.w (=110 kBq/kg based on the 2015 National Institute of Standards and Technology standardization). Two administrations took place with an interval of 6 weeks

Outcomes

Primary Outcome Measures

Estimation of whole-body retention of radioactivity at each imaging time post-injection
Estimation of the individual organ uptake/retention of radioactivity at each time-point post injection
Estimate retention of administered radioactivity in blood
Estimation of elimination of radioactivity in urine and faeces
Calculation of estimated absorbed radiation dose to target organs
Pharmacokinetics

Secondary Outcome Measures

Comparison of the biodistribution and dosimetry after the first and second injection
Prostate specific antigen (PSA) response
PSA decline, defined as the number of patients with a confirmed ≥50% reduction in PSA level after treatment with respect to the pre-injection PSA level and the time to PSA progression after PSA response
Survival
Adverse events
Laboratory variables; serum biochemistry and haematology
Vital signs
Systolic/diastolic blood pressure, respiratory rate, heart rate and body temperature
ECG (12 leads)
Electrocardiogram (12 leads)
Physical examination

Full Information

First Posted
April 24, 2008
Last Updated
December 11, 2015
Sponsor
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT00667537
Brief Title
PK in Pts With HRPC & Skeletal Metastes
Official Title
A Phase I, Open-label, Dosimetry, Biodistribution and Pharmacokinetic Study of Alpharadin™ in Patients With Hormone Refractory Prostate Cancer and Skeletal Metastases
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
July 2007 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
December 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bayer

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary objective: To investigate the biodistribution, radiation dosimetry, and pharmacokinetics of two separate intravenous (IV) injections of Xofigo (100 kBq/kg body weight [b.w.] [=110 kBq/kg based on the 2015 National Institute of Standards and Technology standardization], 6 weeks apart). Secondary objectives: To determine the safety of IV injections of Xofigo after two separate injections (6 weeks apart), to evaluate treatment response (antitumour effect in osteoblastic bone metastases) of Xofigo treatment consisting of two injections of activity 100 kBq/kg b.w. (=110 kBq/kg based on the 2015 National Institute of Standards and Technology standardization), 6 weeks apart and to evaluate long term radiation toxicity and to collect survival data at 6 and 12 months after the first injection

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostatic Neoplasms

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Radium-223 chloride
Arm Type
Experimental
Arm Description
IV administrations of 100 kBq/kg b.w (=110 kBq/kg based on the 2015 National Institute of Standards and Technology standardization). Two administrations took place with an interval of 6 weeks
Intervention Type
Drug
Intervention Name(s)
Radium-223 chloride (Xofigo®, BAY88-8223) injection
Intervention Description
Sterile, clear and colourless aqueous solution of radium-223 chloride free of endotoxins, for intravenous administration
Primary Outcome Measure Information:
Title
Estimation of whole-body retention of radioactivity at each imaging time post-injection
Time Frame
1 week
Title
Estimation of the individual organ uptake/retention of radioactivity at each time-point post injection
Time Frame
1 week
Title
Estimate retention of administered radioactivity in blood
Time Frame
Up to 1 week
Title
Estimation of elimination of radioactivity in urine and faeces
Time Frame
2 days
Title
Calculation of estimated absorbed radiation dose to target organs
Time Frame
1 week
Title
Pharmacokinetics
Time Frame
1 week
Secondary Outcome Measure Information:
Title
Comparison of the biodistribution and dosimetry after the first and second injection
Time Frame
7 weeks
Title
Prostate specific antigen (PSA) response
Description
PSA decline, defined as the number of patients with a confirmed ≥50% reduction in PSA level after treatment with respect to the pre-injection PSA level and the time to PSA progression after PSA response
Time Frame
At baseline, before injections, and at 2 month intervals during the 12 month follow up period
Title
Survival
Time Frame
6 and 12 months after the first injection
Title
Adverse events
Time Frame
1 year
Title
Laboratory variables; serum biochemistry and haematology
Time Frame
1 year
Title
Vital signs
Description
Systolic/diastolic blood pressure, respiratory rate, heart rate and body temperature
Time Frame
12 weeks
Title
ECG (12 leads)
Description
Electrocardiogram (12 leads)
Time Frame
12 weeks
Title
Physical examination
Time Frame
1 year

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of the prostate Hormone refractory with evidence of rising prostate-specific antigen (PSA): Subject must be maintained on androgen ablation therapy with luteinizing hormone-releasing hormone agonist or have undergone bilateral orchiectomy Serum testosterone level required to be ≤50 ng/dL Subjects who have received prior antiandrogen drug therapy: Flutamide, nilutamide, or cyproterone acetate must have stopped at least 4 weeks prior to study drug administration and progression, as defined by rising PSA as defined below, must have been demonstrated since cessation; bicalutamide must have stopped at least 6 weeks prior to study drug administration and progression, as defined by rising PSA as defined below, must have been demonstrated since cessation PSA progression: Progressive rise in PSA, defined as two consecutive increases in PSA documented over a previous reference value (measure 1). The first increase in PSA (measure 2) should occur at a minimum of 1 week from the reference value (measure 1). This increase in PSA should be confirmed (measure 3) after a minimum of 1 week. If the confirmatory PSA value (measure 3) is less than the previous value, the subject will still be eligible provided the next PSA measure (measure 4) is found to be greater than the second PSA value (measure 2) Skeletal metastases confirmed by bone scintigraphy within the last 6 weeks Performance status: Eastern Co-operative Oncology Group (ECOG) 0-2 Life expectancy: ≥6 months Laboratory requirements: Neutrophil count ≥1.5 x 109/L, platelet count ≥100 x109/L, haemoglobin ≥95 g/L, total bilirubin level within normal institutional limits, aspartate aminotransferase and alanine aminotransferase ≤2.5 times upper institutional limit of the normal range, S Creatinine ≤1.5 times upper institutional limit of the normal range Exclusion Criteria: Has received an investigational drug within 4 weeks prior to the administration of radium-223, or is scheduled to receive one during the treatment and post-treatment period Has received chemo-, immunotherapy, or external radiotherapy within the last 4 weeks prior to administration of study drug, or has not recovered from adverse events due to agents administered more than 4 weeks earlier More than one regimen of previous cytotoxic chemotherapy Has received prior hemibody external radiotherapy Has a need for immediate external radiotherapy Has received systemic radiotherapy with radium-223, strontium-89, samarium-153, rhenium-186 or rhenium-188 for the treatment of bony metastases within the last year prior to administration of study drug Has started treatment with bisphosphonates less than 3 months prior to administration of study drug. Patients are allowed to be on bisphosphonates provided patient is on a stable dose for >/= 12 weeks before administration of study drug Patients who are </= 4 weeks (6 weeks for bicalutamide) post withdrawal of antiandrogen therapy Patients who have started or stopped systemic steroids, within a week prior to study drug administration, or are expected to be subject to changes in the systemic steroid medication Other currently active (relapse within the last 3 years) malignancy (except non-melanoma skin cancer) that are not prostate cancer metastases Visceral (e.g. liver, lung) metastases from prostate cancer as assessed by abdominal/ pelvic CT or chest radiograph within six weeks before administration of study drug Lymph node metastases with short-axis diameter greater than 2 cm Bulky loco-regional disease Any other serious illness or medical condition, for example: any uncontrolled infection, any patient who has clinical heart failure severe enough to cause marked limitation of activity, and who is only comfortable at rest; or any patient who has heart failure more severe than this (NYHA Heart Failure Class III or IV), Crohns disease or ulcerative colitis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bayer Study Director
Organizational Affiliation
Bayer
Official's Role
Study Director
Facility Information:
City
Sutton
State/Province
Surrey
ZIP/Postal Code
SM2 5PT
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
22214491
Citation
Cook G Jr, Parker C, Chua S, Johnson B, Aksnes AK, Lewington VJ. 18F-fluoride PET: changes in uptake as a method to assess response in bone metastases from castrate-resistant prostate cancer patients treated with 223Ra-chloride (Alpharadin). EJNMMI Res. 2011 Jun 7;1(1):4. doi: 10.1186/2191-219X-1-4.
Results Reference
result
PubMed Identifier
26182965
Citation
Chittenden SJ, Hindorf C, Parker CC, Lewington VJ, Pratt BE, Johnson B, Flux GD. A Phase 1, Open-Label Study of the Biodistribution, Pharmacokinetics, and Dosimetry of 223Ra-Dichloride in Patients with Hormone-Refractory Prostate Cancer and Skeletal Metastases. J Nucl Med. 2015 Sep;56(9):1304-9. doi: 10.2967/jnumed.115.157123. Epub 2015 Jul 16.
Results Reference
result
PubMed Identifier
22513884
Citation
Hindorf C, Chittenden S, Aksnes AK, Parker C, Flux GD. Quantitative imaging of 223Ra-chloride (Alpharadin) for targeted alpha-emitting radionuclide therapy of bone metastases. Nucl Med Commun. 2012 Jul;33(7):726-32. doi: 10.1097/MNM.0b013e328353bb6e.
Results Reference
result
PubMed Identifier
22546715
Citation
Hobbs RF, Song H, Watchman CJ, Bolch WE, Aksnes AK, Ramdahl T, Flux GD, Sgouros G. A bone marrow toxicity model for (2)(2)(3)Ra alpha-emitter radiopharmaceutical therapy. Phys Med Biol. 2012 May 21;57(10):3207-22. doi: 10.1088/0031-9155/57/10/3207. Epub 2012 May 1.
Results Reference
result
Links:
URL
http://www.clinicaltrialsregister.eu/
Description
Click here to find information about studies related to Bayer Healthcare products conducted in Europe.

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PK in Pts With HRPC & Skeletal Metastes

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