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PROvenge Treatment and Early Cancer Treatment (PROTECT)

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Control
Sipuleucel-T
Sponsored by
Dendreon
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring cancer, prostate cancer, prostatectomy, PSA, sipuleucel-T, PROVENGE, APC8015, non-metastatic, nonmetastatic, androgen-sensitive, androgen sensitive, biochemical recurrence, biochemically recurrent, immune therapy, immunotherapy, vaccine, dendritic cells, antigen-presenting cells, antigen presenting cells, cancer vaccine, therapeutic vaccine, therapeutic cancer vaccine, biologic, booster

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria for the Run-In Phase (Week -13)

  • Histologic diagnosis of adenocarcinoma of the prostate.
  • Within at least 3 months, but not more than 10 years, prior to initiation of the run-in phase with LHRH-a depot, the subject has undergone a radical prostatectomy for Stage T1b - T3c, N0 - N1, Nx, or M0 disease Subjects who experienced their first PSA recurrence within 2 years post completion of initial therapy of curative intent was eligible without consideration of the Gleason score of the tumor specimen. Subjects who experienced their first PSA relapse between 2 and 10 years post completion of initial therapy of curative intent was eligible only if the Gleason score of the tumor specimen was ≥ 7.
  • Therapeutic PSA response to primary therapy was below 0.4 ng/mL.
  • Tumor specimen positive for PAP.
  • PSA relapse while not currently receiving androgen ablation therapy.
  • If androgen ablation was given for a previous PSA relapse, PSA must have increased to a level at least 25% above the nadir observed while on this therapy, and to an absolute level of at least 3 ng/mL.
  • Subjects who had been treated with adjuvant or salvage radiation following radical prostatectomy, or with either LHRH-a (e.g., leuprolide acetate or goserelin acetate) or non-steroidal anti-androgen therapy (e.g., bicalutamide 150 mg/day) for a prior PSA relapse, may enter the study provided: Post-prostatectomy PSA was never ≥ 20 ng/mL; PSA was not rising while subject received hormonal therapy, and; For any hormonal therapy received, the last effective day of androgen deprivation was at least 6 months prior to the date of LHRH-a depot placement.
  • Confirmed Stage M0 disease.
  • Estimated life expectancy of at least 1 year.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
  • Ability to understand the trial procedures and requirements.
  • ≥ 18 and ≤ 80 years of age.
  • Ability to understand and willingness to sign an informed consent form.

Exclusion Criteria:

Exclusion Criteria for Entry into the Run-In Phase (Week -13)

  • Metastasis.
  • Clinical evidence of local recurrence other than PSA elevation (e.g., palpable induration or mass in the prostatic fossa).
  • Any surgery within 4 weeks prior to the date of LHRH-a depot placement.
  • Prior orchiectomy.
  • PSA ≥ 20 ng/mL at any time after radical prostatectomy.
  • Current systemic steroid therapy (inhaled or topical steroids are acceptable).
  • Any chemotherapy within 4 months prior to the LHRH-a depot placement.
  • Prior immunotherapy or therapy with other experimental agents for prostate cancer.
  • Treatment with radioactive seeds within 12 months prior to the LHRH a depot placement.
  • History of any other prior malignancy other than resected basal or squamous cell carcinoma of the skin within 5 years of entry.
  • Concurrent participation in another clinical trial involving experimental medication.
  • Any disease, condition, social, or geographical constraint that in the opinion of the Investigator or medical monitor reduced the probability that the subject will complete the trial or affects the evaluation of study end points

Exclusion Criteria for Randomization (Week 0):

  • Central laboratory value of PSA ≥ 1 ng/mL at the end of the LHRH-a run-in phase.
  • Randomized more than 3 weeks following the last effective date of testicular androgen suppression (as described in the package insert).
  • Any use of herbal preparations (e.g., Prostate Cancer (PC) -SPES or saw palmetto) within 4 weeks prior to randomization.
  • Any contraindication to leukapheresis or infusion of sipuleucel-T or control.
  • Positive serology for human immunodeficiency virus (HIV)-1 or 2, human lymphotropic virus (HTLV)-1 or 2, or evidence of active Hepatitis B or C infection.
  • Any ongoing active bacterial, viral, or fungal infection.

Exclusion Criteria During the Trial:

  • The use of any systemic therapy for prostate cancer following randomization and prior to BF (PSA ≥ 3 ng/mL).
  • Placement of radioactive seeds or salvage radiation before BF (PSA ≥ 3 ng/mL) documented.
  • Initiation of systemic corticosteroids at doses greater than the equivalent of 40 mg hydrocortisone per day (inhaled steroids are allowed) before BF.

Sites / Locations

  • Alta Bates Comprehensive Cancer Center
  • South Orange County Medical Research
  • University of Colorado Health Sciences Center
  • Oncology Specialists, SC
  • Mount Sinai School of Medicine
  • University of Rochester Medical Center
  • McKay Urology
  • AKSM Clinical Research Group
  • Providence Medical Center
  • Oregon Health and Sciences University
  • Oregon Urology Institute
  • Urology Health Specialists - Bryn Mawr
  • Albert Einstein Medical Building
  • Bryn Mawr Urology Group
  • University of Tennessee
  • Urology of Virginia, PC
  • Virginia Mason Medical Center
  • Swedish Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Sipuleucel-T

Control

Arm Description

Subjects received infusion of Sipuleucel-T, at 2-week intervals, for a total of 3 infusions.

Subjects received infusion of control (autologous cellular product consisting of antigen presenting cells (APCs) prepared in the absence of PA2024 antigen) at 2-week intervals, for a total of 3 infusions.

Outcomes

Primary Outcome Measures

Time to Biochemical Failure Cumulative Incidence Percentile
Time to Biochemical Failure (TTBF) was the pre-specified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL
Number of Subjects That Met Biochemical Failure Status
time to biochemical Failure (TTBF) was the pre-scpecified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL.

Secondary Outcome Measures

Full Information

First Posted
October 22, 2008
Last Updated
June 29, 2017
Sponsor
Dendreon
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1. Study Identification

Unique Protocol Identification Number
NCT00779402
Brief Title
PROvenge Treatment and Early Cancer Treatment
Acronym
PROTECT
Official Title
Autologous PAP-loaded Dendritic Cell Vaccine (Sipuleucel-T, APC8015, Provenge®) in Patients With Non-metastatic Prostate Cancer Who Experience PSA Elevation Following Radical Prostatectomy: a Randomized, Controlled, Double-blind Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
October 2001 (undefined)
Primary Completion Date
August 2006 (Actual)
Study Completion Date
May 2015 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The PROTECT-PROvenge Treatment and Early Cancer Treatment trial was a Phase III trial for patients with hormone sensitive prostate cancer. The study was conducted at over 15 participating centers throughout the US. The purpose of the study was to determine if sipuleucel-T was effective for treatment of early stage, non-metastatic prostate cancer. The study compared the active vaccine to control to determine whether the product delayed the time until cancer progression.
Detailed Description
This was a prospective, double blind, controlled, randomized trial of immunotherapy with prostatic acid phosphatase (PAP)-loaded autologous antigen presenting cells (APCs), in subjects with non metastatic prostate cancer. Subjects that qualified for this study were men who had previously undergone a prostatectomy and whose only sign of disease recurrence was a rise in serum prostate specific antigen (PSA). The primary objectives were to compare the time to biochemical failure (BF, PSA greater than or equal to 3 ng/mL) between sipuleucel-T (treatment group) and control, and to study the safety of sipuleucel-T. Following short-term open-label treatment with a luteinizing hormone-releasing hormone-analogue (LHRH-a), Subjects completed a checklist designed to compare androgen suppression-related side effects during periods with and without androgen suppression. Subjects who achieved a PSA of < 1 ng/ml were randomized to blinded treatment assignments of either sipuleucel-T or control in a 2:1 ratio. Following randomization, subjects underwent 3 leukapheresis procedures on alternate weeks (Weeks 0, 2, and 4). Approximately three days following each leukapheresis procedure, subjects received an infusion of either sipuleucel-T or control. At the time BF was confirmed, subjects were eligible for a booster infusion. The booster process consisted of 1 leukapheresis procedure followed by 1 infusion of sipuleucel-T. The booster process, in effect under protocol amendment 5, differed from the previous booster process that consisted of 1 infusion of the same treatment assigned at randomization (sipuleucel-T or control). Subjects continued to be observed until DF was confirmed by bone scan or computed tomography (CT) scan, or other imaging modalities as clinically indicated. After confirmed DF, subjects were followed by telephone every 6 months for safety and survival, treatment-related AEs, any CVEs, or new therapies for prostate cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
cancer, prostate cancer, prostatectomy, PSA, sipuleucel-T, PROVENGE, APC8015, non-metastatic, nonmetastatic, androgen-sensitive, androgen sensitive, biochemical recurrence, biochemically recurrent, immune therapy, immunotherapy, vaccine, dendritic cells, antigen-presenting cells, antigen presenting cells, cancer vaccine, therapeutic vaccine, therapeutic cancer vaccine, biologic, booster

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
176 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sipuleucel-T
Arm Type
Experimental
Arm Description
Subjects received infusion of Sipuleucel-T, at 2-week intervals, for a total of 3 infusions.
Arm Title
Control
Arm Type
Placebo Comparator
Arm Description
Subjects received infusion of control (autologous cellular product consisting of antigen presenting cells (APCs) prepared in the absence of PA2024 antigen) at 2-week intervals, for a total of 3 infusions.
Intervention Type
Other
Intervention Name(s)
Control
Intervention Description
Autologous cellular product consisting of antigen presenting cells (APCs) prepared in the absence of PA2024 antigen.
Intervention Type
Biological
Intervention Name(s)
Sipuleucel-T
Other Intervention Name(s)
Provenge®, APC8015
Intervention Description
Sipuleucel-T is an autologous cellular product consisting of antigen presenting cells (APCs) activated with PA2024, a recombinant fusion protein composed of prostatic acid phosphatase (PAP), linked to granulocyte-macrophage colony-stimulating factor (GM-CSF).
Primary Outcome Measure Information:
Title
Time to Biochemical Failure Cumulative Incidence Percentile
Description
Time to Biochemical Failure (TTBF) was the pre-specified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL
Time Frame
Every 3 months post-infusion
Title
Number of Subjects That Met Biochemical Failure Status
Description
time to biochemical Failure (TTBF) was the pre-scpecified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL.
Time Frame
Every 3 months post-infusion

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria for the Run-In Phase (Week -13) Histologic diagnosis of adenocarcinoma of the prostate. Within at least 3 months, but not more than 10 years, prior to initiation of the run-in phase with LHRH-a depot, the subject has undergone a radical prostatectomy for Stage T1b - T3c, N0 - N1, Nx, or M0 disease Subjects who experienced their first PSA recurrence within 2 years post completion of initial therapy of curative intent was eligible without consideration of the Gleason score of the tumor specimen. Subjects who experienced their first PSA relapse between 2 and 10 years post completion of initial therapy of curative intent was eligible only if the Gleason score of the tumor specimen was ≥ 7. Therapeutic PSA response to primary therapy was below 0.4 ng/mL. Tumor specimen positive for PAP. PSA relapse while not currently receiving androgen ablation therapy. If androgen ablation was given for a previous PSA relapse, PSA must have increased to a level at least 25% above the nadir observed while on this therapy, and to an absolute level of at least 3 ng/mL. Subjects who had been treated with adjuvant or salvage radiation following radical prostatectomy, or with either LHRH-a (e.g., leuprolide acetate or goserelin acetate) or non-steroidal anti-androgen therapy (e.g., bicalutamide 150 mg/day) for a prior PSA relapse, may enter the study provided: Post-prostatectomy PSA was never ≥ 20 ng/mL; PSA was not rising while subject received hormonal therapy, and; For any hormonal therapy received, the last effective day of androgen deprivation was at least 6 months prior to the date of LHRH-a depot placement. Confirmed Stage M0 disease. Estimated life expectancy of at least 1 year. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1. Ability to understand the trial procedures and requirements. ≥ 18 and ≤ 80 years of age. Ability to understand and willingness to sign an informed consent form. Exclusion Criteria: Exclusion Criteria for Entry into the Run-In Phase (Week -13) Metastasis. Clinical evidence of local recurrence other than PSA elevation (e.g., palpable induration or mass in the prostatic fossa). Any surgery within 4 weeks prior to the date of LHRH-a depot placement. Prior orchiectomy. PSA ≥ 20 ng/mL at any time after radical prostatectomy. Current systemic steroid therapy (inhaled or topical steroids are acceptable). Any chemotherapy within 4 months prior to the LHRH-a depot placement. Prior immunotherapy or therapy with other experimental agents for prostate cancer. Treatment with radioactive seeds within 12 months prior to the LHRH a depot placement. History of any other prior malignancy other than resected basal or squamous cell carcinoma of the skin within 5 years of entry. Concurrent participation in another clinical trial involving experimental medication. Any disease, condition, social, or geographical constraint that in the opinion of the Investigator or medical monitor reduced the probability that the subject will complete the trial or affects the evaluation of study end points Exclusion Criteria for Randomization (Week 0): Central laboratory value of PSA ≥ 1 ng/mL at the end of the LHRH-a run-in phase. Randomized more than 3 weeks following the last effective date of testicular androgen suppression (as described in the package insert). Any use of herbal preparations (e.g., Prostate Cancer (PC) -SPES or saw palmetto) within 4 weeks prior to randomization. Any contraindication to leukapheresis or infusion of sipuleucel-T or control. Positive serology for human immunodeficiency virus (HIV)-1 or 2, human lymphotropic virus (HTLV)-1 or 2, or evidence of active Hepatitis B or C infection. Any ongoing active bacterial, viral, or fungal infection. Exclusion Criteria During the Trial: The use of any systemic therapy for prostate cancer following randomization and prior to BF (PSA ≥ 3 ng/mL). Placement of radioactive seeds or salvage radiation before BF (PSA ≥ 3 ng/mL) documented. Initiation of systemic corticosteroids at doses greater than the equivalent of 40 mg hydrocortisone per day (inhaled steroids are allowed) before BF.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Israel, MD
Organizational Affiliation
Valeant Pharmaceuticals North America LLC
Official's Role
Study Director
Facility Information:
Facility Name
Alta Bates Comprehensive Cancer Center
City
Berkeley
State/Province
California
ZIP/Postal Code
94704
Country
United States
Facility Name
South Orange County Medical Research
City
Laguna Hills
State/Province
California
ZIP/Postal Code
92653
Country
United States
Facility Name
University of Colorado Health Sciences Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045-3206
Country
United States
Facility Name
Oncology Specialists, SC
City
Park Ridge
State/Province
Illinois
ZIP/Postal Code
60068-1174
Country
United States
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14642-0001
Country
United States
Facility Name
McKay Urology
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
AKSM Clinical Research Group
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Providence Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Facility Name
Oregon Health and Sciences University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Oregon Urology Institute
City
Springfield
State/Province
Oregon
ZIP/Postal Code
97477
Country
United States
Facility Name
Urology Health Specialists - Bryn Mawr
City
Bryn Mawr
State/Province
Pennsylvania
ZIP/Postal Code
19010
Country
United States
Facility Name
Albert Einstein Medical Building
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19141
Country
United States
Facility Name
Bryn Mawr Urology Group
City
Rosemont
State/Province
Pennsylvania
ZIP/Postal Code
19010
Country
United States
Facility Name
University of Tennessee
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38163
Country
United States
Facility Name
Urology of Virginia, PC
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23462
Country
United States
Facility Name
Virginia Mason Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Facility Name
Swedish Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
23896100
Citation
Beer TM, Schellhammer PF, Corman JM, Glode LM, Hall SJ, Whitmore JB, Frohlich MW, Penson DF. Quality of life after sipuleucel-T therapy: results from a randomized, double-blind study in patients with androgen-dependent prostate cancer. Urology. 2013 Aug;82(2):410-5. doi: 10.1016/j.urology.2013.04.049.
Results Reference
derived
Links:
URL
http://www.ustoo.com
Description
USTOO International

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PROvenge Treatment and Early Cancer Treatment

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