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A Study Evaluating the Pain Palliation Benefit of Adding Custirsen to Docetaxel Retreatment or Cabazitaxel as Second Line Therapy in Men With Metastatic Castrate Resistant Prostate Cancer (mCRPC)

Primary Purpose

Castrate-Resistant Prostate Cancer, Hormone Refractory Prostate Cancer

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
custirsen sodium
isotonic, 0.9% sodium chloride
docetaxel
cabazitaxel
prednisone
Sponsored by
Achieve Life Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Castrate-Resistant Prostate Cancer focused on measuring CRPC patients with cancer related pain, CRPC, HRPC

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria

  1. Age ≥ 18 years on the date of consent.
  2. Histological or cytological diagnosis of adenocarcinoma of the prostate.
  3. Metastatic disease at screening on a chest, abdomen or pelvic CT or bone scan.
  4. Concurrent pain and analgesic use that is viewed by the Investigator to be related to prostate cancer.
  5. Received at least 4 cycles of prior docetaxel-based first-line chemotherapy for metastatic disease based on a q3 week schedule of docetaxel. Patients treated on a weekly or alternate schedule for first-line docetaxel must have received an accumulated dose of docetaxel of at least 300 mg/M2.
  6. Current progressive disease during or after completing first-line docetaxel treatment.
  7. Baseline laboratory values at screening visit within protocol defined limits.
  8. Must be willing to continue primary androgen suppression with luteinizing hormone releasing hormone (LHRH) analogues throughout the study, if not treated with bilateral orchiectomy.
  9. Adequate bone marrow function.
  10. Karnofsky score ≥ 70% at screening visit.
  11. At least 21 days have passed since completing radiotherapy at the time of randomization.
  12. At least 21 days have passed since completing any cytotoxic agent or investigational agent given in combination with the docetaxel-based first-line therapy, including ASOs (except custirsen which is an exclusion criterion), at the time of randomization.
  13. Has recovered from all therapy related toxicity to ≤ grade 2 (except alopecia, anemia and any signs or symptoms of androgen deprivation therapy).
  14. Patient can tolerate a starting dose of docetaxel of 75 mg/M2 or cabazitaxel at 25 mg/M2.
  15. Patient must have remained on the same bisphosphonate or denosumab usage for a minimum of 12 weeks prior to randomization.
  16. Written informed consent must be obtained prior to any protocol-specific procedures being performed.

Exclusion Criteria

  1. More than two interruptions in first-line docetaxel therapy. An interruption will be defined as more than 6 weeks between doses.
  2. Life expectancy less than 12 weeks.
  3. Previously participated in any clinical trial evaluating custirsen.
  4. Received any other cytotoxic chemotherapy as a second-line treatment after first-line docetaxel-based therapy.
  5. Not on any opioid analgesic regimen for their prostate cancer-related pain.
  6. Receiving more than one drug within each of the separate categories of long-acting opioid, short-acting opioid, and non-opioid.
  7. Receiving any analgesic specified in the protocol as unacceptable for this study.
  8. Planned concomitant participation in another clinical trial of an experimental agent, vaccine or device. Concomitant participation in observational studies is acceptable.
  9. Inability to communicate and read in English, Spanish or French.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Custirsen

Placebo

Arm Description

Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of custirsen will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly custirsen infusions (640 mg total dose) on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.

Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of placebo (isotonic, 0.9% sodium chloride) will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly placebo infusions on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.

Outcomes

Primary Outcome Measures

To ascertain whether the investigational arm has a greater proportion of patients with durable pain palliation as compared to the control arm.

Secondary Outcome Measures

To ascertain whether patients randomized to the investigational arm have a longer time to pain progression as compared to patients randomized to the control arm.
Safety
Comparison of treatment arms with respect to the incidence of serious adverse events and the incidence of grade 3 or higher adverse events.

Full Information

First Posted
February 26, 2010
Last Updated
October 7, 2016
Sponsor
Achieve Life Sciences
Collaborators
Teva Pharmaceuticals USA
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1. Study Identification

Unique Protocol Identification Number
NCT01083615
Brief Title
A Study Evaluating the Pain Palliation Benefit of Adding Custirsen to Docetaxel Retreatment or Cabazitaxel as Second Line Therapy in Men With Metastatic Castrate Resistant Prostate Cancer (mCRPC)
Official Title
A Randomized, Placebo-Controlled, Double-Blind, Phase 3 Study Evaluating the Pain Palliation Benefit of Adding Custirsen to a Taxane for Second-Line Chemotherapy in Men With Castrate Resistance Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2016
Overall Recruitment Status
Terminated
Why Stopped
Unable to enroll due to criteria for stable baseline pain
Study Start Date
March 2010 (undefined)
Primary Completion Date
March 2013 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Achieve Life Sciences
Collaborators
Teva Pharmaceuticals USA

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if the addition of study drug (custirsen) can provide durable pain palliation for castrate resistant prostate cancer patients receiving docetaxel retreatment or cabazitaxel as a second line therapy.
Detailed Description
This is a randomized, double-blind, placebo-controlled, multicenter, international trial enrolling patients with metastatic CRPC who had a response to first-line docetaxel therapy and have prostate cancer-related pain with progression of disease. The intended intervention is second-line treatment with docetaxel retreatment or cabazitaxel plus study agent, where custirsen is to be administered in the investigational arm and placebo is to be administered in the control arm. Selection of the chemotherapy (docetaxel re-treatment or cabazitaxel) is to be determined by the treating physician, based on the patient's first-line response. The study will primarily assess pain and analgesic use for evaluation of durable pain palliation in response to study treatment. Pain and analgesic use will be obtained via a 3rd party contact center (direct contact with patient). Study treatment starts with a Loading Dose Period during which three infusions of study agent (custirsen vs. placebo) will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel or cabazitaxel on a 21-day cycle with weekly study agent (custirsen vs. placebo) infusions on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Patients will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol. If study treatment is completed or discontinued prior to pain progression, 6-day assessments will continue every 3 weeks until pain progression is documented. Follow-up after study treatment will occur for safety parameters for 3 weeks after the last study agent infusion in all patients. Survival status updates are to be reported every 12 weeks following documentation of pain progression. The amount of time that patients remain on the study will vary; but the average survival of these patients who receive second line taxane treatment is expected to be 14 to 15 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Castrate-Resistant Prostate Cancer, Hormone Refractory Prostate Cancer
Keywords
CRPC patients with cancer related pain, CRPC, HRPC

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Custirsen
Arm Type
Experimental
Arm Description
Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of custirsen will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly custirsen infusions (640 mg total dose) on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of placebo (isotonic, 0.9% sodium chloride) will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly placebo infusions on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.
Intervention Type
Drug
Intervention Name(s)
custirsen sodium
Other Intervention Name(s)
OGX-011
Intervention Description
An antisense oligonucleotide that blocks production of clusterin
Intervention Type
Drug
Intervention Name(s)
isotonic, 0.9% sodium chloride
Intervention Description
Placebo for custirsen sodium
Intervention Type
Drug
Intervention Name(s)
docetaxel
Intervention Type
Drug
Intervention Name(s)
cabazitaxel
Intervention Type
Drug
Intervention Name(s)
prednisone
Primary Outcome Measure Information:
Title
To ascertain whether the investigational arm has a greater proportion of patients with durable pain palliation as compared to the control arm.
Time Frame
3 to 6 months
Secondary Outcome Measure Information:
Title
To ascertain whether patients randomized to the investigational arm have a longer time to pain progression as compared to patients randomized to the control arm.
Time Frame
6 months.
Title
Safety
Description
Comparison of treatment arms with respect to the incidence of serious adverse events and the incidence of grade 3 or higher adverse events.
Time Frame
6 months

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Age ≥ 18 years on the date of consent. Histological or cytological diagnosis of adenocarcinoma of the prostate. Metastatic disease at screening on a chest, abdomen or pelvic CT or bone scan. Concurrent pain and analgesic use that is viewed by the Investigator to be related to prostate cancer. Received at least 4 cycles of prior docetaxel-based first-line chemotherapy for metastatic disease based on a q3 week schedule of docetaxel. Patients treated on a weekly or alternate schedule for first-line docetaxel must have received an accumulated dose of docetaxel of at least 300 mg/M2. Current progressive disease during or after completing first-line docetaxel treatment. Baseline laboratory values at screening visit within protocol defined limits. Must be willing to continue primary androgen suppression with luteinizing hormone releasing hormone (LHRH) analogues throughout the study, if not treated with bilateral orchiectomy. Adequate bone marrow function. Karnofsky score ≥ 70% at screening visit. At least 21 days have passed since completing radiotherapy at the time of randomization. At least 21 days have passed since completing any cytotoxic agent or investigational agent given in combination with the docetaxel-based first-line therapy, including ASOs (except custirsen which is an exclusion criterion), at the time of randomization. Has recovered from all therapy related toxicity to ≤ grade 2 (except alopecia, anemia and any signs or symptoms of androgen deprivation therapy). Patient can tolerate a starting dose of docetaxel of 75 mg/M2 or cabazitaxel at 25 mg/M2. Patient must have remained on the same bisphosphonate or denosumab usage for a minimum of 12 weeks prior to randomization. Written informed consent must be obtained prior to any protocol-specific procedures being performed. Exclusion Criteria More than two interruptions in first-line docetaxel therapy. An interruption will be defined as more than 6 weeks between doses. Life expectancy less than 12 weeks. Previously participated in any clinical trial evaluating custirsen. Received any other cytotoxic chemotherapy as a second-line treatment after first-line docetaxel-based therapy. Not on any opioid analgesic regimen for their prostate cancer-related pain. Receiving more than one drug within each of the separate categories of long-acting opioid, short-acting opioid, and non-opioid. Receiving any analgesic specified in the protocol as unacceptable for this study. Planned concomitant participation in another clinical trial of an experimental agent, vaccine or device. Concomitant participation in observational studies is acceptable. Inability to communicate and read in English, Spanish or French.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tomasz M Beer, M.D.
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sebastien J Hotte, M.D.
Organizational Affiliation
Juravinski Cancer Centre, McMaster University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Karim Fizazi, M.D., Ph.D.
Organizational Affiliation
Institut Gustave Roussy, University of Paris
Official's Role
Principal Investigator
Facility Information:
City
La Verne
State/Province
California
ZIP/Postal Code
91705
Country
United States
City
Ft. Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96813
Country
United States
City
Urbana
State/Province
Illinois
ZIP/Postal Code
61801
Country
United States
City
Metairie
State/Province
Louisiana
ZIP/Postal Code
70006
Country
United States
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
City
Burlington
State/Province
Massachusetts
ZIP/Postal Code
01805
Country
United States
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64132
Country
United States
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68130
Country
United States
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89169
Country
United States
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
City
Columbia
State/Province
South Carolina
ZIP/Postal Code
29209
Country
United States
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38120
Country
United States
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R3E 0V9
Country
Canada
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8V 5C2
Country
Canada
City
Lyon
Country
France
City
Paris
Country
France
City
Saint Herblain
Country
France
City
Villejuif
Country
France
City
Barcelona
Country
Spain
City
Madrid
Country
Spain
City
Pamplona
Country
Spain
City
Sabadell
Country
Spain
City
Valencia
Country
Spain
City
Cambridge
Country
United Kingdom
City
Sutton
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

A Study Evaluating the Pain Palliation Benefit of Adding Custirsen to Docetaxel Retreatment or Cabazitaxel as Second Line Therapy in Men With Metastatic Castrate Resistant Prostate Cancer (mCRPC)

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