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A Study to Determine the Maximum Tolerated Dose of ASG-5ME in Subjects With Castration-Resistant Prostate Cancer

Primary Purpose

Prostate Neoplasms

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ASG-5ME
Sponsored by
Astellas Pharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Neoplasms focused on measuring Castration-Resistant Prostate Cancer, ASG-5ME, Pharmacokinetics of ASG-5ME

Eligibility Criteria

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

Inclusion Criteria:

  • Subject has histologically-confirmed castration-resistant prostate cancer and meets at least 1 of the following criteria:

    • subject's disease has progressed on or after available standard therapy -OR-
    • there is no effective standard therapy available for treating the subject's disease -OR-
    • subject or his disease is not suitable for standard therapy -OR-
    • subject chooses to defer or decline standard therapy (subject is adequately informed of the availability of clinically meaningful therapy and chooses instead to partake in this research using a product with no documented clinical activity)
  • Testosterone ≤ 50 ng/dL
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Life expectancy of > 6 months as evaluated and documented by the investigator
  • Hematologic function, as follows (no red blood cell (RBC) or platelet transfusions are allowed within 4 weeks of the first dose of ASG-5ME):

    • Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
    • Platelet count ≥ 100 x 109/L
    • Hemoglobin ≥ 9 g/dL
  • Renal function, as follows: creatinine ≤ 1.5 x upper limit of normal (ULN), or creatinine clearance of > 60 mL/min if serum creatinine is > 2.0 mg/dL
  • Total bilirubin < 1. 5 x ULN
  • Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT)≤ 1.5 x ULN
  • International Normalized Ratio (INR) < 1.3 (or < 3.0 if on therapeutic anticoagulation)
  • Serum calcium ≤ ULN
  • Subjects must be taking and agree to remain on a stable dose of luteinizing hormone-releasing hormone (LHRH) agonist therapy or gonadotropin-releasing hormone (GnRH) antagonist for the duration of the trial if not surgically castrated
  • Additional Inclusion criteria for Chemotherapy Naïve Cohort: No prior systemic cytotoxic chemotherapies
  • Additional Inclusion criteria for Chemotherapy Exposed Cohort:

    • Documented disease progression during or after docetaxel treatment or intolerability to docetaxel treatment
    • No additional prior chemotherapy for CRPC is allowed

Exclusion Criteria:

  • History of central nervous system metastasis, including incompletely treated epidural disease
  • History of other primary malignancy (including premalignant myeloid malignancy e.g. myelodysplastic syndrome), unless:

    • Curatively resected non-melanomatous skin cancer
    • Other malignancy curatively treated with no known active disease present and no treatment administered for the last 3 years
  • Active angina or Class III or IV Congestive Heart Failure (CHF) (New York Heart Association CHF Functional Classification System) or clinically significant cardiac disease within 12 months of study enrollment, including myocardial infarction, unstable angina, grade 2 or greater peripheral vascular disease, congestive heart failure, uncontrolled hypertension, or arrhythmias not controlled by outsubject medication
  • The following treatments are not allowed within 4 weeks of enrollment: cytotoxic chemotherapy, radiation therapy or the dietary supplement PC-SPES
  • Use of prednisone (or equivalent corticosteroids) > 20 mg/day are not allowed. Doses < 20 mg/day are allowed only if they have been at the same dose for > 4 weeks
  • Use of anti-androgen therapy (ie, flutamide, bicalutamide and nilutamide) within 6 weeks of study enrollment; non-responders to second-line anti-androgen therapy do not require the 6 week withdrawal period
  • Monoclonal antibody therapy within 3 months of enrollment with the exception of denosumab (prior or concurrent use of denosumab is allowed)
  • Peripheral neuropathy of ≥ grade 2 as defined by the CTCAE criteria version 4.0
  • Major surgery (that requires general anesthesia) within 4 weeks of study enrollment
  • Active infection requiring treatment with systemic (intravenous or oral) anti-infectives (antibiotic, antifungal, or antiviral agent) within 72 hours of screening
  • Use of any investigational drug (including marketed drugs not approved for this indication) within 30 days prior to enrollment
  • History of thromboembolic events and bleeding disorders ≤ 3 months (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE))
  • Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen

Sites / Locations

  • The Sidney Kimmel Comprehensive Cancer Center
  • The Karmanos Cancer Institute
  • Memorial Sloan Kettering Cancer Center
  • University of Wisconsin Madison, Carbone Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm 12

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Dose level 1

Dose level 2

Dose level 3

Dose level 4

Dose level 5

Dose level 5A

Dose level 6

Dose level 7

Dose level 8

Dose level 9

Chemotherapy-naïve subjects

Chemotherapy exposed subjects

Arm Description

Outcomes

Primary Outcome Measures

Safety assessed by recording of adverse events, laboratory assessments and vital signs
Pharmacokinetics assessment of ASG-5ME blood levels through analysis of blood samples

Secondary Outcome Measures

Incidence of anti-ASG-5ME antibody formation
Incidence of tumor response (complete or partial response)
Changes in prostate-specific antigen (PSA) levels
Changes in bone scans
Changes in circulating tumor cells
Changes in cytokeratin-18 levels

Full Information

First Posted
October 21, 2010
Last Updated
June 6, 2013
Sponsor
Astellas Pharma Inc
Collaborators
Seagen Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01228760
Brief Title
A Study to Determine the Maximum Tolerated Dose of ASG-5ME in Subjects With Castration-Resistant Prostate Cancer
Official Title
A Phase 1, Open-label, Multi-center, Dose Escalation Study of the Safety and Pharmacokinetics of ASG-5ME Monotherapy in Subjects With Castration-Resistant Prostate Cancer (CRPC)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
February 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Inc
Collaborators
Seagen Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this dose escalation study is to determine the Maximum Tolerated Dose (MTD) and the recommended Phase 2 dose of ASG-5ME in subjects with castration-resistant prostate cancer (CRPC).
Detailed Description
The study has two components. The first aims to establish a safe dose of ASG-5ME. Once identified, the safety and preliminary estimate of antitumor activity of ASG-5ME will be tested in additional subjects with castration-resistant prostate cancer (CRPC) who are either chemotherapy naïve or chemotherapy exposed in expanded cohorts.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Neoplasms
Keywords
Castration-Resistant Prostate Cancer, ASG-5ME, Pharmacokinetics of ASG-5ME

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose level 1
Arm Type
Experimental
Arm Title
Dose level 2
Arm Type
Experimental
Arm Title
Dose level 3
Arm Type
Experimental
Arm Title
Dose level 4
Arm Type
Experimental
Arm Title
Dose level 5
Arm Type
Experimental
Arm Title
Dose level 5A
Arm Type
Experimental
Arm Title
Dose level 6
Arm Type
Experimental
Arm Title
Dose level 7
Arm Type
Experimental
Arm Title
Dose level 8
Arm Type
Experimental
Arm Title
Dose level 9
Arm Type
Experimental
Arm Title
Chemotherapy-naïve subjects
Arm Type
Experimental
Arm Title
Chemotherapy exposed subjects
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
ASG-5ME
Intervention Description
IV
Primary Outcome Measure Information:
Title
Safety assessed by recording of adverse events, laboratory assessments and vital signs
Time Frame
For 12 weeks during treatment period and up to 4 weeks follow up
Title
Pharmacokinetics assessment of ASG-5ME blood levels through analysis of blood samples
Time Frame
Up to day 15 for cycle 1 and cycle 4 and pre-dose for cycles 2 and 3; every 3 weeks during the second 12 weeks of treatment; and if subject continues on study drug, every 12 weeks thereafter
Secondary Outcome Measure Information:
Title
Incidence of anti-ASG-5ME antibody formation
Time Frame
Baseline; up to day 64 during the first 12 weeks; and if subject continues on study drug, every 3 weeks during the second 12 weeks of treatment and every 12 weeks thereafter
Title
Incidence of tumor response (complete or partial response)
Time Frame
Baseline and every 12 weeks while on study drug
Title
Changes in prostate-specific antigen (PSA) levels
Time Frame
Baseline; up to day 64 during the first 12 weeks; and if the subject continues on study drug, every 3 weeks thereafter
Title
Changes in bone scans
Time Frame
Baseline and every 12 weeks while on study drug
Title
Changes in circulating tumor cells
Time Frame
Baseline; up to day 64 during the first 12 weeks; and if the subject continues on study drug, every 3 weeks during the second 12 weeks of treatment and every 12 weeks thereafter
Title
Changes in cytokeratin-18 levels
Time Frame
Up to day 79 and 4 weeks after the last dose of study drug

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has histologically-confirmed castration-resistant prostate cancer and meets at least 1 of the following criteria: subject's disease has progressed on or after available standard therapy -OR- there is no effective standard therapy available for treating the subject's disease -OR- subject or his disease is not suitable for standard therapy -OR- subject chooses to defer or decline standard therapy (subject is adequately informed of the availability of clinically meaningful therapy and chooses instead to partake in this research using a product with no documented clinical activity) Testosterone ≤ 50 ng/dL Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Life expectancy of > 6 months as evaluated and documented by the investigator Hematologic function, as follows (no red blood cell (RBC) or platelet transfusions are allowed within 4 weeks of the first dose of ASG-5ME): Absolute neutrophil count (ANC) ≥ 1.5 x 109/L Platelet count ≥ 100 x 109/L Hemoglobin ≥ 9 g/dL Renal function, as follows: creatinine ≤ 1.5 x upper limit of normal (ULN), or creatinine clearance of > 60 mL/min if serum creatinine is > 2.0 mg/dL Total bilirubin < 1. 5 x ULN Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT)≤ 1.5 x ULN International Normalized Ratio (INR) < 1.3 (or < 3.0 if on therapeutic anticoagulation) Serum calcium ≤ ULN Subjects must be taking and agree to remain on a stable dose of luteinizing hormone-releasing hormone (LHRH) agonist therapy or gonadotropin-releasing hormone (GnRH) antagonist for the duration of the trial if not surgically castrated Additional Inclusion criteria for Chemotherapy Naïve Cohort: No prior systemic cytotoxic chemotherapies Additional Inclusion criteria for Chemotherapy Exposed Cohort: Documented disease progression during or after docetaxel treatment or intolerability to docetaxel treatment No additional prior chemotherapy for CRPC is allowed Exclusion Criteria: History of central nervous system metastasis, including incompletely treated epidural disease History of other primary malignancy (including premalignant myeloid malignancy e.g. myelodysplastic syndrome), unless: Curatively resected non-melanomatous skin cancer Other malignancy curatively treated with no known active disease present and no treatment administered for the last 3 years Active angina or Class III or IV Congestive Heart Failure (CHF) (New York Heart Association CHF Functional Classification System) or clinically significant cardiac disease within 12 months of study enrollment, including myocardial infarction, unstable angina, grade 2 or greater peripheral vascular disease, congestive heart failure, uncontrolled hypertension, or arrhythmias not controlled by outsubject medication The following treatments are not allowed within 4 weeks of enrollment: cytotoxic chemotherapy, radiation therapy or the dietary supplement PC-SPES Use of prednisone (or equivalent corticosteroids) > 20 mg/day are not allowed. Doses < 20 mg/day are allowed only if they have been at the same dose for > 4 weeks Use of anti-androgen therapy (ie, flutamide, bicalutamide and nilutamide) within 6 weeks of study enrollment; non-responders to second-line anti-androgen therapy do not require the 6 week withdrawal period Monoclonal antibody therapy within 3 months of enrollment with the exception of denosumab (prior or concurrent use of denosumab is allowed) Peripheral neuropathy of ≥ grade 2 as defined by the CTCAE criteria version 4.0 Major surgery (that requires general anesthesia) within 4 weeks of study enrollment Active infection requiring treatment with systemic (intravenous or oral) anti-infectives (antibiotic, antifungal, or antiviral agent) within 72 hours of screening Use of any investigational drug (including marketed drugs not approved for this indication) within 30 days prior to enrollment History of thromboembolic events and bleeding disorders ≤ 3 months (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) Known positive test for human immunodeficiency virus (HIV), hepatitis C, or hepatitis B surface antigen
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chief Medical Officer
Organizational Affiliation
Agensys, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
The Sidney Kimmel Comprehensive Cancer Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
The Karmanos Cancer Institute
City
Detriot
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
University of Wisconsin Madison, Carbone Cancer Center
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53705
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study to Determine the Maximum Tolerated Dose of ASG-5ME in Subjects With Castration-Resistant Prostate Cancer

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