Cediranib Maleate With or Without Dasatinib in Patients With HRPC-Resistant to Treatment With Docetaxel
Primary Purpose
Hormone Refractory Prostate Cancer, Recurrent Prostate Cancer
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
cediranib maleate
dasatinib
Sponsored by

About this trial
This is an interventional treatment trial for Hormone Refractory Prostate Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically/cytologically confirmed prostate cancer
- Measurable/non-measurable disease
- Prior hormonal therapy with medical LHRH agonist or orchiectomy castration (Castrate level of testosterone (< 50 ng/dL) required)
- Clinical/radiographic evidence of progression on or after docetaxel therapy
- No active pleural/pericardial effusion of any grade
No meningeal metastases/untreated known brain metastases
- Patients with treated brain metastasis with radiologic, clinical evidence of stability, with no evidence of cavitation/hemorrhage in the brain lesions allowed if asymptomatic and not requiring corticosteroids
- Life expectancy >3 months
- ECOG PS 0-2 (Karnofsky PS 60-100%)
- ANC >= 1,500/mm^3
- Platelet count >= 100,000/mm^3
- Hemoglobin >= 9 g/dL
- INR=< 1.3
- Total bilirubin =< 1.25 times ULN
- AST and ALT=< 2.0 times ULN (5 x ULN if clearly attributable to liver metastasis)
- Creatinine normal OR creatinine clearance >= 60 mL/min
- LVEF> institutional normal range by ECHO/MUGA
- Urine dipstick for protein < 1+ OR < 1 g on 24-hour urine collection
Exclusion Criteria:
- >5 years since any malignancy except in situ cancer, non-metastatic basal/squamous cell skin cancer, or other cancer for which the patient has been curatively treated
- Fertile patients must use effective contraception
- No condition that impairs ability to swallow/absorb
- No history of allergic reactions attributed to compounds of similar chemical/biologic composition to cediranib/dasatinib
- No systolic BP>150 mmHg and/or diastolic BP>100 mmHg
- QTc prolongation (>=480 msec by Fridericia correction) or other significant ECG abnormalities are ineligible
- No active/uncontrolled infections, serious illness, or medical conditions that would not permit patient to be managed according to protocol
- No known immunodeficiency syndrome
- No clinical/radiological evidence of severe/uncontrolled interstitial lung disease
- No history/concurrent idiopathic pulmonary fibrosis
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No unresolved toxicity>=CTCAE grade 2 (except alopecia) from prior anticancer therapy
- 4 weeks since prior anti-androgens
- 4 weeks since prior chemotherapy following docetaxel for metastatic disease (Any number of regimens allowed)
- 4 weeks since prior hormonal therapy or abiraterone
- 3 weeks since prior radioisotopes or radiotherapy and recovered
- No prior therapy with angiogenesis or Src or FAK inhibitors
- 3 weeks since prior major surgery and recovered
- 1 week since prior corticosteroids
- Concurrent zoledronic acid allowed provided patient has been receiving it prior to start of study treatment
- Concurrent medications or substances known to affect or with the potential to affect the activity or pharmacokinetics of cediranib and dasatinib will be determined following review of their case by the principal investigator or co-investigator
- 14 days before and after study and no concurrent CYP3A4-active agents or substances (including strong inhibitors or inducers)
- Concurrent prophylactic low-dose warfarin (INR must be close monitored) or low-molecular weight heparin allowed
- No other concurrent investigational agents
Sites / Locations
- Illinois CancerCare-Peoria
- Central Illinois Hematology Oncology Center
- Fort Wayne Medical Oncology and Hematology Inc - State Boulevard
- Johns Hopkins University
- University of Michigan
- BCCA-Vancouver Cancer Centre
- Juravinski Cancer Centre at Hamilton Health Sciences
- University Health Network-Princess Margaret Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Arm I
Arm II
Arm Description
Patients receive oral cediranib maleate once daily and oral dasatinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Patients receive cediranib maleate as in arm I. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Outcomes
Primary Outcome Measures
12-week Progression-free Survival as Per the Prostate Cancer Clinical Trials Working Group (PCWG2)
Progression is defined using the Prostate Cancer Clinical Trials Working Group (PCWG2) criteria, which includes a compilation of prostate-specific antigen (PSA), bone scan, and CT-scan assessments (Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Secondary Outcome Measures
Number of Participants With Toxicities
Incidence of toxicities graded according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) v4.0
Qualtiy of Life Assessment Number of Participants With a Score ≥2 on the Present Pain Intensity (PPI) Scale
Present Pain Intensity (PPI) scale. Scale is measured 0-5, where 0=no pain, 1=mild pain, 2=discomforting pain, 3=distressing pain, 4=horrible pain and 5=excruciating pain Participants who were up to completing the assessment (did not decline) and who reported a score >=2 at the end of any cycle are reported.
Number Who Experienced Study Medication Dose Intensity
Number of patients who experienced study medication dose of over 80% during Cycle 1 was assessed.
Treatment Discontinuation
Discontinuation of treatment in cycle 1 (average of 28 days)
Treatment Discontinuation Due to Adverse Events (AEs)
Treatment discontinuation due to Adverse Events
Non-AE Related Treatment Discontinuation
Non-Adverse Event related Treatment Discontinuation
Overall Response Rate
Best overall response rate of each evaluable patient
Treatment Related Deaths
Number of treatment related deaths
Participants for Which Bone Biomarkers for Beta-C Telopeptide Was Reduced
Participants for which beta-C telopeptide was reduced
Number of Participants With Increased Alkaline Phosphatase BAP
Number of participants with increased alkaline phosphatase BAP
Dose Interruption Due to AEs
The number of participants with dose-interruptions in each arm due to adverse events
Dose Reductions
The number of participants with dose reductions in each arm
Overall Response Rate
Response Rate of Stable Disease and Progressive Disease
Quality of Life Assessment Using Functional Assessment of Cancer Therapy - Prostate (FACT-P) Questionnaire
Scale is measured on a range from 0 (worst quality of life) to 156 (best quality of life).
Full Information
NCT ID
NCT01260688
First Posted
December 14, 2010
Last Updated
July 9, 2018
Sponsor
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT01260688
Brief Title
Cediranib Maleate With or Without Dasatinib in Patients With HRPC-Resistant to Treatment With Docetaxel
Official Title
A Phase 2 Randomized Study of Cediranib (AZD2171) Alone Compared With the Combination of Cediranib (AZD2171) Plus BMS-354825 (Dasatinib, Sprycel) in Docetaxel Resistant, Castration Resistant Prostate Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
February 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This randomized phase II trial is studying the side effects and how well giving cediranib maleate together with or without dasatinib works in treating patients with hormone-resistant prostate cancer resistant to treatment with docetaxel. Cediranib maleate and dasatinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth or by blocking blood flow to the tumor. It is not yet known whether giving cediranib maleate together with dasatinib or alone is an effective treatment for prostate cancer.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the progression-free survival of patients with docetaxel-resistant and castration-resistant prostate cancer treated with cediranib maleate with versus without dasatinib.
SECONDARY OBJECTIVES:
I. To confirm the safety and tolerability of cediranib maleate with versus without dasatinib in these patients.
II. To calculate objective response rates of cediranib maleate with versus without dasatinib, according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, in patients with measurable disease at baseline.
III. To perform symptom assessment using the FACT-P questionnaire and the Present Pain Intensity (PPI) scale from the McGill-Melzack questionnaire.
IV. To explore bone resorption markers (e.g., c-telopeptide and bone alkaline phosphatase), and to correlate these biomarkers with clinical outcome.
OUTLINE: This is a multicenter study. Patients are stratified according to the presence of soft tissue (visceral or nodal) vs bone-only disease. Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive oral cediranib maleate once daily and oral dasatinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive cediranib maleate as in arm I. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
After completion of study, patients are followed up for 4 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hormone Refractory Prostate Cancer, Recurrent Prostate Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
22 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Arm I
Arm Type
Experimental
Arm Description
Patients receive oral cediranib maleate once daily and oral dasatinib once daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm II
Arm Type
Experimental
Arm Description
Patients receive cediranib maleate as in arm I. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
cediranib maleate
Other Intervention Name(s)
Recentin
Intervention Description
Given orally
Intervention Type
Drug
Intervention Name(s)
dasatinib
Other Intervention Name(s)
BMS-354825
Intervention Description
Given orally
Primary Outcome Measure Information:
Title
12-week Progression-free Survival as Per the Prostate Cancer Clinical Trials Working Group (PCWG2)
Description
Progression is defined using the Prostate Cancer Clinical Trials Working Group (PCWG2) criteria, which includes a compilation of prostate-specific antigen (PSA), bone scan, and CT-scan assessments (Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Number of Participants With Toxicities
Description
Incidence of toxicities graded according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE) v4.0
Time Frame
Up to 30 days after last dose of study drugs
Title
Qualtiy of Life Assessment Number of Participants With a Score ≥2 on the Present Pain Intensity (PPI) Scale
Description
Present Pain Intensity (PPI) scale. Scale is measured 0-5, where 0=no pain, 1=mild pain, 2=discomforting pain, 3=distressing pain, 4=horrible pain and 5=excruciating pain Participants who were up to completing the assessment (did not decline) and who reported a score >=2 at the end of any cycle are reported.
Time Frame
After every cycle (median duration on study = 4 cycles)
Title
Number Who Experienced Study Medication Dose Intensity
Description
Number of patients who experienced study medication dose of over 80% during Cycle 1 was assessed.
Time Frame
Cycle 1 (an average of 28 days)
Title
Treatment Discontinuation
Description
Discontinuation of treatment in cycle 1 (average of 28 days)
Time Frame
Cycle 1 (average of 28 days)
Title
Treatment Discontinuation Due to Adverse Events (AEs)
Description
Treatment discontinuation due to Adverse Events
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Non-AE Related Treatment Discontinuation
Description
Non-Adverse Event related Treatment Discontinuation
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Overall Response Rate
Description
Best overall response rate of each evaluable patient
Time Frame
Duration of Study (median duration on study = 4 cycles)
Title
Treatment Related Deaths
Description
Number of treatment related deaths
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Participants for Which Bone Biomarkers for Beta-C Telopeptide Was Reduced
Description
Participants for which beta-C telopeptide was reduced
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Number of Participants With Increased Alkaline Phosphatase BAP
Description
Number of participants with increased alkaline phosphatase BAP
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Dose Interruption Due to AEs
Description
The number of participants with dose-interruptions in each arm due to adverse events
Time Frame
Through study completion (median duration on study = 4 cycles)
Title
Dose Reductions
Description
The number of participants with dose reductions in each arm
Time Frame
Duration of Study (median duration on study = 4 cycles)
Title
Overall Response Rate
Description
Response Rate of Stable Disease and Progressive Disease
Time Frame
Duration of Study (median duration on study = 4 cycles)
Title
Quality of Life Assessment Using Functional Assessment of Cancer Therapy - Prostate (FACT-P) Questionnaire
Description
Scale is measured on a range from 0 (worst quality of life) to 156 (best quality of life).
Time Frame
Up to 16 weeks
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically/cytologically confirmed prostate cancer
Measurable/non-measurable disease
Prior hormonal therapy with medical LHRH agonist or orchiectomy castration (Castrate level of testosterone (< 50 ng/dL) required)
Clinical/radiographic evidence of progression on or after docetaxel therapy
No active pleural/pericardial effusion of any grade
No meningeal metastases/untreated known brain metastases
Patients with treated brain metastasis with radiologic, clinical evidence of stability, with no evidence of cavitation/hemorrhage in the brain lesions allowed if asymptomatic and not requiring corticosteroids
Life expectancy >3 months
ECOG PS 0-2 (Karnofsky PS 60-100%)
ANC >= 1,500/mm^3
Platelet count >= 100,000/mm^3
Hemoglobin >= 9 g/dL
INR=< 1.3
Total bilirubin =< 1.25 times ULN
AST and ALT=< 2.0 times ULN (5 x ULN if clearly attributable to liver metastasis)
Creatinine normal OR creatinine clearance >= 60 mL/min
LVEF> institutional normal range by ECHO/MUGA
Urine dipstick for protein < 1+ OR < 1 g on 24-hour urine collection
Exclusion Criteria:
>5 years since any malignancy except in situ cancer, non-metastatic basal/squamous cell skin cancer, or other cancer for which the patient has been curatively treated
Fertile patients must use effective contraception
No condition that impairs ability to swallow/absorb
No history of allergic reactions attributed to compounds of similar chemical/biologic composition to cediranib/dasatinib
No systolic BP>150 mmHg and/or diastolic BP>100 mmHg
QTc prolongation (>=480 msec by Fridericia correction) or other significant ECG abnormalities are ineligible
No active/uncontrolled infections, serious illness, or medical conditions that would not permit patient to be managed according to protocol
No known immunodeficiency syndrome
No clinical/radiological evidence of severe/uncontrolled interstitial lung disease
No history/concurrent idiopathic pulmonary fibrosis
No concurrent combination antiretroviral therapy for HIV-positive patients
No unresolved toxicity>=CTCAE grade 2 (except alopecia) from prior anticancer therapy
4 weeks since prior anti-androgens
4 weeks since prior chemotherapy following docetaxel for metastatic disease (Any number of regimens allowed)
4 weeks since prior hormonal therapy or abiraterone
3 weeks since prior radioisotopes or radiotherapy and recovered
No prior therapy with angiogenesis or Src or FAK inhibitors
3 weeks since prior major surgery and recovered
1 week since prior corticosteroids
Concurrent zoledronic acid allowed provided patient has been receiving it prior to start of study treatment
Concurrent medications or substances known to affect or with the potential to affect the activity or pharmacokinetics of cediranib and dasatinib will be determined following review of their case by the principal investigator or co-investigator
14 days before and after study and no concurrent CYP3A4-active agents or substances (including strong inhibitors or inducers)
Concurrent prophylactic low-dose warfarin (INR must be close monitored) or low-molecular weight heparin allowed
No other concurrent investigational agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sebastien Hotte
Organizational Affiliation
University Health Network-Princess Margaret Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Illinois CancerCare-Peoria
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61615
Country
United States
Facility Name
Central Illinois Hematology Oncology Center
City
Springfield
State/Province
Illinois
ZIP/Postal Code
60702
Country
United States
Facility Name
Fort Wayne Medical Oncology and Hematology Inc - State Boulevard
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46845
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287-8936
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
BCCA-Vancouver Cancer Centre
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E6
Country
Canada
Facility Name
Juravinski Cancer Centre at Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8V 5C2
Country
Canada
Facility Name
University Health Network-Princess Margaret Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
12. IPD Sharing Statement
Citations:
PubMed Identifier
24788563
Citation
Spreafico A, Chi KN, Sridhar SS, Smith DC, Carducci MA, Kavsak P, Wong TS, Wang L, Ivy SP, Mukherjee SD, Kollmannsberger CK, Sukhai MA, Takebe N, Kamel-Reid S, Siu LL, Hotte SJ. A randomized phase II study of cediranib alone versus cediranib in combination with dasatinib in docetaxel resistant, castration resistant prostate cancer patients. Invest New Drugs. 2014 Oct;32(5):1005-16. doi: 10.1007/s10637-014-0106-5. Epub 2014 May 3.
Results Reference
derived
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Cediranib Maleate With or Without Dasatinib in Patients With HRPC-Resistant to Treatment With Docetaxel
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