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Food Effect Study of Abiraterone Acetate for Treatment of Patients With Castration-Resistant Prostate Cancer

Primary Purpose

Castration-resistant Prostate Cancer, Stage IV Prostate Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
abiraterone acetate
Sponsored by
University of Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Castration-resistant Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed prostate cancer with progressive disease defined as either:

    • 2 or more new lesions on bone scan or
    • Progressive disease on computed tomography (CT)/magnetic resonance imaging (MRI) according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria or
    • Rising prostate-specific antigen (PSA): PSA evidence for progressive prostate cancer consists of a minimum PSA level of at least 2 ng/ml, which has subsequently risen on at least 2 successive occasions, at least 2 weeks apart
  • Evidence of castration resistance defined as disease progression despite a testosterone level < 50 ng/dL (or surgical castration)
  • Any prior therapy for castrate disease is acceptable except prior abiraterone, which is excluded; a minimum washout of 28 days for any other anticancer therapy prior to first dose of study drug is required

    • Any other radiotherapy or radionuclide require 28-day washout prior to first dose of study drug
    • Denosumab or zoledronic acid are allowed
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
  • Total bilirubin =< 1.5 x the upper limit of normal
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvate transaminase [SGPT]) =< 2.5 X institutional upper limit of normal
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Therapy with other hormonal therapy, including any dose of megestrol acetate (Megace), finasteride (Proscar), dutasteride (Avodart), or any herbal product known to decrease PSA levels (e.g., saw palmetto and PC-SPES), or any systemic corticosteroid (other than prednisone =< 10 mg/day) within 4 weeks prior to first dose of study drug
  • Therapy with supplements or complementary medicines/botanicals within 4 weeks of first dose of study drug is excluded with the following exceptions:

    • Conventional multivitamin supplements
    • Selenium
    • Lycopene
    • Soy supplements
  • Inability to swallow capsules or known gastrointestinal malabsorption
  • History of other malignancies, with the exception of adequately treated non-melanoma skin cancer or adequately treated superficial bladder cancer or other solid tumors curatively treated with no evidence of disease for >= 5 years from enrollment
  • Blood pressure that is not controlled despite > 2 oral agents (systolic blood pressure [SBP] > 160 and diastolic blood pressure [DBP] > 90 documented during the screening period with no subsequent blood pressure readings < 160/100)
  • Serum potassium (K)+ < 3.5 mmoL/L on more than one reading within the screening period
  • Serious intercurrent infections or non-malignant medical illnesses that are uncontrolled
  • Active psychiatric illness/social situations that would limit compliance with protocol requirements
  • New York Heart Association (NYHA) class II, NYHA class III, or IV congestive heart failure (any symptomatic heart failure)
  • Concurrent therapy with strong inhibitors or inducers of Cytochrome P450 (CYP)3A4 due to concerning possible drug-drug interactions with abiraterone

Sites / Locations

  • Emory University Winship Cancer Institute
  • University of Chicago
  • North Shore University Health System
  • Ingalls Memorial Hospital
  • Illinois Cancer Care
  • National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Arm I (fasting)

Arm II (fed)

Arm Description

Patients receive abiraterone acetate PO daily first thing in morning after an overnight fast of at least 8 hours.

Patients receive abiraterone acetate PO daily within 30 minutes of a conventional low-fat breakfast.

Outcomes

Primary Outcome Measures

Change in PSA Level
Data were analyzed on a log scale: log(week 12) - log(baseline) = log ratio. Smaller (more negative) values indicate a better outcome.

Secondary Outcome Measures

Progression-free Survival (PFS)
Time to PSA progression (25% increase from baseline), radiographic progression, or death.
Adrenal Androgen Production (DHEA-S)
Extragonadal serum adrogen
Number of Participants With Adverse Events (AEs)
Patients with grade 3 or higher AE (CTCAE Version 4.03)
Peak Plasma Concentration of Abiraterone
Analyzed on a log scale due to skewness of distribution

Full Information

First Posted
February 15, 2012
Last Updated
July 2, 2019
Sponsor
University of Chicago
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01543776
Brief Title
Food Effect Study of Abiraterone Acetate for Treatment of Patients With Castration-Resistant Prostate Cancer
Official Title
A Prospective Randomized Pilot Study Evaluating the Food Effect on the Pharmacokinetics and Pharmacodynamics of Abiraterone Acetate in Men With Castrate Resistant Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
January 2012 (undefined)
Primary Completion Date
September 2017 (Actual)
Study Completion Date
December 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Chicago
Collaborators
National Cancer Institute (NCI)

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
This randomized phase II trial studies the best way to give abiraterone acetate in treating patients with castration-resistant prostate cancer. Abiraterone acetate is effective in treating castrate resistant prostate cancer and is taken in the fasting state. However, the body's absorption of abiraterone is increased with food intake. This study will test the whether a lower dose of abiraterone taken with food has a similar effect on prostate specific antigen (PSA) compared to full dose taken fasting.
Detailed Description
PRIMARY OBJECTIVES: I. To compare the pharmacodynamic effect of reduced dose (250mg daily) abiraterone acetate in the prandial state (250mg-Fed) to the full, standard 1000mg daily dose in the fasting state (1000mg-Fasting) as assessed by change in serum prostate-specific antigen (PSA). SECONDARY OBJECTIVES: I. To evaluate the effect of prandial states on plasma levels and the intra-patient pharmacokinetic variability of abiraterone acetate. II. To evaluate the safety profile of reduced dose abiraterone acetate taken in the prandial state. III. To evaluate the pharmacodynamic effect of reduced dose abiraterone acetate in the prandial state as assessed by reduction in the extra-gonadal androgen dihydroepiadrosterone sulfate (DHEA-S) and dihydroepiandrostenedione (DHEA). IV. To evaluate the effect of prandial state on time to disease progression (Working group criteria). OUTLINE: Patients are randomized to one of two treatment arms. ARM I: Patients receive abiraterone acetate orally (PO) daily first thing in morning after an overnight fast of at least 8 hours. ARM II: Patients receive abiraterone acetate PO daily within 30 minutes of a conventional low-fat breakfast. In both arms, courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Both arms will also be treated with prednisone 5mg twice daily. After completion of study treatment, patients are followed up within 30 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Castration-resistant Prostate Cancer, Stage IV Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
72 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (fasting)
Arm Type
Active Comparator
Arm Description
Patients receive abiraterone acetate PO daily first thing in morning after an overnight fast of at least 8 hours.
Arm Title
Arm II (fed)
Arm Type
Experimental
Arm Description
Patients receive abiraterone acetate PO daily within 30 minutes of a conventional low-fat breakfast.
Intervention Type
Drug
Intervention Name(s)
abiraterone acetate
Other Intervention Name(s)
CB7630, Zytiga
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Change in PSA Level
Description
Data were analyzed on a log scale: log(week 12) - log(baseline) = log ratio. Smaller (more negative) values indicate a better outcome.
Time Frame
From baseline to 12 weeks
Secondary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
Time to PSA progression (25% increase from baseline), radiographic progression, or death.
Time Frame
Assessed up to 3 years
Title
Adrenal Androgen Production (DHEA-S)
Description
Extragonadal serum adrogen
Time Frame
Cycle 4 (4 months)
Title
Number of Participants With Adverse Events (AEs)
Description
Patients with grade 3 or higher AE (CTCAE Version 4.03)
Time Frame
Assessed up to 1 year
Title
Peak Plasma Concentration of Abiraterone
Description
Analyzed on a log scale due to skewness of distribution
Time Frame
Up to 4 months

10. Eligibility

Sex
Male
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed prostate cancer with progressive disease defined as either: 2 or more new lesions on bone scan or Progressive disease on computed tomography (CT)/magnetic resonance imaging (MRI) according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 criteria or Rising prostate-specific antigen (PSA): PSA evidence for progressive prostate cancer consists of a minimum PSA level of at least 2 ng/ml, which has subsequently risen on at least 2 successive occasions, at least 2 weeks apart Evidence of castration resistance defined as disease progression despite a testosterone level < 50 ng/dL (or surgical castration) Any prior therapy for castrate disease is acceptable except prior abiraterone, which is excluded; a minimum washout of 28 days for any other anticancer therapy prior to first dose of study drug is required Any other radiotherapy or radionuclide require 28-day washout prior to first dose of study drug Denosumab or zoledronic acid are allowed Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 Total bilirubin =< 1.5 x the upper limit of normal Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvate transaminase [SGPT]) =< 2.5 X institutional upper limit of normal Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: Therapy with other hormonal therapy, including any dose of megestrol acetate (Megace), finasteride (Proscar), dutasteride (Avodart), or any herbal product known to decrease PSA levels (e.g., saw palmetto and PC-SPES), or any systemic corticosteroid (other than prednisone =< 10 mg/day) within 4 weeks prior to first dose of study drug Therapy with supplements or complementary medicines/botanicals within 4 weeks of first dose of study drug is excluded with the following exceptions: Conventional multivitamin supplements Selenium Lycopene Soy supplements Inability to swallow capsules or known gastrointestinal malabsorption History of other malignancies, with the exception of adequately treated non-melanoma skin cancer or adequately treated superficial bladder cancer or other solid tumors curatively treated with no evidence of disease for >= 5 years from enrollment Blood pressure that is not controlled despite > 2 oral agents (systolic blood pressure [SBP] > 160 and diastolic blood pressure [DBP] > 90 documented during the screening period with no subsequent blood pressure readings < 160/100) Serum potassium (K)+ < 3.5 mmoL/L on more than one reading within the screening period Serious intercurrent infections or non-malignant medical illnesses that are uncontrolled Active psychiatric illness/social situations that would limit compliance with protocol requirements New York Heart Association (NYHA) class II, NYHA class III, or IV congestive heart failure (any symptomatic heart failure) Concurrent therapy with strong inhibitors or inducers of Cytochrome P450 (CYP)3A4 due to concerning possible drug-drug interactions with abiraterone
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Russell Szmulewitz
Organizational Affiliation
University of Chicago
Official's Role
Principal Investigator
Facility Information:
Facility Name
Emory University Winship Cancer Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637-1470
Country
United States
Facility Name
North Shore University Health System
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Facility Name
Ingalls Memorial Hospital
City
Harvey
State/Province
Illinois
ZIP/Postal Code
60430
Country
United States
Facility Name
Illinois Cancer Care
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61615
Country
United States
Facility Name
National University Hospital
City
Singapore
Country
Singapore

12. IPD Sharing Statement

Citations:
PubMed Identifier
34845502
Citation
Heiss BL, Geynisman DM, Martinez E, Wong ASC, Yong WP, Szmulewitz RZ, Stadler WM. Comparison of out-of-pocket costs and adherence between the two arms of the prospective, randomized abiraterone food effect trial. Support Care Cancer. 2022 Mar;30(3):2803-2810. doi: 10.1007/s00520-021-06670-3. Epub 2021 Nov 29.
Results Reference
derived
PubMed Identifier
29590007
Citation
Szmulewitz RZ, Peer CJ, Ibraheem A, Martinez E, Kozloff MF, Carthon B, Harvey RD, Fishkin P, Yong WP, Chiong E, Nabhan C, Karrison T, Figg WD, Stadler WM, Ratain MJ. Prospective International Randomized Phase II Study of Low-Dose Abiraterone With Food Versus Standard Dose Abiraterone In Castration-Resistant Prostate Cancer. J Clin Oncol. 2018 May 10;36(14):1389-1395. doi: 10.1200/JCO.2017.76.4381. Epub 2018 Mar 28.
Results Reference
derived

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Food Effect Study of Abiraterone Acetate for Treatment of Patients With Castration-Resistant Prostate Cancer

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