Study of Cabozantinib (XL184) Versus Prednisone in Men With Metastatic Castration-resistant Prostate Cancer Previously Treated With Docetaxel and Abiraterone or MDV3100 (COMET-1)
Primary Purpose
Prostate Cancer, Castration Resistant Prostate Cancer, Pain
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
cabozantinib
prednisone
Sponsored by

About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring prostate cancer, castration resistant prostate cancer, bone pain, CRPC
Eligibility Criteria
Inclusion Criteria:
- Histological or cytological diagnosis of castration resistant prostate cancer (serum testosterone less than 50 ng/dL).
- Evidence of bone metastasis related to prostate cancer on bone scans.
- Received prior docetaxel (minimum cumulative dose of 225 mg/m2) and either abiraterone or MDV3100 treatment and has evidence of prostate cancer progression on each agent independently.
- Maintenance of LHRH agonist or antagonist unless treated with orchiectomy.
- Recovered from toxicities related to any prior treatments, unless the toxicities are clinically non significant or easily manageable.
- Adequate organ and marrow function.
- Capable of understanding and complying with the protocol requirements and signed the informed consent form.
- Sexually active fertile patients and their partners must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment.
Exclusion Criteria:
- Prior treatment with cabozantinib.
- Treatment with docetaxel, abiraterone, or MDV3100 in the last 2 weeks; or with any other type of cytotoxic or investigational anticancer agent in the last 2 weeks.
- Radiation within 4 weeks (excluded if to mediastinum) or radionuclide treatment within 6 weeks of randomization.
- Known brain metastases or cranial epidural disease.
- Requires concomitant treatment, in therapeutic doses, with anticoagulants.
- Requires chronic concomitant treatment of strong CYP3A4 inducers (eg, dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St. John's Wort).
- Uncontrolled, significant intercurrent illness including, but not limited to, cardiovascular disorders, gastrointestinal disorders, active infections, non-healing wounds, recent surgery.
- Clinically significant hematemesis or hemoptysis, or other signs indicative of pulmonary hemorrhage in the last 3 months, or history of other significant bleeding in the past 6 months.
- Cavitating pulmonary lesion(s) or a lesion invading or encasing a major blood vessel.
- QTcF > 500 ms within 7 days of randomization.
- Unable to swallow capsules or tablets.
- Previously-identified allergy or hypersensitivity to components of the study treatment formulations.
- Another diagnosis of malignancy requiring systemic treatment within 2 years of randomization.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
cabozantinib
prednisone
Arm Description
Subjects randomized to the cabozantinib arm will also receive placebo-matched prednisone capsules.
Subjects randomized to the prednisone arm will also receive placebo-matched cabozantinib.
Outcomes
Primary Outcome Measures
Overall Survival (OS)
The primary analysis of OS is defined as the time from randomization to death due to any cause. Participants that had not died or were permanently lost to follow-up were censored at the last known date alive. Median OS was calculated using Kaplan-Meier estimates. Analysis for OS was performed after 614 events had occurred.
Secondary Outcome Measures
Bone Scan Response (BSR)
BSR is defined as >=30% reduction in the bone scan lesion area (BSLA) compared with baseline. Confirmation of bone scan was not required for response or progression. Bone scans were evaluated by an independent radiology facility (IRF) for response.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01605227
Brief Title
Study of Cabozantinib (XL184) Versus Prednisone in Men With Metastatic Castration-resistant Prostate Cancer Previously Treated With Docetaxel and Abiraterone or MDV3100
Acronym
COMET-1
Official Title
A Phase 3, Randomized, Double-blind, Controlled Study of Cabozantinib (XL184) Versus Prednisone in Metastatic Castration-resistant Prostate Cancer Patients Who Have Received Prior Docetaxel and Prior Abiraterone or MDV3100
Study Type
Interventional
2. Study Status
Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
July 2012 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
March 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Exelixis
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will evaluate the effect of cabozantinib compared to prednisone on overall survival in men with previously treated metastatic castration-resistant prostate cancer with bone-dominant disease who have experienced disease progression on docetaxel-containing chemotherapy and abiraterone or MDV3100.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer, Castration Resistant Prostate Cancer, Pain, Prostatic Neoplasms
Keywords
prostate cancer, castration resistant prostate cancer, bone pain, CRPC
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1028 (Actual)
8. Arms, Groups, and Interventions
Arm Title
cabozantinib
Arm Type
Experimental
Arm Description
Subjects randomized to the cabozantinib arm will also receive placebo-matched prednisone capsules.
Arm Title
prednisone
Arm Type
Active Comparator
Arm Description
Subjects randomized to the prednisone arm will also receive placebo-matched cabozantinib.
Intervention Type
Drug
Intervention Name(s)
cabozantinib
Other Intervention Name(s)
XL184
Intervention Description
Tablets taken orally once-daily
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Description
Taken twice a day orally. Commercially-obtained prednisone tablets will be over-encapsulated in order to blind identity.
Primary Outcome Measure Information:
Title
Overall Survival (OS)
Description
The primary analysis of OS is defined as the time from randomization to death due to any cause. Participants that had not died or were permanently lost to follow-up were censored at the last known date alive. Median OS was calculated using Kaplan-Meier estimates. Analysis for OS was performed after 614 events had occurred.
Time Frame
OS was measured from the time of randomization until 614 events, approximately 24 months after study start
Secondary Outcome Measure Information:
Title
Bone Scan Response (BSR)
Description
BSR is defined as >=30% reduction in the bone scan lesion area (BSLA) compared with baseline. Confirmation of bone scan was not required for response or progression. Bone scans were evaluated by an independent radiology facility (IRF) for response.
Time Frame
BSR was measured at the end of Week 12 as determined by the IRF
Other Pre-specified Outcome Measures:
Title
Progression-free Survival (PFS)
Description
The exploratory analysis of PFS is the time from randomization to date of first documented radiographic progression (bone and/or soft tissue) according to the investigator's assessment or death. PFS was defined per mRECIST 1.1 and included evaluation of measurable, nonmeasurable, target and nontarget lesions. A Kaplan-Meier analysis was performed to estimate the median duration.
Time Frame
Duration of PFS was defined as time from the date of randomization to earlier of date of radiographic progression (bone/andor soft tissue) according to the investigator's assessment or death, assessed for up to approximately 24 months
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histological or cytological diagnosis of castration resistant prostate cancer (serum testosterone less than 50 ng/dL).
Evidence of bone metastasis related to prostate cancer on bone scans.
Received prior docetaxel (minimum cumulative dose of 225 mg/m2) and either abiraterone or MDV3100 treatment and has evidence of prostate cancer progression on each agent independently.
Maintenance of LHRH agonist or antagonist unless treated with orchiectomy.
Recovered from toxicities related to any prior treatments, unless the toxicities are clinically non significant or easily manageable.
Adequate organ and marrow function.
Capable of understanding and complying with the protocol requirements and signed the informed consent form.
Sexually active fertile patients and their partners must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 4 months after the last dose of study treatment.
Exclusion Criteria:
Prior treatment with cabozantinib.
Treatment with docetaxel, abiraterone, or MDV3100 in the last 2 weeks; or with any other type of cytotoxic or investigational anticancer agent in the last 2 weeks.
Radiation within 4 weeks (excluded if to mediastinum) or radionuclide treatment within 6 weeks of randomization.
Known brain metastases or cranial epidural disease.
Requires concomitant treatment, in therapeutic doses, with anticoagulants.
Requires chronic concomitant treatment of strong CYP3A4 inducers (eg, dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, and St. John's Wort).
Uncontrolled, significant intercurrent illness including, but not limited to, cardiovascular disorders, gastrointestinal disorders, active infections, non-healing wounds, recent surgery.
Clinically significant hematemesis or hemoptysis, or other signs indicative of pulmonary hemorrhage in the last 3 months, or history of other significant bleeding in the past 6 months.
Cavitating pulmonary lesion(s) or a lesion invading or encasing a major blood vessel.
QTcF > 500 ms within 7 days of randomization.
Unable to swallow capsules or tablets.
Previously-identified allergy or hypersensitivity to components of the study treatment formulations.
Another diagnosis of malignancy requiring systemic treatment within 2 years of randomization.
Facility Information:
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Birmingham
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2217
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Australia
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New South Wales
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2444
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Australia
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Randwick
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2031
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Australia
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Wahroonga
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2076
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2145
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Australia
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South Brisbane
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Queensland
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4101
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Australia
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Southport
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4215
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Australia
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Woolloongabba
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Queensland
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4102
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Australia
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Adelaide
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South Australia
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5000
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Australia
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South Australia
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5037
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Australia
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Hobart
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Tasmania
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7000
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Australia
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Bentleigh East
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Victoria
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3165
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Australia
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Box Hill
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Victoria
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3128
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Australia
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Wodonga
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Victoria
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3690
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Australia
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Perth
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Western Australia
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6000
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Australia
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Linz
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4010
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Austria
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Salzburg
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5020
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Austria
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Wein
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1100
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Austria
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Wien
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1090
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Austria
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Aalst
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9300
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Belgium
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Bonheiden
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2820
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Belgium
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Brussels
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1000
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Belgium
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Brussels
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1090
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Belgium
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Brussels
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1200
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Belgium
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Gent
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9000
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Belgium
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Hasselt
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3500
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Belgium
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Leuven
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B-3000
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Belgium
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Liège
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4000
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Belgium
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Roeselare
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8800
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Belgium
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Calgary
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Alberta
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Canada
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Vancouver
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British Columbia
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Canada
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Miramichi
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New Brunswick
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E1V 1Y3
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Canada
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Halifax
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Nova Scotia
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B3H 1V7
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Canada
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London
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Ontario
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N6A 4L6
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Canada
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Owen Sound
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Ontario
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Canada
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Montreal
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Quebec
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Canada
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Quebec
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Canada
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Angers
ZIP/Postal Code
49933
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France
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Besançon
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25030
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France
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Bordeaux
ZIP/Postal Code
33076
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France
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Caen
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14076
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France
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Clermont Ferrand
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63011
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France
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Dijon
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21079
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France
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La Roche sur Yon
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85925
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France
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Le Mans
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72000
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France
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Lille
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59000
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France
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Lyon Cedex 08
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69373
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France
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Marseille
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13273
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France
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Nancy
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54100
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France
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Paris
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75005
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France
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Paris
ZIP/Postal Code
75010
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France
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Paris
ZIP/Postal Code
75014
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France
City
Paris
ZIP/Postal Code
75015
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France
City
Paris
ZIP/Postal Code
75230
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France
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Pierre Benite
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69495
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France
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Rennes
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35042
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France
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Saint Herblain
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44805
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France
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Strasbourg
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67000
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France
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Suresnes
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92151
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France
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Villejuif Cedex
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94805
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France
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Aachen
ZIP/Postal Code
52062
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Germany
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Aachen
ZIP/Postal Code
52074
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Germany
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Berlin
ZIP/Postal Code
12200
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Germany
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Berlin
ZIP/Postal Code
13055
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Germany
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Braunschweig
ZIP/Postal Code
38126
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Germany
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Dresden
ZIP/Postal Code
01307
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Germany
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Dusseldorf
ZIP/Postal Code
40225
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Germany
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Frankfurt am Main
ZIP/Postal Code
60488
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Germany
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Freiburg
ZIP/Postal Code
79106
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Germany
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Furth
ZIP/Postal Code
90766
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Germany
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Gütersloh
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33332
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Germany
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Hamburg
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20246
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Germany
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Hamburg
ZIP/Postal Code
22399
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Germany
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Hamburg
ZIP/Postal Code
22763
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Germany
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Hannover
ZIP/Postal Code
30625
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Germany
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Heidelberg
ZIP/Postal Code
69120
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Germany
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Homburg
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66421
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Germany
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Kassel
ZIP/Postal Code
34125
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Germany
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Kempen
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47906
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Germany
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Kirchheim
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73230
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Germany
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Koln
ZIP/Postal Code
50968
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Germany
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Mannheim
ZIP/Postal Code
68167
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Germany
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Munchen
ZIP/Postal Code
81675
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Germany
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Munster
ZIP/Postal Code
48149
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Germany
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Nurtingen
ZIP/Postal Code
72622
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Germany
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Offenburg
ZIP/Postal Code
77654
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Germany
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Traunstein
ZIP/Postal Code
83278
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Germany
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Tubingen
ZIP/Postal Code
72076
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Germany
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Weiden
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92637
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Germany
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Wuppertal
ZIP/Postal Code
42103
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Germany
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Cork
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Ireland
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Dublin
ZIP/Postal Code
24
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Ireland
City
Dublin
ZIP/Postal Code
7
Country
Ireland
City
Galway
Country
Ireland
City
Ancona
ZIP/Postal Code
60126
Country
Italy
City
Arezzo
ZIP/Postal Code
52100
Country
Italy
City
Aviano
ZIP/Postal Code
33081
Country
Italy
City
Brindisi
ZIP/Postal Code
72100
Country
Italy
City
Cremona
ZIP/Postal Code
26100
Country
Italy
City
Genova
ZIP/Postal Code
16132
Country
Italy
City
Livorno
ZIP/Postal Code
57123
Country
Italy
City
Meldola
ZIP/Postal Code
47014
Country
Italy
City
Milano
ZIP/Postal Code
20132
Country
Italy
City
Milano
ZIP/Postal Code
20133
Country
Italy
City
Milano
ZIP/Postal Code
20162
Country
Italy
City
Modena
ZIP/Postal Code
41124
Country
Italy
City
Napoli
ZIP/Postal Code
80131
Country
Italy
City
Novara
ZIP/Postal Code
28100
Country
Italy
City
Orbassano
ZIP/Postal Code
10043
Country
Italy
City
Padova
ZIP/Postal Code
35128
Country
Italy
City
Pavia
ZIP/Postal Code
27100
Country
Italy
City
Pisa
ZIP/Postal Code
56126
Country
Italy
City
Pordenone
ZIP/Postal Code
33170
Country
Italy
City
Ravenna
ZIP/Postal Code
48121
Country
Italy
City
Rimini
ZIP/Postal Code
47900
Country
Italy
City
Roma
ZIP/Postal Code
00128
Country
Italy
City
Roma
ZIP/Postal Code
00152
Country
Italy
City
Rozzano
ZIP/Postal Code
20089
Country
Italy
City
Terni
ZIP/Postal Code
05100
Country
Italy
City
Torino
ZIP/Postal Code
10126
Country
Italy
City
Verona
ZIP/Postal Code
37134
Country
Italy
City
Amsterdam
ZIP/Postal Code
1066 CX
Country
Netherlands
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
City
Groningen
ZIP/Postal Code
9728 NT
Country
Netherlands
City
Hoofddorp
ZIP/Postal Code
2134 TM
Country
Netherlands
City
Nieuwegein
ZIP/Postal Code
3435 CM
Country
Netherlands
City
Nijmegen
ZIP/Postal Code
6525 GA
Country
Netherlands
City
Rotterdam
ZIP/Postal Code
3045 PM
Country
Netherlands
City
Rotterdam
ZIP/Postal Code
3075 EA
Country
Netherlands
City
Tilburg
ZIP/Postal Code
5042 AD
Country
Netherlands
City
Zwolle
ZIP/Postal Code
8025 AB
Country
Netherlands
City
Ponce
ZIP/Postal Code
00716
Country
Puerto Rico
City
Málaga
State/Province
Andalucía
ZIP/Postal Code
29010
Country
Spain
City
Sevilla
State/Province
Andalucía
ZIP/Postal Code
41013
Country
Spain
City
Oviedo
State/Province
Asturias
ZIP/Postal Code
33006
Country
Spain
City
Palma de Mallorca
State/Province
Baleares
ZIP/Postal Code
07010
Country
Spain
City
La Laguna
State/Province
Canarias
ZIP/Postal Code
38320
Country
Spain
City
Badalona
State/Province
Cataluña
ZIP/Postal Code
08916
Country
Spain
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08003
Country
Spain
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08023
Country
Spain
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08025
Country
Spain
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08035
Country
Spain
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08036
Country
Spain
City
L'Hospitalet de Llobregat
State/Province
Cataluña
ZIP/Postal Code
08908
Country
Spain
City
Manresa
State/Province
Cataluña
ZIP/Postal Code
08243
Country
Spain
City
Elche
State/Province
Comunidad Valenciana
ZIP/Postal Code
03016
Country
Spain
City
Valencia
State/Province
Comunidad Valenciana
ZIP/Postal Code
46009
Country
Spain
City
A Coruña
State/Province
Galicia
ZIP/Postal Code
15006
Country
Spain
City
Santiago de Compostela
State/Province
Galicia
ZIP/Postal Code
15706
Country
Spain
City
Madrid
State/Province
Madrid, Communidad De
ZIP/Postal Code
28007
Country
Spain
City
Madrid
State/Province
Madrid, Communidad De
ZIP/Postal Code
28040
Country
Spain
City
Madrid
State/Province
Madrid, Communidad De
ZIP/Postal Code
28041
Country
Spain
City
Madrid
State/Province
Madrid, Communidad De
ZIP/Postal Code
28050
Country
Spain
City
Madrid
State/Province
Madrid, Communidad De
ZIP/Postal Code
28922
Country
Spain
City
Majadahonda
State/Province
Madrid, Communidad De
ZIP/Postal Code
28222
Country
Spain
City
Pamplona
State/Province
Navarra
ZIP/Postal Code
31008
Country
Spain
City
Gotenborg
ZIP/Postal Code
SE 41345
Country
Sweden
City
Malmo
ZIP/Postal Code
SE-20502
Country
Sweden
City
Orebro
ZIP/Postal Code
SE-70185
Country
Sweden
City
Stockholm
ZIP/Postal Code
SE-17176
Country
Sweden
City
Umea
ZIP/Postal Code
SE-90184
Country
Sweden
City
Uppsala
ZIP/Postal Code
SE 75185
Country
Sweden
City
Vaxjo
ZIP/Postal Code
SE-35185
Country
Sweden
City
Aberdeen
ZIP/Postal Code
AB25 2ZN
Country
United Kingdom
City
Bath
ZIP/Postal Code
BA1 3NG
Country
United Kingdom
City
Birmingham
ZIP/Postal Code
B15 2TH
Country
United Kingdom
City
Brighton
ZIP/Postal Code
BN2 5BE
Country
United Kingdom
City
Bristol
ZIP/Postal Code
BS2 8ED
Country
United Kingdom
City
Cambridge
ZIP/Postal Code
CB2 2QQ
Country
United Kingdom
City
Cardiff
ZIP/Postal Code
CF14 2TL
Country
United Kingdom
City
Cottingham
ZIP/Postal Code
HU16 5JQ
Country
United Kingdom
City
Edinburgh
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
City
Inverness
ZIP/Postal Code
IV2 3UJ
Country
United Kingdom
City
Lancaster
ZIP/Postal Code
LA1 4RP
Country
United Kingdom
City
Leeds
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
City
London
ZIP/Postal Code
W12 0HS
Country
United Kingdom
City
Maidstone
ZIP/Postal Code
ME16 9QQ
Country
United Kingdom
City
Northwood
ZIP/Postal Code
HA6 2RN
Country
United Kingdom
City
Plymouth
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
City
Sheffield
ZIP/Postal Code
S10 2SJ
Country
United Kingdom
City
Southampton
ZIP/Postal Code
S16 6YD
Country
United Kingdom
City
Sutton
ZIP/Postal Code
SM2 5PT
Country
United Kingdom
City
Wirral
ZIP/Postal Code
CH63 4JY
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
29272162
Citation
Heller G, McCormack R, Kheoh T, Molina A, Smith MR, Dreicer R, Saad F, de Wit R, Aftab DT, Hirmand M, Limon A, Fizazi K, Fleisher M, de Bono JS, Scher HI. Circulating Tumor Cell Number as a Response Measure of Prolonged Survival for Metastatic Castration-Resistant Prostate Cancer: A Comparison With Prostate-Specific Antigen Across Five Randomized Phase III Clinical Trials. J Clin Oncol. 2018 Feb 20;36(6):572-580. doi: 10.1200/JCO.2017.75.2998. Epub 2017 Dec 22.
Results Reference
derived
PubMed Identifier
27400947
Citation
Smith M, De Bono J, Sternberg C, Le Moulec S, Oudard S, De Giorgi U, Krainer M, Bergman A, Hoelzer W, De Wit R, Bogemann M, Saad F, Cruciani G, Thiery-Vuillemin A, Feyerabend S, Miller K, Houede N, Hussain S, Lam E, Polikoff J, Stenzl A, Mainwaring P, Ramies D, Hessel C, Weitzman A, Fizazi K. Phase III Study of Cabozantinib in Previously Treated Metastatic Castration-Resistant Prostate Cancer: COMET-1. J Clin Oncol. 2016 Sep 1;34(25):3005-13. doi: 10.1200/JCO.2015.65.5597. Epub 2016 Jul 11.
Results Reference
derived
Learn more about this trial
Study of Cabozantinib (XL184) Versus Prednisone in Men With Metastatic Castration-resistant Prostate Cancer Previously Treated With Docetaxel and Abiraterone or MDV3100
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