Early Switch From First-Line Docetaxel/Prednisone to Cabazitaxel/Prednisone and the Opposite Sequence, Exploring Molecular Markers in Men With Metastatic Castration-Resistant Prostate Cancer (mCRPC) (TAXYNERGY)
Prostate Cancer Metastatic

About this trial
This is an interventional treatment trial for Prostate Cancer Metastatic
Eligibility Criteria
Inclusion criteria :
- Histologically- or cytologically-confirmed prostate adenocarcinoma with documented distant metastases (M1 disease).
- Progressive disease while receiving hormonal therapy or after surgical castration.
- Effective castration (serum testosterone levels ≤50 ng/dL) by orchiectomy and/or luteinizing hormone releasing hormone agonists or antagonist with or without anti-androgens.
Exclusion criteria:
- Prior chemotherapy for prostate cancer, except estramustine and adjuvant/neoadjuvant treatment completed >3 years ago. Prior treatment with sipuleucel-T immunotherapy was allowed at the condition participant did not receive prior chemotherapy.
- Less than 28 days elapsed from prior treatment with estramustine, radiotherapy or surgery to the time of random allocation.
- Prior beta isotope therapy, whole pelvic radiotherapy, or radiotherapy to >30% of bone marrow.
- Adverse events (excluding alopecia and those listed in the specific exclusion criteria) from any prior anticancer therapy of grade >1(National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] v4.03) at the time of random allocation.
- Less than 18 years of age.
- Eastern Cooperative Oncology Group (ECOG) performance status >2.
- History of brain metastases, uncontrolled spinal cord compression, or carcinomatous meningitis or new evidence of brain or leptomeningeal disease.
- Prior malignancy. Adequately treated basal cell or squamous cell skin or superficial (pTis, pTa and pT1) bladder cancer were allowed, as well as any other cancer for which chemotherapy had been completed ≥3 years ago and from which the participant had been disease-free for ≥3 years.
- Participation in another clinical trial and any concurrent treatment with any investigational drug within 30 days prior to random allocation.
- Any of the following within 6 months prior to study enrollment: myocardial infarction, severe/unstable angina pectoris, coronary/peripheral artery bypass graft, New York Heart Association (NYHA) class III or IV congestive heart failure, stroke or transient ischemic attack.
- Any of the following within 3 months prior to random allocation: treatment resistant peptic ulcer disease, erosive esophagitis or gastritis, infectious or inflammatory bowel disease, diverticulitis, pulmonary embolism, or other uncontrolled thromboembolic event.
- Acquired immunodeficiency syndrome (AIDS)-related illnesses or known HIV disease requiring antiretroviral treatment.
- Any severe acute or chronic medical condition which could impair the ability of the participant to participate in to the study or interfere with interpretation of study results, or participant unable to comply with the study procedures.
- Concomitant treatment with biphosphonates or denosumab except if the dose had been stable for 4 weeks prior to enrollment.
- Absence of signed and dated Institutional Review Board (IRB)-approved participant informed consent prior to enrollment into the study.
- Participants with reproductive potential who did not agree to use an accepted and effective method of contraception during the study treatment period. The definition of "effective method of contraception" was based on the investigator's judgment.
- History of hypersensitivity to docetaxel or polysorbate 80.
- Inadequate organ and bone marrow function.
- Contraindications to the use of corticosteroid treatment.
- Symptomatic peripheral neuropathy grade >2 (NCI CTCAE v.4.03).
- Treatment with strong inhibitors or strong inducers of cytochrome P450 3A4/5 (a two-week wash-out period was necessary for participants who were already on these treatments).
The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Sites / Locations
- Investigational Site Number 840003
- Investigational Site Number 840102
- Investigational Site Number 840005
- Investigational Site Number 840025
- Investigational Site Number 840002
- Investigational Site Number 840007
- Investigational Site Number 840017
- Investigational Site Number 840010
- Investigational Site Number 840015
- Investigational Site Number 840001
- Investigational Site Number 840013
- Investigational Site Number 840009
- Investigational Site Number 840012
- Investigational Site Number 840004
- Investigational Site Number 124001
- Investigational Site Number 124004
- Investigational Site Number 124002
- Investigational Site Number 124006
- Investigational Site Number 124005
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Docetaxel + Prednisone (Treatment A)
Cabazitaxel + Prednisone (Treatment B)
Docetaxel 75 mg/m^2 intravenous (IV) infusion on Day 1 of Cycle 1 and every 3 weeks (q3w) thereafter, in combination with Prednisone (or Prednisolone) 10 mg orally daily. Participants with <30% PSA reduction from baseline at the end of Cycle 4 switched to Cabazitaxel 25mg/m^2 IV infusion on Day 1 of Cycle 5 and q3w thereafter, in combination with Prednisone (or Prednisolone) 10 mg orally daily until disease progression (DP), death, unacceptable toxicity or participant's refusal of further study treatment. Participants with ≥30% PSA reduction from baseline at the end of Cycle 4, continued on the same treatment which they received before switching until DP, death, unacceptable toxicity or participant's refusal of further study treatment.
Cabazitaxel 25 mg/m^2 IV infusion on Day 1 of Cycle 1 and q3w thereafter, in combination with Prednisone (or Prednisolone) 10 mg orally daily. Participants with <30% PSA reduction from baseline at the end of Cycle 4 switched to Docetaxel 75mg/m^2 IV infusion on Day 1 of Cycle 5 and q3w thereafter, in combination with Prednisone (or Prednisolone) 10 mg orally daily until DP, death, unacceptable toxicity or participant's refusal of further study treatment. Participants with ≥30% PSA reduction from baseline at the end of Cycle 4, continued on the same treatment which they received before switching until DP, death, unacceptable toxicity or participant's refusal of further study treatment.