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Abiraterone Acetate Trial in African American Prostate Cancer Patients

Primary Purpose

Prostate Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Abiraterone Acetate
Sponsored by
Icahn School of Medicine at Mount Sinai
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring African American men, metastatic prostate cancer, castration resistant

Eligibility Criteria

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

Inclusion Criteria:

  • 1. Have signed an informed consent document indicating that the subjects understands the purpose of and procedures required for the study and are willing to participate in the study
  • Be willing/able to adhere to the prohibitions and restrictions specified in this protocol
  • Written Authorization for Use and Release of Health and Research Study Information
  • African American or Black (by self identification)
  • Male aged 18 years and above
  • Histologically or cytologically confirmed adenocarcinoma of the prostate
  • Metastatic disease documented by standard imaging
  • Progressive prostate cancer based on either rising PSA, new bone metastases, or progression of measurable disease according to PCWG2 12 guidelines.
  • Patients in either of the following clinical states will be eligible for enrollment:

    i. No prior chemotherapy; ii. Patients previously treated with 1-2 prior chemotherapy regimens permitted, one of which must have been included docetaxel

  • Surgically or medically castrated, with testosterone levels of < 50 ng/dl.
  • Patients previously treated with an anti-androgen must demonstrate progression off of the anti-androgen.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2
  • Have a baseline serum potassium of ≥ 3.5 mEq/L
  • Have aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin levels < 1.5 x ULN
  • Have a serum albumin of ≥ 3.0 g/dL
  • Total bilirubin ≤ 1.5 x ULN
  • Have a platelet count of ≥ 100,000/μL
  • Have an absolute neutrophil count of > 1500 cell/mm3
  • Have a calculated creatinine clearance ≥ 60 mL/min
  • Have a hemoglobin of ≥ 9.0 g/dL
  • Able to swallow the study drug as a whole tablet
  • Willing to take abiraterone acetate on an empty stomach; no food should be consumed at least two hours before and for at least one hour after the dose of abiraterone acetate is taken
  • Patients who have partners of childbearing potential must be willing to use a method of birth control with adequate barrier protection as determined to be acceptable by the principal investigator during the study and for 1 week after last dose of abiraterone acetate

Exclusion Criteria:

  • Active infection or other medical condition that would make prednisone/prednisolone (corticosteroid) use contraindicated
  • Known brain metastasis
  • Uncontrolled hypertension (systolic BP ≥ 160 mmHg or diastolic BP ≥ 95 mmHg) Patients with a history of hypertension are allowed provided blood pressure is controlled by anti-hypertensive treatment
  • Active or symptomatic viral hepatitis or chronic liver disease
  • History of pituitary or adrenal dysfunction
  • Clinically significant heart disease as evidenced by myocardial infarction, or arterial thrombotic events in the past 6 months, severe or unstable angina, or New York Heart Association (NYHA) Class III-IV heart disease or cardiac ejection fraction measurement of < 50% at baseline
  • Administration of an investigational therapeutic within 30 days of screening
  • Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements
  • Have poorly controlled diabetes
  • Have a history of gastrointestinal disorders (medical disorders or extensive surgery) that may interfere with the absorption of the study agents
  • Have a pre-existing condition that warrants long-term corticosteroid use in excess of study dose
  • Have known allergies, hypersensitivity, or intolerance to abiraterone acetate or prednisone or their excipients

Sites / Locations

  • Icahn School of Medicine at Mount Sinai
  • Queens Cancer Center, Queens Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Abiraterone Acetate

Arm Description

Abiraterone acetate 1000mg orally daily until the time of disease progression, in the absence of prohibitive toxicities.

Outcomes

Primary Outcome Measures

Number of Participants With ≥ 30% Change in PSA
The primary objective of this study is to determine a correlation between inherited genetic polymorphisms and antitumor activity (as defined by a decline in PSA of ≥ 30%) in AA patients with castration-resistant prostate cancer treated with Abiraterone. The primary endpoint is the percent change in PSA from baseline to 12 weeks. A decline of ≥ 30% will be correlated with germline SNPs.

Secondary Outcome Measures

Response Assessment
Post-treatment changes in measurable disease by RECIST - Response Evaluation Criteria in Solid Tumors Complete Response (CR): Disappearance of all target lesions Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions
Time to Progression
post-treatment changes in measurable disease by time to disease progression (as per PCWG2 guidelines)
Bone Scan
post-treatment changes in bone scans (as per PCWG2 guidelines) ("no new lesions" versus "new lesions.")
Safety of Abiraterone
To determine the safety of abiraterone Adverse events as defined by CTCAE v4. Number of participants with serious adverse events grade 4 or 5
Testosterone
Post-treatment changes in testosterone

Full Information

First Posted
November 24, 2012
Last Updated
April 4, 2017
Sponsor
Icahn School of Medicine at Mount Sinai
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1. Study Identification

Unique Protocol Identification Number
NCT01735396
Brief Title
Abiraterone Acetate Trial in African American Prostate Cancer Patients
Official Title
A Pilot Study of Abiraterone Acetate in African American/Black Patients With Castration Resistant Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Terminated
Why Stopped
poor accrual
Study Start Date
December 2012 (undefined)
Primary Completion Date
March 2016 (Actual)
Study Completion Date
March 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Icahn School of Medicine at Mount Sinai

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a pilot study of abiraterone acetate in African American/Black patients with castration-resistant prostate cancer. The primary objective is to determine the correlation between germline polymorphisms and antitumor activity (as defined by a decline in PSA of ≥ 30%) in African American patients with castration-resistant prostate cancer treated with abiraterone acetate. Patients will receive abiraterone acetate until the time of disease progression, in the absence of prohibitive toxicities. Patients will be followed for disease progression and survival.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
African American men, metastatic prostate cancer, castration resistant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Abiraterone Acetate
Arm Type
Experimental
Arm Description
Abiraterone acetate 1000mg orally daily until the time of disease progression, in the absence of prohibitive toxicities.
Intervention Type
Drug
Intervention Name(s)
Abiraterone Acetate
Other Intervention Name(s)
Zytiga
Intervention Description
Abiraterone acetate 1000 mg orally daily (supplied as four 250 mg tablets) and prednisone 5 mg orally twice daily
Primary Outcome Measure Information:
Title
Number of Participants With ≥ 30% Change in PSA
Description
The primary objective of this study is to determine a correlation between inherited genetic polymorphisms and antitumor activity (as defined by a decline in PSA of ≥ 30%) in AA patients with castration-resistant prostate cancer treated with Abiraterone. The primary endpoint is the percent change in PSA from baseline to 12 weeks. A decline of ≥ 30% will be correlated with germline SNPs.
Time Frame
baseline and 12 weeks
Secondary Outcome Measure Information:
Title
Response Assessment
Description
Post-treatment changes in measurable disease by RECIST - Response Evaluation Criteria in Solid Tumors Complete Response (CR): Disappearance of all target lesions Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions
Time Frame
up to 12 weeks
Title
Time to Progression
Description
post-treatment changes in measurable disease by time to disease progression (as per PCWG2 guidelines)
Time Frame
up to 12 weeks
Title
Bone Scan
Description
post-treatment changes in bone scans (as per PCWG2 guidelines) ("no new lesions" versus "new lesions.")
Time Frame
up to 12 weeks
Title
Safety of Abiraterone
Description
To determine the safety of abiraterone Adverse events as defined by CTCAE v4. Number of participants with serious adverse events grade 4 or 5
Time Frame
up to 12 weeks
Title
Testosterone
Description
Post-treatment changes in testosterone
Time Frame
up to 12 weeks

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Have signed an informed consent document indicating that the subjects understands the purpose of and procedures required for the study and are willing to participate in the study Be willing/able to adhere to the prohibitions and restrictions specified in this protocol Written Authorization for Use and Release of Health and Research Study Information African American or Black (by self identification) Male aged 18 years and above Histologically or cytologically confirmed adenocarcinoma of the prostate Metastatic disease documented by standard imaging Progressive prostate cancer based on either rising PSA, new bone metastases, or progression of measurable disease according to PCWG2 12 guidelines. Patients in either of the following clinical states will be eligible for enrollment: i. No prior chemotherapy; ii. Patients previously treated with 1-2 prior chemotherapy regimens permitted, one of which must have been included docetaxel Surgically or medically castrated, with testosterone levels of < 50 ng/dl. Patients previously treated with an anti-androgen must demonstrate progression off of the anti-androgen. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2 Have a baseline serum potassium of ≥ 3.5 mEq/L Have aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin levels < 1.5 x ULN Have a serum albumin of ≥ 3.0 g/dL Total bilirubin ≤ 1.5 x ULN Have a platelet count of ≥ 100,000/μL Have an absolute neutrophil count of > 1500 cell/mm3 Have a calculated creatinine clearance ≥ 60 mL/min Have a hemoglobin of ≥ 9.0 g/dL Able to swallow the study drug as a whole tablet Willing to take abiraterone acetate on an empty stomach; no food should be consumed at least two hours before and for at least one hour after the dose of abiraterone acetate is taken Patients who have partners of childbearing potential must be willing to use a method of birth control with adequate barrier protection as determined to be acceptable by the principal investigator during the study and for 1 week after last dose of abiraterone acetate Exclusion Criteria: Active infection or other medical condition that would make prednisone/prednisolone (corticosteroid) use contraindicated Known brain metastasis Uncontrolled hypertension (systolic BP ≥ 160 mmHg or diastolic BP ≥ 95 mmHg) Patients with a history of hypertension are allowed provided blood pressure is controlled by anti-hypertensive treatment Active or symptomatic viral hepatitis or chronic liver disease History of pituitary or adrenal dysfunction Clinically significant heart disease as evidenced by myocardial infarction, or arterial thrombotic events in the past 6 months, severe or unstable angina, or New York Heart Association (NYHA) Class III-IV heart disease or cardiac ejection fraction measurement of < 50% at baseline Administration of an investigational therapeutic within 30 days of screening Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements Have poorly controlled diabetes Have a history of gastrointestinal disorders (medical disorders or extensive surgery) that may interfere with the absorption of the study agents Have a pre-existing condition that warrants long-term corticosteroid use in excess of study dose Have known allergies, hypersensitivity, or intolerance to abiraterone acetate or prednisone or their excipients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matthew Galsky, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
Facility Information:
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Queens Cancer Center, Queens Hospital
City
New York
State/Province
New York
ZIP/Postal Code
11432
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
27742908
Citation
Tsao CK, Sfakianos J, Liaw B, Gimpel-Tetra K, Kemeny M, Bulone L, Shahin M, Oh WK, Galsky MD. Phase II Trial of Abiraterone Acetate Plus Prednisone in Black Men With Metastatic Prostate Cancer. Oncologist. 2016 Dec;21(12):1414-e9. doi: 10.1634/theoncologist.2016-0026. Epub 2016 Oct 14.
Results Reference
derived
Links:
URL
http://www.mssm.edu/research/institutes/tisch-cancer-institute
Description
Mt. Sinai Tisch Cancer Institute

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Abiraterone Acetate Trial in African American Prostate Cancer Patients

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