Phase III Study of DCVAC/PCa Added to Standard Chemotherapy for Men With Metastatic Castration Resistant Prostate Cancer (VIABLE)
Metastatic Castration-resistant Prostate Cancer

About this trial
This is an interventional treatment trial for Metastatic Castration-resistant Prostate Cancer focused on measuring Immunotherapy, Metastatic, Castration-resistant, Prostate cancer, Biological, Vaccine
Eligibility Criteria
Inclusion criteria:
- Male 18 years and older.
- Histologically or cytologically confirmed prostate adenocarcinoma.
Presence of skeletal, or soft-tissue/visceral/nodal metastases according to one of the following criteria:
- Confirmed pathological fracture related to the disease OR
- Confirmation of distant bone and/or soft-tissue and/or visceral metastases on CT or MRI scan or bone scintigraphy OR
- Positive pathology report of metastatic lesion
Disease progression despite androgen-deprivation therapy (ADT) as indicated by:
- Prostate-specific antigen (PSA) increase that is ≥ 2 ng/mL and ≥ 25% above the minimum PSA as reached during ADT or above the pre-treatment level, if no response was observed and which is confirmed by a second value 1 or more weeks later OR
- Progression of measurable lymph nodes (short axis ≥ 15 mm) or visceral lesion measurable per RECIST v1.1 criteria, confirmation by an independent review facility (IRF) required OR
- Two or more new lesions appearing on bone scan/imaging compared with a previous scan (confirmation by IRF required)
- Maintenance of castrate conditions: patients, who have not had a surgical orchiectomy, must continue with hormone therapy with gonadotropin releasing hormone/ luteinizing hormone-releasing hormone (GnRH/LHRH) agonists or antagonists to reach levels of serum testosterone of ≤ 1.7 nmol/L (50 ng/dL). The duration of the castration period must be at least 4 months before screening as evidenced by combination of clinical/laboratory data (see section 6.8.1).
Laboratory criteria:
- White blood cells (WBC) greater than 4,000/mm3 (4.0 x109/L)
- Neutrophil count greater than 1,500/mm3 (1.5 x109/L).
- Hemoglobin of at least 10 g/dL (100 g/L).
- Platelet count of at least 100,000/mm3 (100 x 109/L).
- Total bilirubin within normal limits (benign hereditary hyperbilirubinemias, e.g. Gilbert's syndrome, are permitted).
- Serum alanine aminotransferase, aspartate aminotransferase, and creatinine < 1.5x times the upper limit of normal (ULN).
- Life expectancy of at least 6 months based on Investigator's judgment.
- Eastern Cooperative Oncology Group (ECOG) Performance status 0-2.
- At least 4 weeks after surgery or radiotherapy before randomization.
- A minimum of 28 days beyond initiation of bisphosphonate or denosumab therapy before randomization.
- Recovery from primary local surgical treatment, radiotherapy or orchiectomy before randomization.
- Signed informed consent including patient's ability to comprehend its contents.
Exclusion criteria:
- Confirmed brain and/or leptomeningeal metastases (other visceral metastases are acceptable).
- Current symptomatic spinal cord compression requiring surgery or radiation therapy.
- Prior chemotherapy for prostate cancer.
Patient co-morbidities:
- Subjects who are not indicated for chemotherapy treatment with first line Standard of Care chemotherapy (docetaxel and prednisone).
- HIV positive, human T-lymphotropic virus positive.
- Active hepatitis B (active hepatitis B), active hepatitis C (HCV), active syphilis.
- Evidence of active bacterial, viral or fungal infection requiring systemic treatment.
Clinically significant cardiovascular disease including:
- symptomatic congestive heart failure.
- unstable angina pectoris.
- serious cardiac arrhythmia requiring medication.
- uncontrolled hypertension.
- myocardial infarction or ventricular arrhythmia or stroke within a 6 months before screening, known left ventricular ejection fraction (LVEF) < 40% or serious cardiac conduction system disorders, if a pacemaker is not present.
- Pleural and pericardial effusion of any NCI CTCAE grade.
- Peripheral neuropathy having a NCI CTCAE ≥ grade 2.
- History of malignant disease (with the exception of non-melanoma skin tumors) in the preceding five years.
- Active autoimmune disease requiring treatment.
- History of severe forms of primary immune deficiencies.
- History of anaphylaxis or other serious reaction following vaccination.
- Known hypersensitivity to any constituent of the DCVAC/PCa or placebo product.
- Uncontrolled co-morbidities including, psychiatric or social conditions which, in the Investigator's opinion, would prevent participation in the trial.
- Systemic corticosteroids at doses greater than 40 mg hydrocortisone daily or equivalent for any reason other than treatment of PCa within 6 months before randomization.
- Ongoing systemic immunosuppressive therapy for any reason.
- Treatment with anti-androgens, inhibitors of adrenal-produced androgens or other hormonal tumor-focused treatment performed on the day of randomization (except for GnRH/LHRH agonists or antagonists) to exclude possible anti-androgen withdrawal response. This criterion is not applicable to subjects who have never responded to anti-androgen treatment, as there is no risk of anti-androgen withdrawal response.
- Treatment with immunotherapy against PCa within 6 months before randomization.
- Treatment with radiopharmaceutical within 8 weeks before randomization.
- Participation in a clinical trial using non-immunological experimental therapy within 4 weeks before randomization.
- Participation in a clinical trial using immunological experimental therapy (e.g., monoclonal antibodies, cytokines or active cellular immunotherapies) within 6 months before randomization.
- Refusal to sign the informed consent.
Sites / Locations
- University of South Alabama Mitchell Cancer Institute
- Ironwood Cancer & Research Centers
- Mayo Clinic
- Compassionate Care Research Group, Inc.
- California Cancer Associates for Research and Excellence
- Compassionate Care Research Group, Inc.
- St. Joseph Heritage Healthcare
- Hao Wei Zhang, MD, LLC
- Desert Hematology Oncology Medical Group
- Compassionate Care Research Group, Inc.
- Sharp Clinical Oncology Research
- Oncology Institute of Hope and Innovation
- Rocky Mountain Cancer Centers
- University of Colorado
- Yale Cancer Center
- Eastern CT Hematology and Oncololgy Associates
- Medstar Georgetown University Hospital
- Univ. of Miami, Sylvester Comprehensive Cancer Center
- Winship Cancer Institute of Emory University
- Saint Luke's Cancer Institute
- University of Kansas Cancer Center & Medical Pavilion
- Tulane University
- University of Maryland Greenebaum Cancer Center
- Associates In Oncology/Hematology,P.C
- Dana-Farber Cancer Institute
- Umass Memorial Medical Center
- Henry Ford Health System
- Karmanos Cancer Center
- Minnesota Oncology Hematology, P.A.
- GU Research Network
- Nebraska Cancer Specialists
- Comprehensive Cancer Research Centers of Nevada
- New Jersey Hematology Oncology Associates
- Premier Urology Associates, LLC / AdvanceMed Research
- Cancer Institute of New Jersey
- Montefiore Medical Center
- Mount Sinai Medical Center
- SUNY Upstate Medical University
- UC Health University of Cincinnati
- Oregon Health & Science University
- Northwest Cancer Specialists, P.C.
- Urologic Consultants of Southeastern Pennsylvania
- Cancer Care Associates St. Luke's University and Health Network
- Fox Chase Cancer Center
- UPMC Cancer Center
- Carolina Urologic Research Center
- Associates in Oncology & Hematology
- Arlington Cancer Center
- UT Health, Internal Medicine, Division of Oncology
- Texas Health Physicians Group
- Cancer Care Network of South Texas
- Tyler Hematology Oncology
- Utah Cancer Specialists
- Fort Belvoir Community Hospital
- Virginia Oncology Associates
- Virginia Mason Medical Center
- Northwest Medical Specialties, PLLC
- West Virginia University Mary Babb Randolph Cancer Center
- Universitatsklinikum fur Urologie und Andrologie
- Krankenhaus Barmherzige Brueder
- AKH Universitatskrankenhaus Wien
- N.N. Alexandrov National Research Center
- Minsk City Oncological Hospital
- Clinique d'Oncologie Medicale Institut Jules Bordet
- Erasme Hospital- Urologie
- Cliniques Universitaires Saint Luc- Urologie
- Urologie UZ Gent
- Urology Department St. Elizabeth Ziekenhuis
- Specialized Hospital for Active treatment in Oncology
- Central Oncology Hospital
- Complex Oncology Center
- Multifunctional Hospital for Active Treatment Serdika
- Specialized Hospital for Active Treatment of Oncology Diseases
- General Hospital Varazdin
- Clinical Hospital Center Zagreb
- University Hospital Center Sisters of Charity
- Onkologicke centrum, Nemocnice Chomutov
- Klinika onkologie a radioterapie, Fakultni nemocnice
- Nemocnice Jihlava, urologicke oddeleni
- Urologicke oddeleni, Krajska nemocnice
- Onkologicka klinika, Fakultni nemocnice
- Klinika onkologicka, Fakultni nemocnice
- Fakultni nemocnice Kralovske Vinohrady
- Vseobecna fakultni nemocnice v Praze
- Thomayerova nemocnice
- Fakultni nemocnice v Motole
- Krajska zdravotni, urologicke oddeleni
- Rigshospitalet
- HEGP medical oncology
- St-Louis IDF Medical Oncology
- Hopital St. Joseph
- Hospital Cochin, Service de Urologie
- HIA Begin
- Hospital Civil de Strasbourg
- Charite Universitatsklinikum Berlin
- Stadtisches Klinikum Braunschweig
- Universtatsklinikum Carl Gustav Carus
- Waldkrankenhaus St. Marien
- Krankenhaus Nordwest
- Universitatsklinikum Halle (Saale)
- Asklepios-Klinik Hamburg-Altona
- Vinzenkrankenhaus Hannover
- Medizinische hochschule Hannover
- Universitatskinikum Jena
- Klinik und Poliklinik Urologie
- Universitatsmedizin Mannheim
- Universtatsklinikum Munster
- Studienpraxis Urologie
- Klinikum Oldenburg AOR
- Universitastsklinikum Tubingen
- Universitatsklinikum Ulm
- Ammerland Klinik fur Urologie
- Praxigemeinschaft fur Onkologie und Urologie
- Magyar Honvedseg Egeszsegugyi Kozpont
- Egyesitett Szent Istvan es Szent Laszlo Korhaz-Rendelointeszet
- Bajcsy-Zsilinsky Korhaz
- Jasz-Nagykun-Szolnok Megyei
- CRO Aviano
- A.O.U. Policlinico Vittorio Emanuele
- A.O. Istituti Ospitalieri di Cremona
- A.O. Santa Croce e Carle Oespedale
- Universita di Roma Sapienza
- Azienda Ospedialiera Universitaria Senese
- Oncologia medica Ospedale S. Vincenzo
- Paula Stradina Kliniska Universitates slimnica
- Lithuanian University of Health Science Oncology Institute
- Klaipeda University Hospital
- Vilnius University Hospital
- National Cancer Institute
- VU medical Center
- Wilhemina Ziekenhuis
- Tergooi Ziekenhuizen
- Spaarne Gasthuis
- Oncology Medisch Centrum
- UMC St.Radboud
- Oncology Maasstad Ziekenhuis
- Przychodnia Lekarska (KOMED)
- Szpital im M.Kopernika
- INSTYTUT im. Marii Sklodowskiej-Curie
- Centrum Medyczne Ostrobramska
- Akademicki Szpital Kliniczny im. Jana Mikulicza-Radeckiego
- Hospital da Luz
- Centro Hospitalar de Lisboa Norte, E.P.E - Hospital de Santa Maria
- Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E
- CHC Zemun
- Clinical Center of Serbia
- Institute of Oncology and Radiology of Serbia
- KBC Bezanijska Kosa
- J.Breza MEDICAL s.r.o.
- Urologicka ambulancia CUIMED s.r.o.
- Univerzitna nemocnica Martin
- Urologicka ambulancia Uroexam, spol. s r.o.
- UROX s.r.o.
- Urocentrum MILAB s.r.o.
- Privatna urologicka ambulancia
- Fakultna nemocnica s poliklinikou Zilina
- Hospital Universitario Príncipe de Asturias
- Hospital Clinic I Provincial de Barcelona
- Hospital General Universitario Gregorio Maranón
- Hosp. Clinico Univ. San Carlos
- Instituto de Investigaciones Sanitarias (IIS), Fundacíon Jimenez Díaz (FJD)
- Hospital Universitario 12 de Octubre
- Centro Integral Oncológico Clara Campal (CIOCC)
- Hospital Universitario Puerta de Hierro de Majadahonda
- Hospital Carlos Haya
- Hospital Universitario Quiron Madrid
- University Hospital Umeå, Dept Oncology
- Örebro University Hospital
- The Clatterbridge Cancer Centre
- University Hospitals Birmingham NHS Foundation Trust
- Bristol Haematology and Oncology Centre
- Cambridge University Hospitals NHS Foundation Trust
- St. Luke's Cancer Centre Royal Surrey County Hospital NHS Foundation Trust
- Royal Free Hospital
- The Royal Marsden NHS Foundation Trust
- The Christie NHS Foundation Trust
- Northern Centre for Cancer Care, Freeman Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
DCVAC/PCa with standard of care chemotherapy
Placebo with standard of care chemotherapy
Combination therapy with DCVAC/PCa and standard of care chemotherapy (docetaxel and prednisone)
Combination therapy with placebo and standard of care chemotherapy (docetaxel and prednisone) as comparator