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Sipuleucel-T With or Without Tasquinimod in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer

Primary Purpose

Hormone-Resistant Prostate Cancer, Metastatic Prostate Carcinoma, Recurrent Prostate Carcinoma

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Laboratory Biomarker Analysis
Sipuleucel-T
Tasquinimod
Sponsored by
Roswell Park Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hormone-Resistant Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Metastatic asymptomatic or minimally symptomatic castration-resistant prostate cancer (CRPC) patients who are eligible for sipuleucel-T
  • Disease progression by PSA criteria (PSA Working Group Consensus Criteria Eligibility) and/or Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria
  • Life expectancy >= 6 months
  • Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Hemoglobin >= 100 g/L (>= 10 g/dL)
  • Leukocytes >= 3,000/mm^3
  • Absolute neutrophil count >= 1,500/mm^3
  • Platelets >= 100,000/mm^3
  • Total bilirubin =< 1.5 x laboratory upper limit of normal
  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x laboratory upper limit of normal
  • Creatinine =< 1.5 x laboratory upper limit of normal or calculated creatinine clearance of >= 50 mL/min (please use institutional formula)
  • Prothrombin time (PT)/international normalized ratio (INR) =< 1.5
  • Urine protein < 1+; if >= 1+, 24 hour urine protein should be obtained and should be < 1000 mg
  • Central nervous system (CNS): no recent history (within 6 month) of cerebrovascular accident, transient ischemic attacks, central nervous system or brain metastases
  • Ability to understand and the willingness to sign a written informed consent document
  • Patient verbalizes the ability to swallow and retain oral medication
  • Subject or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

  • Patients who have received systemic steroids within 4 weeks prior to starting study treatment
  • Patients who have received prior immunotherapies
  • History of therapy for an autoimmune disorder
  • Patients receiving any other investigational agents
  • Any medical condition that would preclude adequate evaluation of the safety and toxicity of the study combination
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure (New York Association class II, III, or IV), angina pectoris requiring nitrate therapy, recent myocardial infarction (less than the last 6 months), cardiac arrhythmia, history of cerebrovascular accident (CVA) within 6 months; no uncontrolled hypertension (defined as blood pressure of > 160/90 mmHg) on medication or, history of peripheral vascular disease
  • Ongoing treatment with warfarin unless the international normalized ratio (INR) is well controlled and below 4
  • History of psychiatric illness or social situations that would limit compliance with study requirements
  • History of pancreatitis
  • Human immunodeficiency virus (HIV)-positive patients receiving combination antiretroviral therapy are ineligible
  • Systemic exposure to ketoconazole or other strong cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) isoenzyme inhibitors or inducers within 14 days prior to the start of study treatment; systemic exposure to aminodarone is not allowed within 1 year prior to the start of study treatment
  • Ongoing treatment with sensitive cytochrome P450, family 1, subfamily A, polypeptide 2 (CYP1A2) substrate or CYP1A2 substrate with narrow therapeutic range at the start of study treatment
  • Ongoing treatment with CYP3A4 substrate with narrow therapeutic range at the start of study treatment
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to day 1 of therapy
  • Unwilling or unable to follow protocol requirements
  • Any condition which in the investigator's opinion deems the patient an unsuitable candidate to receive study drug

Sites / Locations

  • Roswell Park Cancer Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Arm I (sipuleucel-T)

Arm II (tasquinimod, sipuleucel-T)

Arm Description

Patients receive sipuleucel-T IV over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity.

Patients receive tasquinimod PO QD beginning on day -14 and sipuleucel-T IV over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients continue on tasquinimod treatment after day 42 until disease progression.

Outcomes

Primary Outcome Measures

Change in Immune Response Assessed by IFN-g ELISPOT Specific for PA2024

Secondary Outcome Measures

Change in PSA Response
PSA doubling time, PSA slope
Duration of PSA Response
Frequency of Toxicities Assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4
The frequency of participants with toxicities will be tabulated by grade across all dose levels and courses.
Immune Response
Immune Response
Immune Response
Immune Response
Immune Response (Arm 2 Only)
Objective Response Rates (Partial or Complete)
Overall Survival
Progression-free Survival
Time to PSA Progression

Full Information

First Posted
June 9, 2014
Last Updated
April 25, 2023
Sponsor
Roswell Park Cancer Institute
Collaborators
Active Biotech AB
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1. Study Identification

Unique Protocol Identification Number
NCT02159950
Brief Title
Sipuleucel-T With or Without Tasquinimod in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer
Official Title
A Phase II Randomized Open Label Study of Sipuleucel-T vs. Sipuleucel-T and Tasquinimod in Patients With Metastatic Castrate-Resistant Prostate Cancer (CRPC)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Roswell Park Cancer Institute
Collaborators
Active Biotech AB

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized phase II trial studies how well sipuleucel-T with or without tasquinimod works in treating patients with hormone-resistant prostate cancer that has spread to other parts of the body. Vaccines made from a person's tumor cells and white blood cells may help the body build an effective immune response to kill tumor cells. Tasquinimod may stop the growth of prostate cancer by blocking the growth of new blood vessels necessary for tumor growth. It is not yet known whether sipuleucel-T is more effective with or without tasquinimod in treating prostate cancer.
Detailed Description
PRIMARY OBJECTIVES: I. To determine whether tasquinimod augments immune response to sipuleucel-T. SECONDARY OBJECTIVES: I. To assess the safety and tolerability of the combination of sipuleucel-T and tasquinimod in patients with castration-resistant metastatic prostate cancer. II. To obtain preliminary evidence of the clinical benefit of the combination of sipuleucel-T and tasquinimod; to include changes in prostate specific antigen (PSA) over time, and duration of progression-free survival/overall survival. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive sipuleucel-T intravenously (IV) over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive tasquinimod orally (PO) once daily (QD) beginning on day -14 and sipuleucel-T IV over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients continue on tasquinimod treatment after day 42 until disease progression. After completion of study treatment, patients are followed up every 3 months for up to 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hormone-Resistant Prostate Cancer, Metastatic Prostate Carcinoma, Recurrent Prostate Carcinoma, 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
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (sipuleucel-T)
Arm Type
Experimental
Arm Description
Patients receive sipuleucel-T IV over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm II (tasquinimod, sipuleucel-T)
Arm Type
Experimental
Arm Description
Patients receive tasquinimod PO QD beginning on day -14 and sipuleucel-T IV over 60 minutes on day 4. Treatment repeats every 2 weeks for 3 courses in the absence of disease progression or unacceptable toxicity. Patients continue on tasquinimod treatment after day 42 until disease progression.
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Biological
Intervention Name(s)
Sipuleucel-T
Other Intervention Name(s)
APC8015, APC8015 Vaccine, PA2024 (PAP/GM-CSF)-Loaded Dendritic Cell Vaccine, Provenge
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Tasquinimod
Other Intervention Name(s)
ABR-215050, TASQ
Intervention Description
Given PO
Primary Outcome Measure Information:
Title
Change in Immune Response Assessed by IFN-g ELISPOT Specific for PA2024
Time Frame
Baseline up to 50 weeks
Secondary Outcome Measure Information:
Title
Change in PSA Response
Description
PSA doubling time, PSA slope
Time Frame
Baseline to up to 3 years
Title
Duration of PSA Response
Time Frame
Up to 3 years
Title
Frequency of Toxicities Assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4
Description
The frequency of participants with toxicities will be tabulated by grade across all dose levels and courses.
Time Frame
Up to 3 years
Title
Immune Response
Time Frame
Week 6
Title
Immune Response
Time Frame
Week 10
Title
Immune Response
Time Frame
Week 26
Title
Immune Response
Time Frame
Week 50
Title
Immune Response (Arm 2 Only)
Time Frame
Week 0
Title
Objective Response Rates (Partial or Complete)
Time Frame
Up to 3 years
Title
Overall Survival
Time Frame
Up to 3 years
Title
Progression-free Survival
Time Frame
Up to 3 years
Title
Time to PSA Progression
Time Frame
Up to 3 years
Other Pre-specified Outcome Measures:
Title
Effects of Tasquinimod on the Inhibition of Immune Cells
Time Frame
Up to week 50

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Metastatic asymptomatic or minimally symptomatic castration-resistant prostate cancer (CRPC) patients who are eligible for sipuleucel-T Disease progression by PSA criteria (PSA Working Group Consensus Criteria Eligibility) and/or Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria Life expectancy >= 6 months Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 Hemoglobin >= 100 g/L (>= 10 g/dL) Leukocytes >= 3,000/mm^3 Absolute neutrophil count >= 1,500/mm^3 Platelets >= 100,000/mm^3 Total bilirubin =< 1.5 x laboratory upper limit of normal Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 x laboratory upper limit of normal Creatinine =< 1.5 x laboratory upper limit of normal or calculated creatinine clearance of >= 50 mL/min (please use institutional formula) Prothrombin time (PT)/international normalized ratio (INR) =< 1.5 Urine protein < 1+; if >= 1+, 24 hour urine protein should be obtained and should be < 1000 mg Central nervous system (CNS): no recent history (within 6 month) of cerebrovascular accident, transient ischemic attacks, central nervous system or brain metastases Ability to understand and the willingness to sign a written informed consent document Patient verbalizes the ability to swallow and retain oral medication Subject or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure Exclusion Criteria: Patients who have received systemic steroids within 4 weeks prior to starting study treatment Patients who have received prior immunotherapies History of therapy for an autoimmune disorder Patients receiving any other investigational agents Any medical condition that would preclude adequate evaluation of the safety and toxicity of the study combination Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure (New York Association class II, III, or IV), angina pectoris requiring nitrate therapy, recent myocardial infarction (less than the last 6 months), cardiac arrhythmia, history of cerebrovascular accident (CVA) within 6 months; no uncontrolled hypertension (defined as blood pressure of > 160/90 mmHg) on medication or, history of peripheral vascular disease Ongoing treatment with warfarin unless the international normalized ratio (INR) is well controlled and below 4 History of psychiatric illness or social situations that would limit compliance with study requirements History of pancreatitis Human immunodeficiency virus (HIV)-positive patients receiving combination antiretroviral therapy are ineligible Systemic exposure to ketoconazole or other strong cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) isoenzyme inhibitors or inducers within 14 days prior to the start of study treatment; systemic exposure to aminodarone is not allowed within 1 year prior to the start of study treatment Ongoing treatment with sensitive cytochrome P450, family 1, subfamily A, polypeptide 2 (CYP1A2) substrate or CYP1A2 substrate with narrow therapeutic range at the start of study treatment Ongoing treatment with CYP3A4 substrate with narrow therapeutic range at the start of study treatment Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to day 1 of therapy Unwilling or unable to follow protocol requirements Any condition which in the investigator's opinion deems the patient an unsuitable candidate to receive study drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Saby George
Organizational Affiliation
Roswell Park Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Roswell Park Cancer Institute
City
Buffalo
State/Province
New York
ZIP/Postal Code
14263
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Sipuleucel-T With or Without Tasquinimod in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer

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