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PLX3397, Radiation Therapy, and Antihormone Therapy in Treating Patients With Intermediate- or High-Risk Prostate Cancer

Primary Purpose

Stage I Prostate Adenocarcinoma, Stage II Prostate Adenocarcinoma, Stage III Prostate Adenocarcinoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Antiandrogen Therapy
Laboratory Biomarker Analysis
Multitargeted Tyrosine Kinase Inhibitor PLX3397
Radiation Therapy
Sponsored by
Barbara Ann Karmanos Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stage I Prostate Adenocarcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Pathologically confirmed diagnosis of prostate adenocarcinoma
  • Must have confirmed viable archival prostate biopsy tissue available as per Section 8.1 (this will be collected for patients going on study after the MTD has been reached
  • Intermediate or high risk prostate cancer patients who are candidates for radiation therapy:
  • Gleason >7 or
  • Clinical or pathological > T2b disease or
  • PSA > 10 ng/mL
  • No evidence of metastatic disease by clinical and radiological staging
  • Eastern Cooperative Oncology Group (ECOG) Performance Status 0 to 1
  • No standard contraindications to radiation therapy including prior significant radiation therapy, inflammatory bowel disease, irritable bowel syndrome or collagen vascular disease
  • Prior history of up to 8 weeks of androgen deprivation therapy defined as lutenizing-hormone releasing hormone (LHRH) or other medical castration therapy prior to registration is acceptable. This will be in addition to the 6 months of ADT on study.
  • Life expectancy of at least 3 months
  • Adequate hematologic, hepatic, and renal function as defined by:
  • Absolute neutrophil count ≥ 1.5 × 109/L
  • Hemoglobin > 10 g/dL
  • Platelet count ≥ 100 × 109/L
  • AST and ALT ≤ upper limit of normal (ULN)
  • TBil and DBil ≤ ULN with an exception of patients with confirmed Gilbert's syndrome. For patients with confirmed Gilbert's syndrome, the TBil should be ≤ 1.5 × ULN
  • Serum creatinine ≤ 1.5 × ULN
  • Must have ability to take oral medication
  • Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures
  • Ability to understand and willingness to sign a written informed consent document
  • Willingness to be treated with radiation therapy and androgen deprivation Therapy

Exclusion Criteria:

  • Investigational drug use within 28 days of the first dose of PLX3397 or concurrently
  • At Screening QTcF ≥450 msec
  • Patients with serious illnesses, uncontrolled infection, medical conditions, or other medical history including abnormal laboratory results, which in the investigator's opinion would be likely to interfere with a patient's participation in the study, or with the interpretation of the results
  • Refractory nausea and vomiting, malabsorption, biliary shunt, or significant bowel resection that would preclude adequate absorption of study drug
  • Known active or chronic human immunodeficiency virus (HIV) or hepatitis C virus (HCV) infection, or positive hepatitis B (Hep B) surface antigen. Prior hepatitis infection that has been treated with highly effective therapy with no evidence of residual infection and with normal liver function (ALT, AST, total and direct bilirubin ≤ ULN) is allowed.
  • Hepatobiliary diseases including biliary tract diseases, autoimmune hepatitis, inflammation, fibrosis, cirrhosis of liver caused by viral, alcohol, or genetic reasons. Gilbert's disease is allowed if TBil is ≤ 1.5 × ULN.
  • Active cancer (either concurrent or within the last 3 years) that requires nonsurgical therapy (e.g. chemotherapy or radiation therapy), with the exception of surgically treated basal or squamous cell carcinoma of the skin, or melanoma insitu.
  • AST/ALT > 2.5X ULN or >5X ULN in the presence of liver metastases.
  • Current treatment with anti-androgen is allowed for a maximum of one month to prevent flare response with ADT
  • Concomitant use of acid reducing agents (e.g., proton pump inhibitors, H2 receptor antagonists, antacids)
  • Concomitant use of strong and moderate CYP3A4 inhibitors and inducers
  • Patients currently receiving anticancer therapies or who have received anticancer therapies within 4 weeks of the start of the study drug (including chemotherapy, radiation therapy, antibody based therapy, etc.)

Sites / Locations

  • Wayne State University/Karmanos Cancer Institute
  • Karmanos Cancer Institute at McLaren Northern Michigan - Petoskey Radiation Oncology
  • Karmanos Cancer Institute at McLaren Northern Michigan- Petoskey Medical Oncology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (PLX3397, radiation therapy, ADT)

Arm Description

Patients receive multitargeted tyrosine kinase inhibitor PLX3397 PO BID for 6 months, undergo radiation therapy for 2 months daily (Monday-Friday) beginning at month 3, and undergo ADT with leuprolide acetate, goserelin acetate, or degarelix injections in any month.

Outcomes

Primary Outcome Measures

Grade of specific types of toxicity
Frequency distributions will be generated by dose level, and overall.
MTD of multitargeted tyrosine kinase inhibitor PLX3397, determined according to incidence of DLT

Secondary Outcome Measures

Change in metabolic syndrome parameters
Descriptive statistics will be used to summarize the 7 metabolic syndrome parameters), and changes in them. These statistics will be calculated only for patients treated at the MTD, where the correlatives are measured, and will be generated for all 12 MTD patients combined, and separately by MTD randomization arm.
Change in PSA levels
PSA levels (and their change) will be tabulated for individual patients, regardless of dose level. Descriptive statistics will be used to summarize PSA, and changes in it. Serial PSA levels will be displayed using spaghetti plots, and changes in PSA using waterfall plots.
Change TAM levels as measured by immunohistochemistry
Frequency distributions will be generated for patients treated at the MTD. Descriptive statistics will be used to summarize all markers, and changes in them.

Full Information

First Posted
June 11, 2015
Last Updated
October 4, 2020
Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT02472275
Brief Title
PLX3397, Radiation Therapy, and Antihormone Therapy in Treating Patients With Intermediate- or High-Risk Prostate Cancer
Official Title
Targeting the Prostatic Tumor Microenvironment With PLX3397, a Tumor-Associated Macrophage Inhibitor in Men With Unfavorable Risk Prostate Cancer Undergoing Radiation Therapy and Androgen Deprivation Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
August 5, 2019 (Actual)
Study Completion Date
August 5, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Barbara Ann Karmanos Cancer Institute
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I trial studies the side effects and best dose of multitargeted tyrosine kinase inhibitor PLX3397 (PLX3397) when given together with radiation therapy and antihormone therapy in treating patients with prostate cancer that is at intermediate or high risk of spreading. Multitargeted tyrosine kinase inhibitor PLX3397 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth, and may also help the radiation therapy work better. Radiation therapy uses high-energy x-rays to kill tumor cells. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as leuprolide acetate, goserelin acetate, or degarelix, may lessen the amount of androgens made by the body. Giving multitargeted tyrosine kinase inhibitor PLX3397 with radiation therapy and antihormone therapy may be a better treatment for prostate cancer.
Detailed Description
PRIMARY OBJECTIVES: I. To conduct a phase I, dose escalation trial with a primary objective of establishing the maximum tolerated dose (MTD) and the dose limiting toxicity (DLT). SECONDARY OBJECTIVES: I. To assess the effects of radiation therapy (RT), androgen deprivation therapy (ADT), and PLX3397 (at its MTD) on tumor-associated macrophages (TAMs) in the prostate biopsy after treatment. OUTLINE: This is a dose-escalation study of multitargeted tyrosine kinase inhibitor PLX3397. Patients receive multitargeted tyrosine kinase inhibitor PLX3397 orally (PO) twice daily (BID) for 6 months, undergo radiation therapy for 2 months daily (Monday-Friday) beginning at month 3, and undergo ADT with leuprolide acetate, goserelin acetate, or degarelix injections in any month. After completion of study treatment, patients are followed up at 20-30 days and then every 12 weeks thereafter.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage I Prostate Adenocarcinoma, Stage II Prostate Adenocarcinoma, Stage III Prostate Adenocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (PLX3397, radiation therapy, ADT)
Arm Type
Experimental
Arm Description
Patients receive multitargeted tyrosine kinase inhibitor PLX3397 PO BID for 6 months, undergo radiation therapy for 2 months daily (Monday-Friday) beginning at month 3, and undergo ADT with leuprolide acetate, goserelin acetate, or degarelix injections in any month.
Intervention Type
Drug
Intervention Name(s)
Antiandrogen Therapy
Other Intervention Name(s)
ADT, Androgen Deprivation Therapy, Anti-androgen Therapy, Anti-androgen Treatment, Antiandrogen Treatment, Hormone Deprivation Therapy, Hormone-Deprivation Therapy
Intervention Description
Undergo ADT with leuprolide acetate, goserelin acetate, or degarelix
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Drug
Intervention Name(s)
Multitargeted Tyrosine Kinase Inhibitor PLX3397
Other Intervention Name(s)
PLX3397
Intervention Description
Given PO
Intervention Type
Radiation
Intervention Name(s)
Radiation Therapy
Other Intervention Name(s)
Cancer Radiotherapy, Irradiate, Irradiated, Irradiation, RADIATION, Radiotherapeutics, Radiotherapy, RT, Therapy, Radiation
Intervention Description
Undergo radiation therapy
Primary Outcome Measure Information:
Title
Grade of specific types of toxicity
Description
Frequency distributions will be generated by dose level, and overall.
Time Frame
Up to 30 days after end of study treatment
Title
MTD of multitargeted tyrosine kinase inhibitor PLX3397, determined according to incidence of DLT
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Change in metabolic syndrome parameters
Description
Descriptive statistics will be used to summarize the 7 metabolic syndrome parameters), and changes in them. These statistics will be calculated only for patients treated at the MTD, where the correlatives are measured, and will be generated for all 12 MTD patients combined, and separately by MTD randomization arm.
Time Frame
Baseline to month 7
Title
Change in PSA levels
Description
PSA levels (and their change) will be tabulated for individual patients, regardless of dose level. Descriptive statistics will be used to summarize PSA, and changes in it. Serial PSA levels will be displayed using spaghetti plots, and changes in PSA using waterfall plots.
Time Frame
Baseline to up to month 7
Title
Change TAM levels as measured by immunohistochemistry
Description
Frequency distributions will be generated for patients treated at the MTD. Descriptive statistics will be used to summarize all markers, and changes in them.
Time Frame
Baseline to month 2

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically confirmed diagnosis of prostate adenocarcinoma Must have confirmed viable archival prostate biopsy tissue available as per Section 8.1 (this will be collected for patients going on study after the MTD has been reached Intermediate or high risk prostate cancer patients who are candidates for radiation therapy: Gleason >7 or Clinical or pathological > T2b disease or PSA > 10 ng/mL No evidence of metastatic disease by clinical and radiological staging Eastern Cooperative Oncology Group (ECOG) Performance Status 0 to 1 No standard contraindications to radiation therapy including prior significant radiation therapy, inflammatory bowel disease, irritable bowel syndrome or collagen vascular disease Prior history of up to 8 weeks of androgen deprivation therapy defined as lutenizing-hormone releasing hormone (LHRH) or other medical castration therapy prior to registration is acceptable. This will be in addition to the 6 months of ADT on study. Life expectancy of at least 3 months Adequate hematologic, hepatic, and renal function as defined by: Absolute neutrophil count ≥ 1.5 × 109/L Hemoglobin > 10 g/dL Platelet count ≥ 100 × 109/L AST and ALT ≤ upper limit of normal (ULN) TBil and DBil ≤ ULN with an exception of patients with confirmed Gilbert's syndrome. For patients with confirmed Gilbert's syndrome, the TBil should be ≤ 1.5 × ULN Serum creatinine ≤ 1.5 × ULN Must have ability to take oral medication Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures Ability to understand and willingness to sign a written informed consent document Willingness to be treated with radiation therapy and androgen deprivation Therapy Exclusion Criteria: Investigational drug use within 28 days of the first dose of PLX3397 or concurrently At Screening QTcF ≥450 msec Patients with serious illnesses, uncontrolled infection, medical conditions, or other medical history including abnormal laboratory results, which in the investigator's opinion would be likely to interfere with a patient's participation in the study, or with the interpretation of the results Refractory nausea and vomiting, malabsorption, biliary shunt, or significant bowel resection that would preclude adequate absorption of study drug Known active or chronic human immunodeficiency virus (HIV) or hepatitis C virus (HCV) infection, or positive hepatitis B (Hep B) surface antigen. Prior hepatitis infection that has been treated with highly effective therapy with no evidence of residual infection and with normal liver function (ALT, AST, total and direct bilirubin ≤ ULN) is allowed. Hepatobiliary diseases including biliary tract diseases, autoimmune hepatitis, inflammation, fibrosis, cirrhosis of liver caused by viral, alcohol, or genetic reasons. Gilbert's disease is allowed if TBil is ≤ 1.5 × ULN. Active cancer (either concurrent or within the last 3 years) that requires nonsurgical therapy (e.g. chemotherapy or radiation therapy), with the exception of surgically treated basal or squamous cell carcinoma of the skin, or melanoma insitu. AST/ALT > 2.5X ULN or >5X ULN in the presence of liver metastases. Current treatment with anti-androgen is allowed for a maximum of one month to prevent flare response with ADT Concomitant use of acid reducing agents (e.g., proton pump inhibitors, H2 receptor antagonists, antacids) Concomitant use of strong and moderate CYP3A4 inhibitors and inducers Patients currently receiving anticancer therapies or who have received anticancer therapies within 4 weeks of the start of the study drug (including chemotherapy, radiation therapy, antibody based therapy, etc.)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elisabeth I. Heath, M.D.
Organizational Affiliation
Barbara Ann Karmanos Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wayne State University/Karmanos Cancer Institute
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
Karmanos Cancer Institute at McLaren Northern Michigan - Petoskey Radiation Oncology
City
Petoskey
State/Province
Michigan
ZIP/Postal Code
49770
Country
United States
Facility Name
Karmanos Cancer Institute at McLaren Northern Michigan- Petoskey Medical Oncology
City
Petoskey
State/Province
Michigan
ZIP/Postal Code
49770
Country
United States

12. IPD Sharing Statement

Learn more about this trial

PLX3397, Radiation Therapy, and Antihormone Therapy in Treating Patients With Intermediate- or High-Risk Prostate Cancer

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