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Study of SXL01 in Patients With Metastatic Castration-Resistant Prostate Cancer (PROSTIRNA) (PROSTIRNA)

Primary Purpose

Prostatic Cancer, Castration-Resistant

Status
Withdrawn
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
SXL01
Sponsored by
Institut Claudius Regaud
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostatic Cancer, Castration-Resistant

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males age 18-80 years.
  2. ECOG performance status 0 - 1.
  3. Life expectancy of more than 3 months.
  4. Histologically confirmed prostate adenocarcinoma without neuroendocrine differentiation or small cell feature.
  5. Metastatic prostate cancer deemed to be unresponsive or refractory to hormone therapy.
  6. Detectable metastases by bone scan, CT scan or MRI.
  7. Surgically or medically castrated, with testosterone levels of < 50 ng/dL (< 2.0 nM). If the patient is being treated with LHRH agonists (patient who have not undergone orchiectomy), this therapy must have been initiated at least 4 weeks prior to Cycle 1 Day 1 and must be continued throughout the study.
  8. Documented prostate cancer progression as assessed by the investigator with one of the following:

    8.1. PSA progression defined by a minimum of two raising PSA levels with an interval of >1 week between each determination. The PSA values at the screening visit must be ≥ 1 µg/l (1 ng/mL).

    8.2. Radiographic progression of soft tissue disease by modified RECIST criteria 1.1 or of bone metastasis with two or more documented new bone lesions on a bone scan with or without PSA progression.

  9. Adequate hepatic, renal, and hematologic function: AST/ALT ≤ 2.5 X ULN; Normal bilirubin or ≤ 1.5 ULN in case of Gilbert's syndrome; Serum creatinine CL> 60 mL/min by the Cockcroft-Gault formula; Hemoglobin ≥ 10 g/dL; Absolute neutrophil count ≥ 1500/mm3, Platelet count ≥ 100,000/mm3.
  10. Patients must have recovered from the toxic effects of prior therapy (except alopecia) to NCIC CTCAE version 4.03 grade ≤1 and to baseline laboratory values as defined in inclusion criteria 9.
  11. If sexually active, willing to use barrier contraception during the treatment phase of the protocol.
  12. Written informed consent and any locally required authorization (e.g., Social security for France (Health Insurance)) obtained from the patient prior to performing any protocol-related procedures, including screening evaluations.
  13. Patient willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.

Exclusion Criteria:

  1. BMI ≥ 30.
  2. Evidence of brain metastasis.
  3. Patient seropositive for HIV and/or hepatitis B antigen positive and/or Hepatitis C antibody.
  4. Patient with history of autoimmune disease with the exception of vitiligo, psoriasis and controlled diabetes.
  5. Active suspected or prior documented autoimmune disease (including inflammatory bowel disease, celiac disease, irritable bowel syndrome, Wegener's granulomatosis and Hashimoto's thyroiditis).
  6. Patient with history of another malignancy, except for the following: skin cancers (melanoma excluded), previously treated cancer with no sign of disease for at least 3 years.
  7. Patient with concurrent infection or concurrent chronic or acute illness such as pulmonary (asthma or COPD), cardiac (NYHA class III or IV) or hepatic disease, or other illness considered by the principal investigator to constitute an unwarranted high risk for investigational drug administration will be excluded.
  8. Patient who has got a medical condition contraindicated for subcutaneous administration.
  9. Chronic systemic corticosteroid use within 4 weeks of the first administration of SXL01 (more than 2 weeks for a dose > 0.5 mg/kg of prednisolone).
  10. Treatment with any hormonal therapy or androgen antagonist, including flutamide, bicalutamide, nilutamide, ketoconazole, diethylstilbestrol, Abiraterone, or enzalutamide, within 4 weeks of the first administration with the exception of GnRH agonists.
  11. Patients requiring a continuous curative anti-coagulant treatment.
  12. Patients requiring a continuous bisphosphonate or denosumab treatment at inclusion. Note: the use of bisphosphonate and denosumab during the course of the study will be allowed.
  13. Planned to initiate any other anti-tumor therapies during the study.
  14. Radiation therapy or surgery within 4 weeks of the first administration of SXL01.
  15. Mental impairment (psychiatric illness/social situations) that may compromise the ability of the patient to give informed consent and comply with the requirements of the study.
  16. Patient who has forfeited his/her freedom by administrative or legal award or who is under guardianship.

Sites / Locations

  • Institut Claudius Regaud

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dose escalation

Arm Description

The standard method "3+3" will be used for dose escalation: the first 3 patients will be treated at level 1; consecutive cohorts of 3 to 6 patients will be treated with increasing doses of SXL01. Treatment will be administered until patient experiences unacceptable toxicity, PSA raising, progressive disease and/or treatment is discontinued at the discretion of the investigator or withdrawal of consent. Additional patients will be included at the Recommended Phase II Dose (RP2D) in the expansion phase.

Outcomes

Primary Outcome Measures

Incidence rate of Dose Limiting Toxicities (DLT) during the first cycle of treatment with SXL01.
Characteristics of Dose Limiting Toxicities (DLT) during the first cycle of treatment with SXL01.
Incidence and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs)
Tolerability and safety will be assessed through recording of adverse events using National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE) toxicity classification, monitoring biological parameters and vital signs measurement.

Secondary Outcome Measures

Preliminary efficacy endpoint : rate of patients presenting Prostate Specific Antigen (PSA) progression defined using Prostate Cancer Clinical Trial Working Group 3 (PCWG3)
Preliminary efficacy endpoint : rate of patients presenting clinical or radiological progression using Response Evaluation Criteria in Solid Tumours (RECIST) V1.1 as defined by PCWG3.
Pharmacokinetics - SXL01 plasma concentration

Full Information

First Posted
August 8, 2016
Last Updated
January 15, 2021
Sponsor
Institut Claudius Regaud
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1. Study Identification

Unique Protocol Identification Number
NCT02866916
Brief Title
Study of SXL01 in Patients With Metastatic Castration-Resistant Prostate Cancer (PROSTIRNA)
Acronym
PROSTIRNA
Official Title
Phase I Study of SXL01 in Patients With Metastatic Castration-Resistant Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Withdrawn
Why Stopped
Study cancelled
Study Start Date
September 2017 (Anticipated)
Primary Completion Date
June 2020 (Anticipated)
Study Completion Date
June 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institut Claudius Regaud

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a single site, open-label, non-randomized, dose escalation phase I study designed to evaluate the safety, the tolerability and the Recommended Phase II Dose (RP2D) of SXL01, a synthetic small interfering ribonucleic acid (RNA) targeting the androgen receptor messenger RNA (mRNA), in patients with metastatic castration-resistant prostate cancer. A standard method "3+3" will be used for dose escalation. A maximum of 30 patients will complete the dose-escalation phase of the study; 12 additional patients will be included at the RP2D in the expansion phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostatic Cancer, Castration-Resistant

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Dose escalation
Arm Type
Experimental
Arm Description
The standard method "3+3" will be used for dose escalation: the first 3 patients will be treated at level 1; consecutive cohorts of 3 to 6 patients will be treated with increasing doses of SXL01. Treatment will be administered until patient experiences unacceptable toxicity, PSA raising, progressive disease and/or treatment is discontinued at the discretion of the investigator or withdrawal of consent. Additional patients will be included at the Recommended Phase II Dose (RP2D) in the expansion phase.
Intervention Type
Drug
Intervention Name(s)
SXL01
Intervention Description
Treatment will be administered continuously over 24h through the subcutaneous route.
Primary Outcome Measure Information:
Title
Incidence rate of Dose Limiting Toxicities (DLT) during the first cycle of treatment with SXL01.
Time Frame
25 months
Title
Characteristics of Dose Limiting Toxicities (DLT) during the first cycle of treatment with SXL01.
Time Frame
25 months
Title
Incidence and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs)
Description
Tolerability and safety will be assessed through recording of adverse events using National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE) toxicity classification, monitoring biological parameters and vital signs measurement.
Time Frame
33 months
Secondary Outcome Measure Information:
Title
Preliminary efficacy endpoint : rate of patients presenting Prostate Specific Antigen (PSA) progression defined using Prostate Cancer Clinical Trial Working Group 3 (PCWG3)
Time Frame
33 months
Title
Preliminary efficacy endpoint : rate of patients presenting clinical or radiological progression using Response Evaluation Criteria in Solid Tumours (RECIST) V1.1 as defined by PCWG3.
Time Frame
33 months
Title
Pharmacokinetics - SXL01 plasma concentration
Time Frame
Cycle 1: pre-dose (T0) then 0.5, 3, 6, 24 hours post dose on day 1 ; T0 on days 4, 8, 15, 22. Subsequent cycles : before administration on day 1 (CXD1). The day of treatment discontinuation (CXDX) : 0.5, 1, 2, 24 hours post-dose.

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males age 18-80 years. ECOG performance status 0 - 1. Life expectancy of more than 3 months. Histologically confirmed prostate adenocarcinoma without neuroendocrine differentiation or small cell feature. Metastatic prostate cancer deemed to be unresponsive or refractory to hormone therapy. Detectable metastases by bone scan, CT scan or MRI. Surgically or medically castrated, with testosterone levels of < 50 ng/dL (< 2.0 nM). If the patient is being treated with LHRH agonists (patient who have not undergone orchiectomy), this therapy must have been initiated at least 4 weeks prior to Cycle 1 Day 1 and must be continued throughout the study. Documented prostate cancer progression as assessed by the investigator with one of the following: 8.1. PSA progression defined by a minimum of two raising PSA levels with an interval of >1 week between each determination. The PSA values at the screening visit must be ≥ 1 µg/l (1 ng/mL). 8.2. Radiographic progression of soft tissue disease by modified RECIST criteria 1.1 or of bone metastasis with two or more documented new bone lesions on a bone scan with or without PSA progression. Adequate hepatic, renal, and hematologic function: AST/ALT ≤ 2.5 X ULN; Normal bilirubin or ≤ 1.5 ULN in case of Gilbert's syndrome; Serum creatinine CL> 60 mL/min by the Cockcroft-Gault formula; Hemoglobin ≥ 10 g/dL; Absolute neutrophil count ≥ 1500/mm3, Platelet count ≥ 100,000/mm3. Patients must have recovered from the toxic effects of prior therapy (except alopecia) to NCIC CTCAE version 4.03 grade ≤1 and to baseline laboratory values as defined in inclusion criteria 9. If sexually active, willing to use barrier contraception during the treatment phase of the protocol. Written informed consent and any locally required authorization (e.g., Social security for France (Health Insurance)) obtained from the patient prior to performing any protocol-related procedures, including screening evaluations. Patient willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up. Exclusion Criteria: BMI ≥ 30. Evidence of brain metastasis. Patient seropositive for HIV and/or hepatitis B antigen positive and/or Hepatitis C antibody. Patient with history of autoimmune disease with the exception of vitiligo, psoriasis and controlled diabetes. Active suspected or prior documented autoimmune disease (including inflammatory bowel disease, celiac disease, irritable bowel syndrome, Wegener's granulomatosis and Hashimoto's thyroiditis). Patient with history of another malignancy, except for the following: skin cancers (melanoma excluded), previously treated cancer with no sign of disease for at least 3 years. Patient with concurrent infection or concurrent chronic or acute illness such as pulmonary (asthma or COPD), cardiac (NYHA class III or IV) or hepatic disease, or other illness considered by the principal investigator to constitute an unwarranted high risk for investigational drug administration will be excluded. Patient who has got a medical condition contraindicated for subcutaneous administration. Chronic systemic corticosteroid use within 4 weeks of the first administration of SXL01 (more than 2 weeks for a dose > 0.5 mg/kg of prednisolone). Treatment with any hormonal therapy or androgen antagonist, including flutamide, bicalutamide, nilutamide, ketoconazole, diethylstilbestrol, Abiraterone, or enzalutamide, within 4 weeks of the first administration with the exception of GnRH agonists. Patients requiring a continuous curative anti-coagulant treatment. Patients requiring a continuous bisphosphonate or denosumab treatment at inclusion. Note: the use of bisphosphonate and denosumab during the course of the study will be allowed. Planned to initiate any other anti-tumor therapies during the study. Radiation therapy or surgery within 4 weeks of the first administration of SXL01. Mental impairment (psychiatric illness/social situations) that may compromise the ability of the patient to give informed consent and comply with the requirements of the study. Patient who has forfeited his/her freedom by administrative or legal award or who is under guardianship.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Pierre DELORD, MD, PhD
Organizational Affiliation
IUCT-O
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institut Claudius Regaud
City
Toulouse
ZIP/Postal Code
31059
Country
France

12. IPD Sharing Statement

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Study of SXL01 in Patients With Metastatic Castration-Resistant Prostate Cancer (PROSTIRNA)

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