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A Study to Evaluate the Safety, Tolerability and Efficacy of a Liproca® Depot Injection in Patients With Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
2-Hydroxyflutamide Depot
Sponsored by
Lidds AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent prior to any study specific procedures being performed
  • 18 - 80 years of age, inclusive
  • Assigned to Active Surveillance
  • Histologically confirmed, localized prostate cancer within 24 months of Screening
  • Gleason score 3+3 or 3+4 with one or more of the following characteristics:

PSA > 6.0 μg/L (ng/mL) and PSA density > 0.15; PSA > 10.0 μg/L and < 20 μg/L (ng/mL); Any systematic core > 50% involvement; Any PI-RADS score 4 or 5 on MRI; Any Gleason grade 4, Men of African descent

  • Patient has a negative bone scan within the last 12 months
  • Patient is able to have an MRI
  • Prostate volume ≤ 80 mL (measured by MRI within 12 months of Screening or has been scheduled for an MRI prior to Screening)
  • eGFR ≥ 30 mL/min, using the Cockcroft - Gault Equation: = [{(140 - age in years) x (weight in kg)} x 1.23] / serum Creatinine in micromol/l
  • AST, ALT and ALP ≤ 1.5 times upper limit of normal
  • Patient must be willing to comply with all study procedures
  • Patients must agree to the use of medically acceptable methods of contraception, including non-hormonal intrauterine device (IUD) or double barrier method (condom with foam or vaginal spermicidal suppository, diaphragm with spermicide) for the duration of the study (24 weeks), unless the patient and/or their partner has been surgically sterilized

Exclusion Criteria:

  • PSA > 20 μg/L (ng/mL)
  • Previous or ongoing hormonal therapy for prostate cancer
  • Positive urine culture before treatment with prophylactic antibiotics
  • Ongoing or previous therapy with finasteride or dutasteride in the last 3 months
  • Ongoing or previous invasive therapy for benign prostate hyperplasia (BPH) (e.g. TURP,TUMT, HIFU, etc.)
  • Use of pacemaker or other implanted electronic devices
  • Metal implant in the pelvis (e.g. hip replacement) that may affect the MRI of the prostate
  • Allergy to Liproca® Depot and its ingredients
  • Severe micturition symptoms (I-PSS >15 or residual urine volume > 150 mL) confirmed by repeat measurement or Qmax< 12 mL/s
  • Ongoing therapy with the anticoagulant Acetyl Salicylic Acid (ASA) (more than 100mg/day) as preventive anti-thrombotic therapy should be withdrawn temporarily before treatment with Liproca® Depot, as determined by the Investigator. Other anticoagulants should be withdrawn in cooperation with the treating physician
  • Use of any previous focal prostate cancer treatment, such as transurethral resection, cryotherapy, high intensity frequency ultrasound (HIFU) and/or photodynamic therapy
  • Concomitant systemic treatment with corticosteroids or immune modulating agents
  • Known immunosuppressive disease (e.g. HIV, Type II Diabetes). Patients with well controlled Type II Diabetes may be included, as determined by Investigator
  • Simultaneous participation in any other study involving an investigational product or device,or having participated in a prostate cancer study within the last 12 months prior to starting treatment with Liproca® Depot
  • Infection in WHO Risk Group 2, 3 or 4

Sites / Locations

  • Nova Scotia Health Authority
  • Jonathan Giddens Medicine Professional Corporation
  • G. Kenneth Jansz Medicine Professional Corporation
  • The Fe/Male Health Centres
  • Sunnybrook Health Sciences Centre
  • CIUSSS de l'Estrie - CHUS
  • Helsinki University Hospital
  • Tampere University Hospital
  • Hospital of Lithuanian University of Health Sciences
  • National Cancer Institute - Oncourology Department

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Stage I: Dose = 35% of prostate volume

Stage I: Dose = 45% of prostate volume

Stage II: Dose = 16mL

Stage II: Dose = 20mL

Arm Description

Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 35 % of their prostate volume.

Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 45 % of their prostate volume.

Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 16mL

Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 20mL

Outcomes

Primary Outcome Measures

Highest Tolerable Dose of Liproca Depot
To define the highest tolerable dose of Liproca Depot for transrectal injection into the prostate.

Secondary Outcome Measures

Liproca Depot Effect on Prostate Specific Antigen Levels
To determine the absolute level and % decrease of PSA level at Week 8, 16, 20 and 24, and PSA nadir.
Liproca Depot Effect on Prostate Volume
To determine the effect on prostate volume at Week 20 after treatment with one of four doses of Liproca Depot based on an MRI evaluation. Measured by %decrease versus Baseline and as absolute values.
Evaluation of Lesions
MRI evaluation of Lesions based on PI-RADS (Prostate Imaging Reporting and Data System) score 20 weeks after treatment with one of four doses of Liproca Depot.
Quality of Life (QoL) Questionnaire Score
Assessment of QoL Questionnaire scores at Baseline, Week 8,16,20 and 24 after treatment with one of four doses of Liproca Depot.
Micturition Status using the International Prostate Symptom Score (I-PSS)
Micturition status will be assessed using the I-PSS Questionnaire at Week 8, 20 and 24 after treatment with one of four doses of Liproca Depot.
Frequency of Adverse Events
All adverse events related to Liproca Depot or its administration, incidence of AEs, withdrawals due to AEs and all Serious Adverse Events (SAEs) will be assessed. All adverse events will be reported and followed until resolved or until, in the Investigator's opinion, the condition has become stable and is unlikely to change further.
Change in Testosterone Levels
Testosterone levels (nmol/L) will be assessed at Baseline, Week 8 and 24 after treatment with one of four doses of Liproca Depot.
Systematic Exposure of 2-hydroxyflutamide
To examine the systematic exposure of 2-hydroxyflutamide at Baseline, Hour 2, Day 2,4,7 and 14, week 8 and end of study for all subjects in Phase I and a subset of 12 subjects in Stage II.
Pharmacokinetics of 2-hydroxyflutamide
To examine the pharmacokinetics of 2-hydroxyflutamide at Baseline, Hour 2, Day 2,4,7 and 14, week 8 and end of study for all subjects in Phase I and a subset of 12 subjects in Stage II.

Full Information

First Posted
November 1, 2017
Last Updated
December 18, 2020
Sponsor
Lidds AB
Collaborators
CMX Research
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1. Study Identification

Unique Protocol Identification Number
NCT03348527
Brief Title
A Study to Evaluate the Safety, Tolerability and Efficacy of a Liproca® Depot Injection in Patients With Prostate Cancer
Official Title
A Single Blind, Two-Stage Dose Finding Study to Evaluate the Safety, Tolerability and Efficacy of a Single Liproca® Depot Injection Into the Prostate in Patients With Localized Prostate Cancer, Assigned to Active Surveillance Who Are at High Risk for Disease Progression (Followed by an Open Label Extension With a Repeat Injection (Optional)).
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
May 12, 2017 (Actual)
Primary Completion Date
October 30, 2020 (Actual)
Study Completion Date
November 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lidds AB
Collaborators
CMX Research

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
A Single Blind, Two-Stage Dose Finding Study to Evaluate the Safety, Tolerability and Efficacy of a Single Liproca® Depot Injection into the Prostate in Patients with Localized Prostate Cancer,Assigned to Active Surveillance who are at High Risk for Disease Progression (followed by an Open Label Extension with a Repeat Injection (Optional))
Detailed Description
Patients assigned to Active Surveillance and who have fulfilled all inclusion criteria will receive a prophylactic antibiotic and a local anaesthetic (according to the Investigator's Standard of Care) prior to administration of Liproca® Depot. 60 subjects will be enrolled. The Single Dose Study will be conducted in two stages: In Stage I, 20 subjects will be randomized into two groups to receive one dose of Liproca® Depot equal to 35% (Cohort 1) or 45 % (Cohort 2) of their prostate volume (mL) (N=10:10). Two weeks after all subjects have received their initial dose, the Data Safety Monitoring Board (DSMB) will review the subjects' safety and tolerability data over the first 14 days after receiving treatment. In Stage II, 40 subjects will be randomized to receive either 16mL (Cohort 3) or 20mL (Cohort 4) of Liproca® Depot. All subjects in Stage I and Stage II will be followed for 24 weeks. Subjects who complete the Single Dose Study and who experience no safety or tolerability issues, as determined by the Investigator, may be offered an option to participate in the Open Label Extension Study (OLE). Subjects enrolled in the OLE will be observed for PSA recurrence every 8 weeks. If PSA recurrence is confirmed (defined as a PSA level exceeding at least 100 % of Baseline value) subjects will receive a second treatment of Liproca® Depot. The dose will be injected into the tumour focus/foci and in close proximity to the tumour, based on a prostate biopsy (and MRI, if applicable), using a TRUS for guidance. Stage I subjects who received 35% volume of Liproca® Depot will receive 16 mL and subjects who received 45% volume of Liproca® Depot will receive 20 mL. Stage II subjects will receive the same dose of Liproca® Depot that was administered in the first treatment. Subjects in the OLE receiving a second injection will be followed up for an additional 24 weeks for safety, tolerability and efficacy. After this period, subjects may undergo MRI imaging and a prostate biopsy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Stage I: 20 Subjects will be enrolled into one of two groups, each receiving a single dose of Liproca®Depot. The target treatment dose will be 35% (Cohort 1) or 45% (Cohort 2) of the prostate volume (mL). Stage II: 40 subjects will be randomized to receive either 16 mL (Cohort 3) or 20mL (Cohort 4) of Liproca®Depot.
Masking
Participant
Masking Description
Participant is blinded to whether they are receiving a treatment dose of 35% or 45% of total prostate volume in stage I or 16mL or 20mL in stage II.
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stage I: Dose = 35% of prostate volume
Arm Type
Experimental
Arm Description
Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 35 % of their prostate volume.
Arm Title
Stage I: Dose = 45% of prostate volume
Arm Type
Experimental
Arm Description
Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 45 % of their prostate volume.
Arm Title
Stage II: Dose = 16mL
Arm Type
Experimental
Arm Description
Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 16mL
Arm Title
Stage II: Dose = 20mL
Arm Type
Experimental
Arm Description
Subject will be randomized into a group receiving one dose of 2-hydroxyflutamide depot (Liproca® Depot) equal to 20mL
Intervention Type
Drug
Intervention Name(s)
2-Hydroxyflutamide Depot
Other Intervention Name(s)
Liproca® Depot Injection
Intervention Description
Liproca® Depot is a depot formulation containing a bioresorbable, controlled-release,formulation of the nonsteroidal antiandrogen 2-hydroxyflutamide
Primary Outcome Measure Information:
Title
Highest Tolerable Dose of Liproca Depot
Description
To define the highest tolerable dose of Liproca Depot for transrectal injection into the prostate.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Liproca Depot Effect on Prostate Specific Antigen Levels
Description
To determine the absolute level and % decrease of PSA level at Week 8, 16, 20 and 24, and PSA nadir.
Time Frame
24 weeks
Title
Liproca Depot Effect on Prostate Volume
Description
To determine the effect on prostate volume at Week 20 after treatment with one of four doses of Liproca Depot based on an MRI evaluation. Measured by %decrease versus Baseline and as absolute values.
Time Frame
20 weeks
Title
Evaluation of Lesions
Description
MRI evaluation of Lesions based on PI-RADS (Prostate Imaging Reporting and Data System) score 20 weeks after treatment with one of four doses of Liproca Depot.
Time Frame
20 weeks
Title
Quality of Life (QoL) Questionnaire Score
Description
Assessment of QoL Questionnaire scores at Baseline, Week 8,16,20 and 24 after treatment with one of four doses of Liproca Depot.
Time Frame
24 weeks
Title
Micturition Status using the International Prostate Symptom Score (I-PSS)
Description
Micturition status will be assessed using the I-PSS Questionnaire at Week 8, 20 and 24 after treatment with one of four doses of Liproca Depot.
Time Frame
24 weeks
Title
Frequency of Adverse Events
Description
All adverse events related to Liproca Depot or its administration, incidence of AEs, withdrawals due to AEs and all Serious Adverse Events (SAEs) will be assessed. All adverse events will be reported and followed until resolved or until, in the Investigator's opinion, the condition has become stable and is unlikely to change further.
Time Frame
24 weeks
Title
Change in Testosterone Levels
Description
Testosterone levels (nmol/L) will be assessed at Baseline, Week 8 and 24 after treatment with one of four doses of Liproca Depot.
Time Frame
24 weeks
Title
Systematic Exposure of 2-hydroxyflutamide
Description
To examine the systematic exposure of 2-hydroxyflutamide at Baseline, Hour 2, Day 2,4,7 and 14, week 8 and end of study for all subjects in Phase I and a subset of 12 subjects in Stage II.
Time Frame
24 weeks
Title
Pharmacokinetics of 2-hydroxyflutamide
Description
To examine the pharmacokinetics of 2-hydroxyflutamide at Baseline, Hour 2, Day 2,4,7 and 14, week 8 and end of study for all subjects in Phase I and a subset of 12 subjects in Stage II.
Time Frame
24 weeks

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: Signed informed consent prior to any study specific procedures being performed 18 - 80 years of age, inclusive Assigned to Active Surveillance Histologically confirmed, localized prostate cancer within 24 months of Screening Gleason score 3+3 or 3+4 with one or more of the following characteristics: PSA > 6.0 μg/L (ng/mL) and PSA density > 0.15; PSA > 10.0 μg/L and < 20 μg/L (ng/mL); Any systematic core > 50% involvement; Any PI-RADS score 4 or 5 on MRI; Any Gleason grade 4, Men of African descent Patient has a negative bone scan within the last 12 months Patient is able to have an MRI Prostate volume ≤ 80 mL (measured by MRI within 12 months of Screening or has been scheduled for an MRI prior to Screening) eGFR ≥ 30 mL/min, using the Cockcroft - Gault Equation: = [{(140 - age in years) x (weight in kg)} x 1.23] / serum Creatinine in micromol/l AST, ALT and ALP ≤ 1.5 times upper limit of normal Patient must be willing to comply with all study procedures Patients must agree to the use of medically acceptable methods of contraception, including non-hormonal intrauterine device (IUD) or double barrier method (condom with foam or vaginal spermicidal suppository, diaphragm with spermicide) for the duration of the study (24 weeks), unless the patient and/or their partner has been surgically sterilized Exclusion Criteria: PSA > 20 μg/L (ng/mL) Previous or ongoing hormonal therapy for prostate cancer Positive urine culture before treatment with prophylactic antibiotics Ongoing or previous therapy with finasteride or dutasteride in the last 3 months Ongoing or previous invasive therapy for benign prostate hyperplasia (BPH) (e.g. TURP,TUMT, HIFU, etc.) Use of pacemaker or other implanted electronic devices Metal implant in the pelvis (e.g. hip replacement) that may affect the MRI of the prostate Allergy to Liproca® Depot and its ingredients Severe micturition symptoms (I-PSS >15 or residual urine volume > 150 mL) confirmed by repeat measurement or Qmax< 12 mL/s Ongoing therapy with the anticoagulant Acetyl Salicylic Acid (ASA) (more than 100mg/day) as preventive anti-thrombotic therapy should be withdrawn temporarily before treatment with Liproca® Depot, as determined by the Investigator. Other anticoagulants should be withdrawn in cooperation with the treating physician Use of any previous focal prostate cancer treatment, such as transurethral resection, cryotherapy, high intensity frequency ultrasound (HIFU) and/or photodynamic therapy Concomitant systemic treatment with corticosteroids or immune modulating agents Known immunosuppressive disease (e.g. HIV, Type II Diabetes). Patients with well controlled Type II Diabetes may be included, as determined by Investigator Simultaneous participation in any other study involving an investigational product or device,or having participated in a prostate cancer study within the last 12 months prior to starting treatment with Liproca® Depot Infection in WHO Risk Group 2, 3 or 4
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Casey, MD
Organizational Affiliation
CMX Research
Official's Role
Study Director
Facility Information:
Facility Name
Nova Scotia Health Authority
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 2Y9
Country
Canada
Facility Name
Jonathan Giddens Medicine Professional Corporation
City
Brampton
State/Province
Ontario
ZIP/Postal Code
L6T 4S5
Country
Canada
Facility Name
G. Kenneth Jansz Medicine Professional Corporation
City
Burlington
State/Province
Ontario
ZIP/Postal Code
L7N 3V2
Country
Canada
Facility Name
The Fe/Male Health Centres
City
Oakville
State/Province
Ontario
ZIP/Postal Code
L6H 3 P1
Country
Canada
Facility Name
Sunnybrook Health Sciences Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4N 3M5
Country
Canada
Facility Name
CIUSSS de l'Estrie - CHUS
City
Sherbrooke
State/Province
Quebec
ZIP/Postal Code
J1H 5N4
Country
Canada
Facility Name
Helsinki University Hospital
City
Helsinki
ZIP/Postal Code
FIN-00100
Country
Finland
Facility Name
Tampere University Hospital
City
Tampere
ZIP/Postal Code
FI-33521
Country
Finland
Facility Name
Hospital of Lithuanian University of Health Sciences
City
Kaunas
ZIP/Postal Code
50161
Country
Lithuania
Facility Name
National Cancer Institute - Oncourology Department
City
Vilnius
ZIP/Postal Code
08660
Country
Lithuania

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Safety, Tolerability and Efficacy of a Liproca® Depot Injection in Patients With Prostate Cancer

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