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The Efficacy and Safety of Docetaxel Combined With Platinum for Metastatic Hormone-sensitive Prostate Cancer

Primary Purpose

Hormone Sensitive Metastatic Prostate Cancer, DNA Damage Repair Deficiency, Chemotherapy Effect

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Docetaxel
Prednisolone Acetate
Platinum-based drugs
Sponsored by
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hormone Sensitive Metastatic Prostate Cancer

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients must be ≥ 40 and ≤75 years of age.
  • All patients must have been histologically diagnozed of prostate cancer.
  • Metastatic disease confirmed by imaging: positive bone scan, or soft tissue or visceral metastases confirmed by abdominal/pelvic/chest contrast CT or MRI or PSMA PET-CT scan.
  • Participants who were treated with androgen deprivation therapy (ADT) (LHRH agonist/antagonist or orchectomy) with or without first-generation anti-androgens within 12 weeks prior to random assignment must maintain serum testosterone castration levels, i.e., ≤50 ng/dL (≤ 1.75 nmol/L) during the study period. First-generation anti-androgens must be discontinued at least 1 day before the start of study therapy.
  • Participants must carry one of the following DNA repair gene mutation: 1) HRR-related genes: ATM, BARD1, BRCA1, BRCA2, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, RAD51B, RAD51C, RAD51D, RAD54L; 2) Lynch syndrome-related genes: EPCAM, MLH1, MSH2, MSH6, PMS2.
  • Eastern Cooperative Oncology Group (ECOG) physical condition score ≤1.
  • Patients must have adequate hematologic function, hepatic function and renal function within 28 days prior to registration.
  • Patients must participate voluntarily and sign an informed consent form(ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must be willing to obey the prohibitions and restrictions specified in the research protocol.
  • Sexually active male subjects and their partner must agree the use of condoms as an effective contraceptive method and to avoid sperm donation during the whole treatment and within 4 weeks after the end of treatment.

Exclusion Criteria:

  • Patients with neuroendocrine, small cell, or signet ring cell histological features are not eligible.
  • Patients with brain/meningeal metastases are not eligible..
  • Patients previously received any of the following treatments are not eligible: 1) LHRH agonists/antagonists within 12 weeks prior to the start of study therapy; 2) Second generation androgen receptor (AR) inhibitors, such as enzaluamine, dalotamide, apatamide, etc; 3) Cytochrome P17 enzyme inhibitors (e.g., abiraterone acetate or oral ketoconazole) as antitumor therapy for PCa; 4) Chemotherapy (including docetaxel) or immunotherapy for PCa; 5) Systemic corticosteroids > 10 mg/day equivalent dose of prednisone within 28 days prior to random assignment.
  • Patients who were known to have hypersensitivity to any research drug or similar drug are not eligible.
  • Patients received local treatments such as pre-focal treatment,radiotherapy and palliative endoscopic resection
  • Patients with severe or uncontrolled concurrent infections are not eligible.
  • Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration.
  • Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection.
  • Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled.
  • Patients with mental illness, mental disability or inability to give informed consent are not eligible.

Sites / Locations

  • Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Docetaxel plus platinum

Docetaxel alone

Arm Description

Docetaxel combined with platinum-based drugs will be applied every 3 weeks for 6 cycles.

Docetaxel alone will be applied every 3 weeks for 6 cycles.

Outcomes

Primary Outcome Measures

Time to Metastatic Castration-Resistant Prostate Cancer (mCRPC)
Time from treatment initiation to Metastatic Castration-Resistant Prostate Cancer (mCRPC). Patients with metastatic prostate cancer develop PCa progression during androgen deprivation therapy (or after bilateral orchiectomy), meet any of the following criteria was defined as mCRPC. 1)PSA progression (defined as elevated PSA levels(≥1ng/ml) for no less than 2 measurements at least 1 week apart); 2) Radiographic progression in soft tissues, with or without PSA progression, according to RECIST 1.1 criteria; 3) Bone progression (defined as 2 or more new bone lesions on bone scans) with or without PSA progression, according to PCWG.

Secondary Outcome Measures

Overall survival
The survival rate of participants during follow-up time.
rPFS
Radiographic progression-free survival. The survival of participants without radiographic progression.
Time to PSA progression
PSA progression is defined as elevated PSA levels(≥2ng/ml) for no less than 2 measurements at least 1 week apart.
Time to subsequent anti-tumor therapy
Time from end of treatment to the time when subsequent anti-tumor therapy is needed.
Adverse events
All grades of adverse events will be recorded according to NCI CTCAE (v.5.0)

Full Information

First Posted
July 13, 2022
Last Updated
October 21, 2022
Sponsor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
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1. Study Identification

Unique Protocol Identification Number
NCT05461261
Brief Title
The Efficacy and Safety of Docetaxel Combined With Platinum for Metastatic Hormone-sensitive Prostate Cancer
Official Title
A Randomized Controlled Trial to Evaluate the Efficacy and Safety of Docetaxel Combined With Platinum-based Drugs Compared With Docetaxel Alone for Metastatic Hormone-sensitive Prostate Cancer Patients Carrying DNA Repair Mutation
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 1, 2022 (Actual)
Primary Completion Date
June 30, 2025 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This randomized controlled trial was designed to evaluate the efficacy and safety of Docetaxel combined with Platinum-based drugs compared with Docetaxel alone for metastatic hormone-sensitive prostate cancer patients carrying DNA repair mutation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hormone Sensitive Metastatic Prostate Cancer, DNA Damage Repair Deficiency, Chemotherapy Effect, Chemotherapeutic Toxicity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Docetaxel plus platinum
Arm Type
Experimental
Arm Description
Docetaxel combined with platinum-based drugs will be applied every 3 weeks for 6 cycles.
Arm Title
Docetaxel alone
Arm Type
Active Comparator
Arm Description
Docetaxel alone will be applied every 3 weeks for 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Docetaxel
Intervention Description
Docetaxel will be given intravenously 75 mg/m2 every 3 weeks for 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Prednisolone Acetate
Intervention Description
5mg Prednisolone Acetate will be given orally twice a day during treatment.
Intervention Type
Drug
Intervention Name(s)
Platinum-based drugs
Intervention Description
Platinum-based drugs will be given intravenously 70 mg/m2 every 3 weeks for 6 cycles. Cisplatin or carboplatin will be carefully chosen according to each patient's Creatinine Clearance.
Primary Outcome Measure Information:
Title
Time to Metastatic Castration-Resistant Prostate Cancer (mCRPC)
Description
Time from treatment initiation to Metastatic Castration-Resistant Prostate Cancer (mCRPC). Patients with metastatic prostate cancer develop PCa progression during androgen deprivation therapy (or after bilateral orchiectomy), meet any of the following criteria was defined as mCRPC. 1)PSA progression (defined as elevated PSA levels(≥1ng/ml) for no less than 2 measurements at least 1 week apart); 2) Radiographic progression in soft tissues, with or without PSA progression, according to RECIST 1.1 criteria; 3) Bone progression (defined as 2 or more new bone lesions on bone scans) with or without PSA progression, according to PCWG.
Time Frame
up to 3 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
The survival rate of participants during follow-up time.
Time Frame
up to 5 years
Title
rPFS
Description
Radiographic progression-free survival. The survival of participants without radiographic progression.
Time Frame
up to 5 years
Title
Time to PSA progression
Description
PSA progression is defined as elevated PSA levels(≥2ng/ml) for no less than 2 measurements at least 1 week apart.
Time Frame
up to 5 years
Title
Time to subsequent anti-tumor therapy
Description
Time from end of treatment to the time when subsequent anti-tumor therapy is needed.
Time Frame
up to 5 years
Title
Adverse events
Description
All grades of adverse events will be recorded according to NCI CTCAE (v.5.0)
Time Frame
up to 3 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must be ≥ 40 and ≤75 years of age. All patients must have been histologically diagnozed of prostate cancer. Metastatic disease confirmed by imaging: positive bone scan, or soft tissue or visceral metastases confirmed by abdominal/pelvic/chest contrast CT or MRI or PSMA PET-CT scan. Participants who were treated with androgen deprivation therapy (ADT) (LHRH agonist/antagonist or orchectomy) with or without first-generation anti-androgens within 12 weeks prior to random assignment must maintain serum testosterone castration levels, i.e., ≤50 ng/dL (≤ 1.75 nmol/L) during the study period. First-generation anti-androgens must be discontinued at least 1 day before the start of study therapy. Participants must carry one of the following DNA repair gene mutation: 1) HRR-related genes: ATM, BARD1, BRCA1, BRCA2, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, RAD51B, RAD51C, RAD51D, RAD54L; 2) Lynch syndrome-related genes: EPCAM, MLH1, MSH2, MSH6, PMS2. Eastern Cooperative Oncology Group (ECOG) physical condition score ≤1. Patients must have adequate hematologic function, hepatic function and renal function within 28 days prior to registration. Patients must participate voluntarily and sign an informed consent form(ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must be willing to obey the prohibitions and restrictions specified in the research protocol. Sexually active male subjects and their partner must agree the use of condoms as an effective contraceptive method and to avoid sperm donation during the whole treatment and within 4 weeks after the end of treatment. Exclusion Criteria: Patients with neuroendocrine, small cell, or signet ring cell histological features are not eligible. Patients with brain/meningeal metastases are not eligible.. Patients previously received any of the following treatments are not eligible: 1) LHRH agonists/antagonists within 12 weeks prior to the start of study therapy; 2) Second generation androgen receptor (AR) inhibitors, such as enzaluamine, dalotamide, apatamide, etc; 3) Cytochrome P17 enzyme inhibitors (e.g., abiraterone acetate or oral ketoconazole) as antitumor therapy for PCa; 4) Chemotherapy (including docetaxel) or immunotherapy for PCa; 5) Systemic corticosteroids > 10 mg/day equivalent dose of prednisone within 28 days prior to random assignment. Patients who were known to have hypersensitivity to any research drug or similar drug are not eligible. Patients received local treatments such as pre-focal treatment,radiotherapy and palliative endoscopic resection Patients with severe or uncontrolled concurrent infections are not eligible. Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration. Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection. Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled. Patients with mental illness, mental disability or inability to give informed consent are not eligible.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shun Zhang, MD
Phone
15050589789
Email
explorershun@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hongqian Guo, MD
Email
dr.ghq@nju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hongqian Guo
Organizational Affiliation
Nanjing Drum Tower Hospital, affiliated to medical school of Nanjing University Locations: China, Jiangsu
Official's Role
Study Chair
Facility Information:
Facility Name
Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shun Zhang
Phone
15050589789
Ext
15050589789
Email
explorershun@126.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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The Efficacy and Safety of Docetaxel Combined With Platinum for Metastatic Hormone-sensitive Prostate Cancer

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