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Biomarker-driven Intermittent Docetaxel Versus Standard-of-care (SOC) Docetaxel in Metastatic Castration-resistant Prostate Cancer (GUIDE)

Primary Purpose

Castration Resistant Prostatic Cancer

Status
Recruiting
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
Docetaxel intermittent
Docetaxel standard of care
Sponsored by
Australian and New Zealand Urogenital and Prostate Cancer Trials Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Castration Resistant Prostatic Cancer

Eligibility Criteria

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

PRESCREENING INCLUSION CRITERIA

  1. Patient has provided written informed consent using the GUIDE pre-screening PICF
  2. Age ≥ 18 years at the time of pre-screening consent
  3. Males with metastatic castration-resistant prostate cancer (as per PCWG3) AND are planned to commence docetaxel chemotherapy
  4. WHO Eastern Cooperative Oncology Group (ECOG) performance status 0-2 (Appendix 1)
  5. Histological confirmation of prostate cancer
  6. Patients must have adequate bone marrow and hepatic function within 14 days prior Cycle 1 day 1:

    • Haemoglobin ≥ 90 g/L independent of transfusions (no red blood cell transfusion in last 4 weeks)
    • Platelets ≥ 100 x 109/L
    • Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
    • Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN)
    • Alanine aminotransferase (ALT)/Aspartate aminotransferase (AST) ≤ 2.5 x ULN
  7. Willing and able to comply with all pre-screening study requirements, including blood tests for mGSTP1 analysis before and during docetaxel treatment

PRESCREENING EXCLUSION CRITERIA

  1. Prior docetaxel or cabazitaxel chemotherapy for castration-resistant prostate cancer
  2. Prior docetaxel in the castration sensitive prostate cancer setting within the previous 2 years
  3. Known hypersensitivity to docetaxel or its excipients
  4. Concurrent illness, including severe infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety
  5. Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol

MAIN SCREENING INCLUSION CRITERIA

  1. Patient has provided written informed consent for the main GUIDE study PICF
  2. Patient has a detectable plasma mGSTP1 deoxyribonucleic acid (DNA) as measured by central laboratory at prescreening prior to commencing first cycle of docetaxel chemotherapy
  3. Patient has commenced 3 cycles of docetaxel
  4. Patient has undetectable plasma mGSTP1 DNA as measured by central laboratory from blood taken prior to the third cycle of docetaxel
  5. Patient is willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments.

MAIN SCREENING EXCCLUSION CRITERIA

  1. Known hypersensitivity to docetaxel or its excipients
  2. Concurrent illness, including severe infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety
  3. Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol
  4. Progressive disease by RECIST 1.1 within the first 3 cycles of docetaxel

Sites / Locations

  • Border Medical Oncology Research Unit / The Border Cancer HospitalRecruiting
  • Chris O'Brien LifehouseRecruiting
  • St Vincent's HospitalRecruiting
  • Dubbo Base HospitalRecruiting
  • Concord Repatriation General HospitalRecruiting
  • Frankston Hospital-Peninsula HealthRecruiting
  • Goulburn Valley HealthRecruiting
  • LaTrobe Regional Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Arm 1: Intermittent docetaxel treatment

Arm 2: Standard of Care docetaxel treatment

Arm Description

suspend docetaxel prior to cycle 4, recommencement based on mGSTP1 monitoring

Docetaxel administered as per Standard of Care: as per clinician recommendation

Outcomes

Primary Outcome Measures

Radiographic progression free survival (rPFS)
Radiographic progression free survival (rPFS) is defined as the time from randomisation (i.e. prior to cycle 4), the date of first documented progression on imaging by site investigator (PCWG3 criteria for bone lesions and RECIST 1.1 for soft tissue lesions) or death due to any cause.

Secondary Outcome Measures

Time on treatment holidays
Time on treatment holidays is defined as the total length of time patients on the intermittent docetaxel arm spend off docetaxel within the treatment period i.e. prior to permanent treatment discontinuation
Overall treatment safety
Incidence and severity of adverse events (AEs) using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.
Overall survival
Overall survival is defined as the time from randomisation to the date of death due to any cause
Overall quality of life
Quality of Life using the EORTC QLQ-C30 (European Organisation for Research on Treatment of Cancer - Quality of Life Questionnaire for cancer patients) instrument. The instrument uses 28 questions about overall quality of life with each question answerable using a scale from 1 (not at all) to 4 (very much). Overall scores can be from a minimum of 28 indicating a better quality of life and higher scores with a maximum of 112 indicating lower overall quality of life. The questionnaire also has two summary questions which asks participants to rank 1) overall health and 2) overall quality of life on scale of from 1, very poor, to 7, excellent.
Fatigue
Fatigue, using the EORTC FA-12 (European Organisation for Research on Treatment of Cancer - Fatigue) instrument. This instrument uses 12 questions for participants about fatigue with each question answerable on a scale of 1 (not at all) to 4 (Very Much) to a maximum score of 48 indicating worse overall self-rated fatigue.
Fear of progression
Fear of progression using the short FOP12 (Fear of Progression) instrument. This instrument uses 12 questions about participant's own Fear of Progression with each question answerable using a scale from "Never" to "very often" with lower scores indicating a better outcome.
Patient reported adverse events
Patient reported adverse events using the patient reported modified PRO-CTCAE instrument
Frequency of health resource utilisation
To compare resource use associated with mGSTP1 directed therapy per treatment group. Will be measured from trial based eCRFs and will include frequency of mGSTP1 testing, use of docetaxel and corticosteroids, pathology tests and imaging. Men participating in the GUIDE study will be consented for access to their Medicare claims data providing information on outpatient use of PBS listed therapies (such as those for metastatic bone disease) and Medicare services (such as outpatient clinician services)
Overall cost associated with treatment
To compare costs associated with treatment per treatment group. Will be reported by type of health care used and the total cost of health care used over the period of the trial and follow-up. Market prices will be applied to items of resource use to estimate costs.

Full Information

First Posted
May 26, 2021
Last Updated
March 27, 2023
Sponsor
Australian and New Zealand Urogenital and Prostate Cancer Trials Group
Collaborators
Peter MacCallum Cancer Centre, Australia
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1. Study Identification

Unique Protocol Identification Number
NCT04918810
Brief Title
Biomarker-driven Intermittent Docetaxel Versus Standard-of-care (SOC) Docetaxel in Metastatic Castration-resistant Prostate Cancer
Acronym
GUIDE
Official Title
A Randomised Non-comparative Phase II Trial of Biomarker-driven Intermittent Docetaxel Versus Standard-of-care (SOC) Docetaxel in Metastatic Castration-resistant Prostate Cancer (mCRPC)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 11, 2021 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Australian and New Zealand Urogenital and Prostate Cancer Trials Group
Collaborators
Peter MacCallum Cancer Centre, Australia

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
The purpose of this study is to see if a prostate cancer marker in the blood (mGSTP1) can be used to guide chemotherapy treatment. Based on the level of this blood marker, some men may be able to have breaks in treatment rather than having chemotherapy continuously which is the current standard of care. This study will tell us if having these treatment breaks guided by mGSTP1 can improve how men feel during treatment while still treating the prostate cancer effectively. Docetaxel is a chemotherapy drug that is approved to treat prostate cancer and has been used for many years to treat prostate cancer like yours. Your doctor has already discussed this with you and you have both agreed that docetaxel is the best treatment for you to have at this time. You will have already started this chemotherapeutic treatment with docetaxel.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Parallel Assignment randomised non-comparative
Masking
None (Open Label)
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1: Intermittent docetaxel treatment
Arm Type
Experimental
Arm Description
suspend docetaxel prior to cycle 4, recommencement based on mGSTP1 monitoring
Arm Title
Arm 2: Standard of Care docetaxel treatment
Arm Type
Active Comparator
Arm Description
Docetaxel administered as per Standard of Care: as per clinician recommendation
Intervention Type
Drug
Intervention Name(s)
Docetaxel intermittent
Intervention Description
After 3 cycles of docetaxel chemotherapy (75mg/m^2 every 21) in combination with an undetectable mGSTP1 level, patients randomised to this arm will stop docetaxel treatment. Plasma mGSTP1 is measured every 21 days and docetaxel treatment will be recommenced if it mGSTP1 becomes detectable again.
Intervention Type
Drug
Intervention Name(s)
Docetaxel standard of care
Intervention Description
After 3 cycles of docetaxel chemotherapy (75mg/m^2 every 21) in combination with an undetectable mGSTP1 level, patients randomised to this arm will continue with standard Docetaxel treatment (75mg/m^2 every 21)
Primary Outcome Measure Information:
Title
Radiographic progression free survival (rPFS)
Description
Radiographic progression free survival (rPFS) is defined as the time from randomisation (i.e. prior to cycle 4), the date of first documented progression on imaging by site investigator (PCWG3 criteria for bone lesions and RECIST 1.1 for soft tissue lesions) or death due to any cause.
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Secondary Outcome Measure Information:
Title
Time on treatment holidays
Description
Time on treatment holidays is defined as the total length of time patients on the intermittent docetaxel arm spend off docetaxel within the treatment period i.e. prior to permanent treatment discontinuation
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Overall treatment safety
Description
Incidence and severity of adverse events (AEs) using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.
Time Frame
From the date of signing consent on the Main study until 90 days after the last day of protocol treatment, on average 3.5 years
Title
Overall survival
Description
Overall survival is defined as the time from randomisation to the date of death due to any cause
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Overall quality of life
Description
Quality of Life using the EORTC QLQ-C30 (European Organisation for Research on Treatment of Cancer - Quality of Life Questionnaire for cancer patients) instrument. The instrument uses 28 questions about overall quality of life with each question answerable using a scale from 1 (not at all) to 4 (very much). Overall scores can be from a minimum of 28 indicating a better quality of life and higher scores with a maximum of 112 indicating lower overall quality of life. The questionnaire also has two summary questions which asks participants to rank 1) overall health and 2) overall quality of life on scale of from 1, very poor, to 7, excellent.
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Fatigue
Description
Fatigue, using the EORTC FA-12 (European Organisation for Research on Treatment of Cancer - Fatigue) instrument. This instrument uses 12 questions for participants about fatigue with each question answerable on a scale of 1 (not at all) to 4 (Very Much) to a maximum score of 48 indicating worse overall self-rated fatigue.
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Fear of progression
Description
Fear of progression using the short FOP12 (Fear of Progression) instrument. This instrument uses 12 questions about participant's own Fear of Progression with each question answerable using a scale from "Never" to "very often" with lower scores indicating a better outcome.
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Patient reported adverse events
Description
Patient reported adverse events using the patient reported modified PRO-CTCAE instrument
Time Frame
From randomisation until last patient has completed 2 years in follow up, on average 3.5 years
Title
Frequency of health resource utilisation
Description
To compare resource use associated with mGSTP1 directed therapy per treatment group. Will be measured from trial based eCRFs and will include frequency of mGSTP1 testing, use of docetaxel and corticosteroids, pathology tests and imaging. Men participating in the GUIDE study will be consented for access to their Medicare claims data providing information on outpatient use of PBS listed therapies (such as those for metastatic bone disease) and Medicare services (such as outpatient clinician services)
Time Frame
From time of consent until End of Study, on average 3.5 years
Title
Overall cost associated with treatment
Description
To compare costs associated with treatment per treatment group. Will be reported by type of health care used and the total cost of health care used over the period of the trial and follow-up. Market prices will be applied to items of resource use to estimate costs.
Time Frame
From time of consent until End of Study, on average 3.5 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
PRESCREENING INCLUSION CRITERIA Patient has provided written informed consent using the GUIDE pre-screening PICF Age ≥ 18 years at the time of pre-screening consent Males with metastatic castration-resistant prostate cancer (as per PCWG3) AND are planned to commence docetaxel chemotherapy WHO Eastern Cooperative Oncology Group (ECOG) performance status 0-2 (Appendix 1) Histological confirmation of prostate cancer Patients must have adequate bone marrow and hepatic function within 14 days prior Cycle 1 day 1: Haemoglobin ≥ 90 g/L independent of transfusions (no red blood cell transfusion in last 4 weeks) Platelets ≥ 100 x 109/L Absolute neutrophil count (ANC) ≥ 1.5 x 109/L Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN) Alanine aminotransferase (ALT)/Aspartate aminotransferase (AST) ≤ 2.5 x ULN Willing and able to comply with all pre-screening study requirements, including blood tests for mGSTP1 analysis before and during docetaxel treatment PRESCREENING EXCLUSION CRITERIA Prior docetaxel or cabazitaxel chemotherapy for castration-resistant prostate cancer Prior docetaxel in the castration sensitive prostate cancer setting within the previous 2 years Known hypersensitivity to docetaxel or its excipients Concurrent illness, including severe infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol MAIN SCREENING INCLUSION CRITERIA Patient has provided written informed consent for the main GUIDE study PICF Patient has a detectable plasma mGSTP1 deoxyribonucleic acid (DNA) as measured by central laboratory at prescreening prior to commencing first cycle of docetaxel chemotherapy Patient has commenced 3 cycles of docetaxel Patient has undetectable plasma mGSTP1 DNA as measured by central laboratory from blood taken prior to the third cycle of docetaxel Patient is willing and able to comply with all study requirements, including treatment, timing and/or nature of required assessments. MAIN SCREENING EXCCLUSION CRITERIA Known hypersensitivity to docetaxel or its excipients Concurrent illness, including severe infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety Serious medical or psychiatric conditions that might limit the ability of the patient to comply with the protocol Progressive disease by RECIST 1.1 within the first 3 cycles of docetaxel
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ronan Burder
Phone
03 8559 5088
Email
ronan.burder@petermac.org
First Name & Middle Initial & Last Name or Official Title & Degree
Margaret McJannett
Phone
02 9562 5033
Email
margaret@anzup.org.au
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kate Mahon
Organizational Affiliation
Chris Obrien Lifehouse
Official's Role
Principal Investigator
Facility Information:
Facility Name
Border Medical Oncology Research Unit / The Border Cancer Hospital
City
Albury
State/Province
New South Wales
ZIP/Postal Code
2460
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Craig Underhill
Email
cunderhill@bordermedonc.com.au
First Name & Middle Initial & Last Name & Degree
Jacqui McBurnie
Phone
+61 2 6064 1508
Email
jacqui.mcburnie@bordermedonc.com.au
Facility Name
Chris O'Brien Lifehouse
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jacquie Harvey
First Name & Middle Initial & Last Name & Degree
Kate Mahon
Facility Name
St Vincent's Hospital
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2021
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robert Kent
First Name & Middle Initial & Last Name & Degree
Megan Crumbaker
Facility Name
Dubbo Base Hospital
City
Dubbo
State/Province
New South Wales
ZIP/Postal Code
2830
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Florian Honeyball
First Name & Middle Initial & Last Name & Degree
Alicia Bell
First Name & Middle Initial & Last Name & Degree
Florian Honeyball
Facility Name
Concord Repatriation General Hospital
City
Sydney
State/Province
New South Wales
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Karen Ji
First Name & Middle Initial & Last Name & Degree
Martin Stockler
Facility Name
Frankston Hospital-Peninsula Health
City
Frankston
State/Province
Victoria
ZIP/Postal Code
3199
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jade Rice
First Name & Middle Initial & Last Name & Degree
Sanjeev Seewak
Facility Name
Goulburn Valley Health
City
Shepparton
State/Province
Victoria
ZIP/Postal Code
3630
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Javier Torres
Email
javier.torres@gvhealth.org.au
First Name & Middle Initial & Last Name & Degree
Carole Mott
First Name & Middle Initial & Last Name & Degree
Javier Torres
Facility Name
LaTrobe Regional Hospital
City
Traralgon
State/Province
Victoria
ZIP/Postal Code
3844
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jhodie Duncan
First Name & Middle Initial & Last Name & Degree
Hieu Chau

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.anzup.org.au/
Description
ANZUP website

Learn more about this trial

Biomarker-driven Intermittent Docetaxel Versus Standard-of-care (SOC) Docetaxel in Metastatic Castration-resistant Prostate Cancer

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