Cabazitaxel Plus Prednisone With Octreotide For Castration-Resistant Prostate Cancer (CRPC) Previously Treated With Docetaxel
Primary Purpose
Diarrhea, Hormone-resistant Prostate Cancer, Recurrent Prostate Cancer
Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
cabazitaxel
prednisone
octreotide pamoate
questionnaire administration
octreotide acetate
Sponsored by
About this trial
This is an interventional supportive care trial for Diarrhea
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed prostate cancer
- Measurable disease on computed tomography (CT) or evaluable disease with an elevated PSA
- Documented progression on (a) at least one prior hormone treatment, which must have incorporated luteinizing hormone-releasing hormone (LHRH) agonist therapy AND (b) at least one chemotherapy regimen, which must have included docetaxel; progression may be demonstrated by radiologic criteria or by PSA only if accompanied by new or worsening symptoms (pain progression)
- Eastern Cooperative Oncology Group (ECOG) performance score of 0-2
- Absolute neutrophil count (ANC) more than or equal to 1500/ul
- Hemoglobin more than or equal to 8.0 g/dL
- Platelet count more than or equal to 100,000/ul
- Serum creatinine less than or equal to 1.5x the upper limit of normal (ULN)
- Bilirubin less than or equal to ULN
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 1.5x ULN
- Must be recovered from acute and late effects of any prior surgery, radiotherapy or other anti-neoplastic therapy
- Patients or their legal representatives must be able to read, understand, and provide informed consent
- Men of childbearing potential must consent to use barrier contraception while on treatment and for 90 days thereafter
- Palliative radiation for metastatic disease is allowed if less or equal to 40% of the total bone marrow was irradiated; 28 days must have elapsed since completion of radiation therapy (RT) with bone marrow recovery; soft tissue disease irradiated in the prior 2 months may not be designated as measurable disease
- Concomitant bisphosphonate use is permitted if the dose had been stable for 12 weeks prior to enrollment
Exclusion Criteria:
- Treatment with radiotherapy, chemotherapy or any investigational agent in the prior 4 weeks
- Major surgery in the prior 4 weeks
- Prior treatment with cabazitaxel
- Patients with known hypersensitivity to cabazitaxel, other drugs formulated with polysorbate 80 or octreotide
- Inability to tolerate oral prednisone
- Grade 2 or greater diarrhea in the prior 2 weeks
- Grade 2 or greater neuropathy or stomatitis
- Presence of an active uncontrolled infection or fever greater or equal to 38.5 degrees
- Presence of parenchymal brain metastases; patients with neurological symptoms must have a CT or magnetic resonance imaging (MRI) of the brain showing no metastases within 60 days of enrollment
- Prior malignancy within the past 5 years with the exception of curatively treated basal cell or squamous cell carcinoma of the skin or superficial bladder or other stage I or stage II cancer in complete remission for at least 12 months
- History of unstable or newly diagnosed angina pectoris, documented history of current serious arrhythmia or congestive heart failure (CHF) or recent myocardial infarction (MI)within 6 months of enrollment
- Known human immunodeficiency virus (HIV) or hepatitis infection
- Life expectancy less than 3 months
- Presence of any other medical condition, including mental illness or substance abuse, deemed by the investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interfere with interpretation of the results
- Lack of ability/willingness to give informed consent
- Lack of ability/willingness to receive octreotide injection
- Anticipated non-availability for study visits/procedures
- Patients with uncontrolled diabetes, defined as a HbA1c greater than 7% or greater or equal to 8% despite therapy, or a fasting plasma glucose more than 2x ULN; at the investigator's discretion, non-eligible patients can be re-screened after adequate medical therapy has been instituted
Sites / Locations
- USC/Norris Comprehensive Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Supportive care (management of therapy complications)
Arm Description
Patients receive cabazitaxel IV over 1 hour on day 1, prednisone PO QD, and octreotide pamoate IM on day 1. Patients also receive octreotide acetate SC TID on days 1-14 of course 1 only. Treatment with cabazitaxel repeats every 21 days and treatment with prednisone and octreotide pamoate repeats every 4 weeks for up to 10 courses in the absence of disease progression or unacceptable toxicity.
Outcomes
Primary Outcome Measures
Development of Grade 2 plus diarrhea
Defined by Common Terminology Criteria for Adverse Events (CTCAE) v4.0 criteria as an increase in frequency of 4 or greater stools per day over baseline, incontinence, diarrhea warranting hospitalization or diarrhea limiting self-care activities of daily living (ADL). Baseline frequency will be defined in the pre-treatment assessment from cycle 1 as the maximum number of stools in one 24 hour period during the past 2 weeks. Any incidence of grade 2 or greater diarrhea during treatment or for up to 21 days after the last administration of cabazitaxel will be included in this endpoint.
Secondary Outcome Measures
Progression-Free Survival
Overall Survival
RECIST response for patients with measurable disease
Prostate-Specific Antigen response
Pain palliation in patients with a baseline pain score greater or equal to 2
Toxicity (adverse events considered to be at least possibly drug-related)
Full Information
NCT ID
NCT01469338
First Posted
November 1, 2011
Last Updated
November 21, 2014
Sponsor
University of Southern California
Collaborators
National Cancer Institute (NCI), Sanofi
1. Study Identification
Unique Protocol Identification Number
NCT01469338
Brief Title
Cabazitaxel Plus Prednisone With Octreotide For Castration-Resistant Prostate Cancer (CRPC) Previously Treated With Docetaxel
Official Title
A Phase II Clinical Trial of Cabazitaxel Plus Prednisone With Octreotide in the Treatment of Castration-Resistant Prostate Cancer (CRPC) Previously Treated With Docetaxel
Study Type
Interventional
2. Study Status
Record Verification Date
November 2014
Overall Recruitment Status
Terminated
Why Stopped
lack of funding
Study Start Date
July 2012 (undefined)
Primary Completion Date
October 2014 (Actual)
Study Completion Date
November 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Southern California
Collaborators
National Cancer Institute (NCI), Sanofi
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This phase II trial studies how well octreotide works in reducing diarrhea in patients receiving cabazitaxel and prednisone for hormone-resistant prostate cancer (HRPC) previously treated with docetaxel. Octreotide may prevent diarrhea by blocking the secretion of several hormones in patients receiving chemotherapy for prostate cancer
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the impact of octreotide in reducing the incidence of grade 2 or greater diarrhea in men receiving cabazitaxel plus prednisone for castration-resistant prostate cancer (CRPC) after docetaxel therapy.
SECONDARY OBJECTIVES:
I. Overall survival (OS).
II. Progression-free survival (PFS) (defined as the time between treatment start and the first date of progression as measured by objective tumor progression using the Response Evaluation Criteria In Solid Tumors (RECIST), pain progression or death).
III. Prostate-specific antigen (PSA) response rate.
IV. Objective response rate.
V. Pain response.
VI. Toxicity.
OUTLINE:
Patients receive cabazitaxel as intravenous (IV) infusion over 1 hour on day 1, prednisone by mouth (PO) every day (QD), and octreotide pamoate given as intramuscular (IM) injection on day 1. Patients also receive octreotide acetate as a subcutaneous (SC) injection three times a day (TID) on days 1-14 of course 1 only. Treatment with cabazitaxel repeats every 21 days and treatment with prednisone and octreotide pamoate repeats every 4 weeks for up to 10 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 1 month, every 3 months until disease progression, and then every 6 months thereafter.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea, Hormone-resistant Prostate Cancer, Recurrent Prostate Cancer, Stage I Prostate Cancer, Stage IIA Prostate Cancer, Stage IIB Prostate Cancer, Stage III Prostate Cancer, Stage IV Prostate Cancer
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Supportive care (management of therapy complications)
Arm Type
Experimental
Arm Description
Patients receive cabazitaxel IV over 1 hour on day 1, prednisone PO QD, and octreotide pamoate IM on day 1. Patients also receive octreotide acetate SC TID on days 1-14 of course 1 only. Treatment with cabazitaxel repeats every 21 days and treatment with prednisone and octreotide pamoate repeats every 4 weeks for up to 10 courses in the absence of disease progression or unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
cabazitaxel
Other Intervention Name(s)
Jevtana, RPR-116258A, taxoid XRP6258, XRP6258
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
prednisone
Other Intervention Name(s)
DeCortin, Deltra
Intervention Description
Given PO
Intervention Type
Drug
Intervention Name(s)
octreotide pamoate
Other Intervention Name(s)
OP LAR, Sandostatin pamoate, Sandostatin pamoate LAR, SMS 201-995 pa, SMS 201-995 pa LAR
Intervention Description
Given IM
Intervention Type
Other
Intervention Name(s)
questionnaire administration
Intervention Description
Ancillary studies
Intervention Type
Drug
Intervention Name(s)
octreotide acetate
Other Intervention Name(s)
Longastatin, Longastatina, Samilstin, SMS 201-995
Intervention Description
Given SC
Primary Outcome Measure Information:
Title
Development of Grade 2 plus diarrhea
Description
Defined by Common Terminology Criteria for Adverse Events (CTCAE) v4.0 criteria as an increase in frequency of 4 or greater stools per day over baseline, incontinence, diarrhea warranting hospitalization or diarrhea limiting self-care activities of daily living (ADL). Baseline frequency will be defined in the pre-treatment assessment from cycle 1 as the maximum number of stools in one 24 hour period during the past 2 weeks. Any incidence of grade 2 or greater diarrhea during treatment or for up to 21 days after the last administration of cabazitaxel will be included in this endpoint.
Time Frame
Baseline through 21 days after the last administration of cabazitaxel
Secondary Outcome Measure Information:
Title
Progression-Free Survival
Time Frame
At 1 month after completion of treatment, every 3 months until disease progression, and then every 6 months thereafter
Title
Overall Survival
Time Frame
At 1 month after completion of treatment, every 3 months until disease progression, and then every 6 months thereafter
Title
RECIST response for patients with measurable disease
Time Frame
Baseline, after every 4 courses, at the end of treatment, and then every 6 months
Title
Prostate-Specific Antigen response
Time Frame
Baseline, day 1 of each course, at the end of treatment, and then every 6 months
Title
Pain palliation in patients with a baseline pain score greater or equal to 2
Time Frame
Baseline, day 1 of each 3 week course, at the end of treatment, and then every 6 months for up to 52 weeks
Title
Toxicity (adverse events considered to be at least possibly drug-related)
Time Frame
Baseline, day 1 of each course, and at the end of treatment
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed prostate cancer
Measurable disease on computed tomography (CT) or evaluable disease with an elevated PSA
Documented progression on (a) at least one prior hormone treatment, which must have incorporated luteinizing hormone-releasing hormone (LHRH) agonist therapy AND (b) at least one chemotherapy regimen, which must have included docetaxel; progression may be demonstrated by radiologic criteria or by PSA only if accompanied by new or worsening symptoms (pain progression)
Eastern Cooperative Oncology Group (ECOG) performance score of 0-2
Absolute neutrophil count (ANC) more than or equal to 1500/ul
Hemoglobin more than or equal to 8.0 g/dL
Platelet count more than or equal to 100,000/ul
Serum creatinine less than or equal to 1.5x the upper limit of normal (ULN)
Bilirubin less than or equal to ULN
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than or equal to 1.5x ULN
Must be recovered from acute and late effects of any prior surgery, radiotherapy or other anti-neoplastic therapy
Patients or their legal representatives must be able to read, understand, and provide informed consent
Men of childbearing potential must consent to use barrier contraception while on treatment and for 90 days thereafter
Palliative radiation for metastatic disease is allowed if less or equal to 40% of the total bone marrow was irradiated; 28 days must have elapsed since completion of radiation therapy (RT) with bone marrow recovery; soft tissue disease irradiated in the prior 2 months may not be designated as measurable disease
Concomitant bisphosphonate use is permitted if the dose had been stable for 12 weeks prior to enrollment
Exclusion Criteria:
Treatment with radiotherapy, chemotherapy or any investigational agent in the prior 4 weeks
Major surgery in the prior 4 weeks
Prior treatment with cabazitaxel
Patients with known hypersensitivity to cabazitaxel, other drugs formulated with polysorbate 80 or octreotide
Inability to tolerate oral prednisone
Grade 2 or greater diarrhea in the prior 2 weeks
Grade 2 or greater neuropathy or stomatitis
Presence of an active uncontrolled infection or fever greater or equal to 38.5 degrees
Presence of parenchymal brain metastases; patients with neurological symptoms must have a CT or magnetic resonance imaging (MRI) of the brain showing no metastases within 60 days of enrollment
Prior malignancy within the past 5 years with the exception of curatively treated basal cell or squamous cell carcinoma of the skin or superficial bladder or other stage I or stage II cancer in complete remission for at least 12 months
History of unstable or newly diagnosed angina pectoris, documented history of current serious arrhythmia or congestive heart failure (CHF) or recent myocardial infarction (MI)within 6 months of enrollment
Known human immunodeficiency virus (HIV) or hepatitis infection
Life expectancy less than 3 months
Presence of any other medical condition, including mental illness or substance abuse, deemed by the investigator to be likely to interfere with a patient's ability to sign informed consent, cooperate and participate in the study, or interfere with interpretation of the results
Lack of ability/willingness to give informed consent
Lack of ability/willingness to receive octreotide injection
Anticipated non-availability for study visits/procedures
Patients with uncontrolled diabetes, defined as a HbA1c greater than 7% or greater or equal to 8% despite therapy, or a fasting plasma glucose more than 2x ULN; at the investigator's discretion, non-eligible patients can be re-screened after adequate medical therapy has been instituted
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jacek Pinski
Organizational Affiliation
University of Southern California
Official's Role
Principal Investigator
Facility Information:
Facility Name
USC/Norris Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Cabazitaxel Plus Prednisone With Octreotide For Castration-Resistant Prostate Cancer (CRPC) Previously Treated With Docetaxel
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