S1014 Abiraterone Acetate in Treating Patients With Prostate Cancer Who Have Undergone Initial Hormone Therapy
Prostate Cancer
About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring adenocarcinoma of the prostate, hormone-resistant prostate cancer, stage IV prostate cancer, recurrent prostate cancer
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically or cytologically proven diagnosis of adenocarcinoma of the prostate
- Metastatic (M1) disease as evidenced by soft tissue and/or bony metastases at the time of initiation of androgen-deprivation therapy (ADT)
Must have at least one of the following:
- Visceral disease (liver, lung, other viscera)
- Bone metastases to sites in either the axial (spine, pelvis, ribs, or skull) and/or the appendicular (clavicle, humerus, or femur) skeleton
- Distant lymph node disease (e.g., above the aortic bifurcation, etc.)
- No small cell or neuroendocrine prostate cancer
Patients must be receiving ADT (e.g., gonadotropin-releasing hormone [GNRH] antagonist, with or without antiandrogen) prior to entering this study
- Degarelix, a FDA-approved GNRH antagonist, is an acceptable form of ADT
- Bilateral surgical orchiectomy is also acceptable
Suboptimal response to ADT induction as defined by the following criteria:
Declining PSA (current PSA is less than the PSA prior to starting ADT) that fails to reach 4 ng/mL or below despite continuous ADT
- PSA of > 4 ng/mL must be observed between 6-12 months after the initiation of ADT
Documentation of failure to achieve this PSA of ≤ 4 ng/mL must be within 28 days of registration
- The PSA must be obtained after any applicable antiandrogen washout period
- If the PSA is declining or stable (defined as a PSA rise ≤ 0.1 ng/mL from nadir) and the patient is on an antiandrogen, they must remain on the antiandrogen
- Patients with stable or declining PSA who have had previous antiandrogen exposure, but are not taking an antiandrogen at the time of registration, must wait at least 6 weeks from the last antiandrogen dose before registration and still demonstrate a stable or falling PSA which is > 4 ng/mL by month 12, in order to be eligible
- If the PSA is rising and they are on an antiandrogen, formal antiandrogen washout must be performed (4 weeks for flutamide and 6 weeks for bicalutamide and nilutamide with no evidence of a falling PSA after washout)
- No patients with radiographic progression when compared to available imaging studies performed prior to starting the GNRH agonist/antagonist therapy
- Patients who have measurable disease must have radiographic assessment (at least an abdominal/pelvic CT scan) within 28 days prior to registration
- Non-measurable disease must be assessed (i.e., bone scan) within 42 days prior to registration
No patients with a history of brain metastases or who currently have treated or untreated brain metastases
- Patients with clinical evidence of brain metastases must have a brain CT scan or MRI negative for metastatic disease within 56 days prior to registration
PATIENT CHARACTERISTICS:
- Zubrod performance status 0-2
- ANC ≥ 1,500/μL
- Platelet count ≥ 100,000/μL
- Hemoglobin ≥ 10 g/dL
- Serum creatinine ≤ 1.5 times the upper limit of normal (ULN) OR creatinine clearance ≥ 60 mL/min
- Bilirubin ≤ 1.5 times ULN (unless documented Gilbert disease)
- AST and ALT < 1.5 times ULN
- Potassium ≥ 3.5 mmol/L
- Patient must have a testosterone value of < 50 ng/dL obtained within 28 days prior to registration
Patients must have controlled blood pressure defined as systolic blood pressure < 160 mm Hg and diastolic blood pressure < 95 mm Hg
- Patients with a history of hypertension are eligible provided blood pressure is controlled by anti-hypertensive treatment
- Patients who have partners of child-bearing potential must be willing to use a method of birth control with adequate barrier protection during the study and for 1 week after the last study drug administration
- Must be able to take oral medication without crushing, dissolving, or chewing tablets
- Patients must not have a history of gastrointestinal disorders (medical disorders or extensive surgery) that may interfere with the absorption of abiraterone acetate
No other prior malignancy is allowed except for any of the following:
- Adequately treated basal cell or squamous cell skin cancer
- Adequately treated stage I or II cancer from which the patient is currently in complete remission
- Any other cancer from which the patient has been disease-free for 5 years
No patients with active or symptomatic viral hepatitis or chronic liver disease
- No moderate (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment
No history of NYHA class III or IV heart failure
- Patients must have LVEF ≥ 50%
- No known allergies, hypersensitivity, or intolerance to abiraterone acetate, prednisone, or their excipients
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
Patients with a history of prior neoadjuvant or adjuvant GNRH agonist/antagonist therapy (related to previous surgery or radiation) are eligible provided they finished this therapy at least two years prior to registration
- Prior enrollment to SWOG-S0925 (either arm) is not exclusionary
- At least 6 weeks since prior and no concurrent finasteride or dutasteride
- At least 28 days since prior radiotherapy or surgery and recovered
- At least 4 weeks since prior investigational products
At least 4 weeks since prior flutamide (6 weeks for bicalutamide and nilutamide) with no evidence of a falling PSA
- No other concurrent oral antiandrogen
- No prior or concurrent cytotoxic chemotherapy or radiopharmaceuticals for prostate cancer
- No prior or concurrent ketoconazole for the treatment of prostate cancer
- Not requiring more than 10 mg a day of prednisone for another medical indication
- Not planning to receive any concurrent cytotoxic chemotherapy, immunotherapy, surgery, or radiotherapy during protocol treatment
- No concurrent hormonal-acting agents, including diethylstilbestrol/DES, aldosterone, PC-SPES, or spironolactone
- No concurrent antifungal medication (e.g., fluconazole or itraconazole)
- No medications that alter cardiac conduction
- No prior Provenge (sipuleucel-T)
Sites / Locations
- NEA Medical Clinic - East Matthews
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Highlands Oncology Group - Springdale
- Kaiser Permanente - Deer Valley
- Kaiser Permanente - Fremont
- Kaiser Permanente Fresno Medical Center
- Kaiser Permanente Medical Center - Hayward
- Tibotec Therapeutics - Division of Ortho Biotech Products, LP
- Kaiser Permanente Medical Center - Oakland
- Kaiser Permanente Medical Center - Redwood City
- Kaiser Permanente Medical Center - Richmond
- Kaiser Permanente Medical Center - Roseville
- University of California Davis Cancer Center
- South Sacramento Kaiser-Permanente Medical Center
- Kaiser Permanente Medical Center - Sacramento
- Kaiser Permanente Medical Center - San Francisco Geary Campus
- Kaiser Permanente Medical Center - Santa Teresa
- Kaiser Foundation Hospital - San Rafael
- Kaiser Permanente Medical Center - Santa Clara Kiely Campus
- Kaiser Permanente Medical Center - Santa Rosa
- Kaiser Permanente Medical Center - South San Francisco
- Kaiser Permanente Medical Facility - Stockton
- Tahoe Forest Cancer Center
- Kaiser Permanente Medical Center - Vacaville
- Kaiser Permanente Medical Center - Vallejo
- Kaiser Permanente Medical Center - Walnut Creek
- San Luis Valley Regional Medical Center
- University of Colorado Cancer Center at UC Health Sciences Center
- Memorial Hospital Cancer Center - Colorado Springs
- Shaw Regional Cancer Center
- Poudre Valley Hospital
- Front Range Cancer Specialists
- Valley View Hospital Cancer Center
- St. Mary's Regional Cancer Center at St. Mary's Hospital and Medical Center
- Montrose Memorial Hospital Cancer Center
- Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
- M.D. Anderson Cancer Center at Orlando
- Kapiolani Medical Center at Pali Momi
- Oncare Hawaii, Incorporated - Pali Momi
- Cancer Research Center of Hawaii
- OnCare Hawaii, Incorporated - Lusitana
- Queen's Cancer Institute at Queen's Medical Center
- Straub Clinic and Hospital, Incorporated
- OnCare Hawaii, Incorporated - Kuakini
- Kuakini Medical Center
- Kaiser Permanente - Moanalua Medical Center and Clinic
- Kapiolani Medical Center for Women and Children
- Tripler Army Medical Center
- Castle Medical Center
- Kauai Medical Clinic
- Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center
- Mountain States Tumor Institute at St. Luke's Regional Medical Center
- Saint Luke's Mountain States Tumor Institute - Fruitland
- St. Joseph Regional Medical Center
- Mountain States Tumor Institute - Meridian
- Saint Luke's Mountain States Tumor Institute
- Mountain States Tumor Institute at St. Luke's
- Decatur Memorial Hospital Cancer Care Institute
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Good Samaritan Regional Health Center
- Mid-Illinois Hematology-Oncology Associates at Community Cancer Center
- Regional Cancer Center at Memorial Medical Center
- Genesis Regional Cancer Center at Genesis Medical Center
- Cancer Center of Kansas, PA - Chanute
- Cancer Center of Kansas, PA - Dodge City
- Cancer Center of Kansas - Fort Scott
- St. Rose Ambulatory and Surgery Center
- Hays Medical Center
- Hutchinson Hospital Corporation
- Cancer Center of Kansas-Independence
- Kansas City Cancer Centers - West
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Cancer Center of Kansas, PA - Kingman
- Lawrence Memorial Hospital
- Cancer Center of Kansas, PA - Liberal
- Cancer Center of Kansas, PA - Newton
- Kansas City Cancer Centers - Southwest
- Cancer Center of Kansas, PA - Parsons
- Mount Carmel Regional Cancer Center
- Cancer Center of Kansas, PA - Pratt
- Cancer Center of Kansas, PA - Salina
- Tammy Walker Cancer Center at Salina Regional Health Center
- Kansas City Cancer Center - Shawnee Mission
- Cotton-O'Neil Cancer Center
- St. Francis Comprehensive Cancer Center
- Cancer Center of Kansas, PA - Wellington
- Associates in Womens Health, PA - North Review
- Cancer Center of Kansas, PA - Medical Arts Tower
- Cancer Center of Kansas, PA - Wichita
- CCOP - Wichita
- Via Christi Cancer Center at Via Christi Regional Medical Center
- Cancer Center of Kansas, PA - Winfield
- Central Baptist Hospital
- Tulane Cancer Center Office of Clinical Research
- Hematology-Oncology Clinic
- Cancer Center of Acadiana at Lafayette General Medical Center
- Highland Clinic
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
- Caritas Holy Family Hospital
- Saint Joseph Mercy Cancer Center
- CCOP - Michigan Cancer Research Consortium
- University of Michigan Comprehensive Cancer Center
- Battle Creek Health System Cancer Care Center
- Bay Regional Medical Center
- Mecosta County Medical Center
- Oakwood Cancer Center at Oakwood Hospital and Medical Center
- Barbara Ann Karmanos Cancer Institute
- Josephine Ford Cancer Center at Henry Ford Hospital
- Genesys Hurley Cancer Institute
- Hurley Medical Center
- McLaren Cancer Institute
- Singh and Arora Hematology Oncology, PC
- Butterworth Hospital at Spectrum Health
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Foote Memorial Hospital
- Sparrow Regional Cancer Center
- Great Lakes Cancer Institute - Lapeer Campus
- St. Mary Mercy Hospital
- Clemens Regional Medical Center
- Mercy General Health Partners
- Northern Michigan Hospital
- St. Joseph Mercy Oakland
- Mercy Regional Cancer Center at Mercy Hospital
- Spectrum Health Reed City Hospital
- Seton Cancer Institute at Saint Mary's - Saginaw
- Munson Medical Center
- St. John Macomb Hospital
- University of Mississippi Cancer Clinic
- Saint Francis Medical Center
- Truman Medical Center - Hospital Hill
- Kansas City Cancer Centers - South
- Kansas City Cancer Centers - North
- Kansas City Cancer Centers - East
- Midwest Hematology Oncology Group, Incorporated
- CCOP - St. Louis-Cape Girardeau
- David C. Pratt Cancer Center at St. John's Mercy
- CCOP - Cancer Research for the Ozarks
- St. John's Regional Health Center
- Hulston Cancer Center at Cox Medical Center South
- CCOP - Montana Cancer Consortium
- St. Vincent Healthcare Cancer Care Services
- Hematology-Oncology Centers of the Northern Rockies - Billings
- Billings Clinic - Downtown
- Bozeman Deaconess Cancer Center
- Great Falls Clinic - Main Facility
- Sletten Cancer Institute at Benefis Healthcare
- St. Peter's Hospital
- Glacier Oncology, PLLC
- Kalispell Regional Medical Center
- Montana Cancer Specialists at Montana Cancer Center
- Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
- University Medical Center of Southern Nevada
- CCOP - Nevada Cancer Research Foundation
- Valley Hospital - Ridgewood
- Hematology Oncology Associates, PC
- University of New Mexico Cancer Center
- New Mexico Cancer Care Associates
- Falck Cancer Center at Arnot Ogden Medical Center
- Tucker Center for Cancer Care at Orange Regional Medical Center
- Winthrop University Hospital
- St. Luke's - Roosevelt Hospital Center - St.Luke's Division
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Wayne Memorial Hospital, Incorporated
- Iredell Memorial Hospital
- Adena Regional Medical Center
- Charles M. Barrett Cancer Center at University Hospital
- Riverside Methodist Hospital Cancer Care
- CCOP - Columbus
- Grant Medical Center Cancer Care
- Mount Carmel Health - West Hospital
- Doctors Hospital at Ohio Health
- Grady Memorial Hospital
- Fairfield Medical Center
- Strecker Cancer Center at Marietta Memorial Hospital
- Knox Community Hospital
- Licking Memorial Cancer Care Program at Licking Memorial Hospital
- Southern Ohio Medical Center Cancer Center
- Community Hospital of Springfield and Clark County
- Mount Carmel St. Ann's Cancer Center
- Genesis - Good Samaritan Hospital
- Hollings Cancer Center at Medical University of South Carolina
- McLeod Regional Medical Center
- Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center
- Thompson Cancer Survival Center
- Baylor University Medical Center - Houston
- Ben Taub General Hospital
- St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital
- Veterans Affairs Medical Center - Houston
- UMC Southwest Cancer and Research Center
- CCOP - Scott and White Hospital
- Huntsman Cancer Institute at University of Utah
- Providence Centralia Hospital
- Providence Regional Cancer Partnership
- St. Francis Hospital
- Providence St. Peter Hospital Regional Cancer Center
- Good Samaritan Cancer Center
- Franciscan Cancer Center at St. Joseph Medical Center
- Allenmore Hospital
- CCOP - Northwest
- MultiCare Regional Cancer Center at Tacoma General Hospital
- St. Clare Hospital
- Rocky Mountain Oncology
Arms of the Study
Arm 1
Experimental
Abiraterone acetate + prednisone
Abiraterone, 1,000 mg, oral (on an empty stomach at least 2 hours after or 1 hour before eating); to be taken daily Prednisone, 5 mg, oral, 5 mg twice daily