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出境医 / 临床实验 / CASCARA: Castration Sensitive Carboplatin, Cabazitaxel and Abiraterone

CASCARA: Castration Sensitive Carboplatin, Cabazitaxel and Abiraterone

Study Description
Brief Summary:
This is a phase II clinical trial in patients with metastatic castration sensitive prostate cancer. The objective of the study is to determine the efficacy and further define the safety of the treatment combination. This study will evaluate dose levels of carboplatin AUC 4 with cabazitaxel 20 mg/m2. Patients will be treated with the combination of ADT and carboplatin and cabazitaxel for 6 cycles. After 6 cycles of chemotherapy, they will start abiraterone with ADT. The primary objective is to determine the percent of subjects that have no PSA or radiographic progression at 1 year. Secondary objectives will include determining the progression-free survival, time to PSA nadir and time to PSA progression of carboplatin and cabazitaxel in combination with ADT.

Condition or disease Intervention/treatment Phase
Prostate Cancer Drug: Cabazitaxel Drug: Carboplatin Drug: Abiraterone Drug: Prednisone Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 61 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Carboplatin, Cabazitaxel and Abiraterone in High Volume Metastatic Castration Sensitive Prostate Cancer
Actual Study Start Date : October 10, 2019
Estimated Primary Completion Date : May 2025
Estimated Study Completion Date : May 2025
Arms and Interventions
Arm Intervention/treatment
Experimental: Carboplatin, Cabazitaxel and Abiraterone Drug: Cabazitaxel
20 mg/m2 Q 21 days

Drug: Carboplatin
AUC 4 Q21 Days x 6 cycles with ADT

Drug: Abiraterone
1000 mg PO daily

Drug: Prednisone
5 mg PO daily on chemotherapy completion

Outcome Measures
Primary Outcome Measures :
  1. Prostate-Specific Antigen (PSA) or Radiographic Progression [ Time Frame: 1 Year ]
    Proportion of patients who have no PSA or radiographic progression as determined by RECIST 1.1 or PCWG3 criteria


Secondary Outcome Measures :
  1. Progression-Free Survival (PFS) [ Time Frame: 1 Year ]
    Incidence of PFS

  2. PSA Nadir [ Time Frame: 1 Year ]
    Time to time to PSA nadir

  3. Incidence of adverse events [ Time Frame: 1 Year ]
    Safety and Tolerability

  4. Incidence of Homologous Recombination Deficiency (HRD) [ Time Frame: 1 Year ]
    Incidence of HRD

  5. PSA Complete Response Rate [ Time Frame: 1 Year ]
    PSA complete response rate (PSA <0.2 ng/ml) in patient with mutations in DNA repair genes

  6. PSA Complete Response Rate [ Time Frame: 1 Year ]
    PSA complete response rate (PSA <0.2 ng/ml) in patient without mutations in DNA repair genes

  7. PSA Progression [ Time Frame: 1 Year ]
    Time to PSA progression


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Willing and able to provide, or have a legally authorized representative provide, written informed consent and HIPAA authorization for the release of personal health information. A signed informed consent must be obtained before screening procedures are performed.
  • Histologically confirmed prostate cancer.
  • High volume metastatic disease (defined as the presence of visceral metastases or ≥3 bone lesions).
  • ADT for ≤3 months by day 1 of study chemotherapy; Prior episodes of ADT are allowed (i.e. ADT used previously in courses of radiation).
  • Testosterone <50 ng/dL. Patients must continue primary ADT with an LHRH analogue if they have not undergone orchiectomy.
  • ECOG Performance Status 0 or 1 (see Appendix A)
  • Patient has adequate bone marrow and organ function as defined by the following laboratory values:

    • Absolute neutrophil count ≥ 1.5 × 10^9/L
    • Platelets ≥ 100 × 10^9/L
    • Hemoglobin ≥ 9 g/dl
    • Serum creatinine ≤ 1.5mg/dL or estimated creatinine clearance ≥ 50 ml/min
    • In the absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <2.5 x ULN. If the patient has liver metastases, ALT and AST <5 x ULN
    • Total bilirubin < ULN; or total bilirubin ≤3.0 x ULN or direct bilirubin ≤1.5 x ULN in patients with well-documented Gilbert's Syndrome.
  • Sexually active males must use a condom during intercourse while taking study drugs and for 30 days after stopping treatment and should not father a child in this period. A condom is required to be used also by vasectomized men in order to prevent delivery of the drug via seminal fluid. Fertile males must use a condom with spermicide (double barrier method).
  • Age ≥ 18 years

Exclusion Criteria:

  • Prior exposure to any chemotherapy, PARPi, or immunotherapy for prostate cancer.
  • Prior abiraterone or enzalutamide, unless therapy was for < 2 weeks
  • Radiation therapy (including palliative radiotherapy to a metastatic lesion) within 14 days or major surgery (e.g., open abdominal, pelvic, thoracic, orthopedic or neurosurgery) within 28 days of the date of the first dose.
  • Other systemic therapies for prostate cancer within 28 days or 5 half-lives, whichever is shorter, prior to day 1 of chemotherapy (with the exception of anti-androgens like bicalutamide).
  • PSA <2.0 ng/mL at diagnosis.
  • If present, peripheral neuropathy must be ≤ Grade 1
  • Patients with an active second malignancy that could, in the investigator's opinion, potentially interfere with the patient's ability to participate and/or complete this trial.
  • Patients with central nervous system (CNS) involvement unless they meet ALL of the following criteria:

    • At least 4 weeks from prior therapy completion (including radiation and/or surgery) prior to starting the study treatment
    • Clinically stable CNS tumor at the time of screening.
    • Baseline screening for CNS metastases is not required unless presence of signs and/or symptoms of involvement
  • Patients with severe psychiatric illness/social situations that would limit compliance with study requirements in the judgment of treating investigator.
  • Patient has a history of non-compliance to medical regimen or inability to grant consent.
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Tamy Grainger 612 273 2800 tgraing1@fairview.org
Contact: Charles Ryan, MD 6126249487 ryanc@umn.edu

Locations
Layout table for location information
United States, Arizona
Mayo Clinic Arizona Recruiting
Phoenix, Arizona, United States, 85054
Principal Investigator: Alan Bryce, MD         
United States, Illinois
Northwestern University Recruiting
Chicago, Illinois, United States, 60611
Contact: David VanderWeele, MD, PhD         
University of Chicago Recruiting
Chicago, Illinois, United States, 60637
Contact: Walter Stadler, MD         
United States, Louisiana
Tulane University Recruiting
New Orleans, Louisiana, United States, 70112
Contact: Pedro C Barata, MD.MSc         
United States, Minnesota
Masonic Cancer Center at University of Minnesota Recruiting
Minneapolis, Minnesota, United States, 55455
Contact: Tamy Grainger    612-273-2800    tgraing1@fairview.org   
United States, Nevada
Comprehensive Cancer Centers of Nevada Recruiting
Las Vegas, Nevada, United States, 89169
Principal Investigator: Nicholas J Vogelzang, MD         
United States, Pennsylvania
Thomas Jeferson University Recruiting
Philadelphia, Pennsylvania, United States, 19107
Principal Investigator: William Kevin Kelly, DO         
United States, Rhode Island
Lifespan Cancer Institute Recruiting
Providence, Rhode Island, United States, 02903
Principal Investigator: Andre De Souza, MD         
Sponsors and Collaborators
Masonic Cancer Center, University of Minnesota
Investigators
Layout table for investigator information
Principal Investigator: Charles Ryan, MD University of Minnesota, Division of Hematology, Oncology and Transplantation
Tracking Information
First Submitted Date  ICMJE April 26, 2019
First Posted Date  ICMJE May 2, 2019
Last Update Posted Date May 28, 2021
Actual Study Start Date  ICMJE October 10, 2019
Estimated Primary Completion Date May 2025   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 30, 2019)
Prostate-Specific Antigen (PSA) or Radiographic Progression [ Time Frame: 1 Year ]
Proportion of patients who have no PSA or radiographic progression as determined by RECIST 1.1 or PCWG3 criteria
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: April 30, 2019)
  • Progression-Free Survival (PFS) [ Time Frame: 1 Year ]
    Incidence of PFS
  • PSA Nadir [ Time Frame: 1 Year ]
    Time to time to PSA nadir
  • Incidence of adverse events [ Time Frame: 1 Year ]
    Safety and Tolerability
  • Incidence of Homologous Recombination Deficiency (HRD) [ Time Frame: 1 Year ]
    Incidence of HRD
  • PSA Complete Response Rate [ Time Frame: 1 Year ]
    PSA complete response rate (PSA <0.2 ng/ml) in patient with mutations in DNA repair genes
  • PSA Complete Response Rate [ Time Frame: 1 Year ]
    PSA complete response rate (PSA <0.2 ng/ml) in patient without mutations in DNA repair genes
  • PSA Progression [ Time Frame: 1 Year ]
    Time to PSA progression
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE CASCARA: Castration Sensitive Carboplatin, Cabazitaxel and Abiraterone
Official Title  ICMJE A Phase II Study of Carboplatin, Cabazitaxel and Abiraterone in High Volume Metastatic Castration Sensitive Prostate Cancer
Brief Summary This is a phase II clinical trial in patients with metastatic castration sensitive prostate cancer. The objective of the study is to determine the efficacy and further define the safety of the treatment combination. This study will evaluate dose levels of carboplatin AUC 4 with cabazitaxel 20 mg/m2. Patients will be treated with the combination of ADT and carboplatin and cabazitaxel for 6 cycles. After 6 cycles of chemotherapy, they will start abiraterone with ADT. The primary objective is to determine the percent of subjects that have no PSA or radiographic progression at 1 year. Secondary objectives will include determining the progression-free survival, time to PSA nadir and time to PSA progression of carboplatin and cabazitaxel in combination with ADT.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Prostate Cancer
Intervention  ICMJE
  • Drug: Cabazitaxel
    20 mg/m2 Q 21 days
  • Drug: Carboplatin
    AUC 4 Q21 Days x 6 cycles with ADT
  • Drug: Abiraterone
    1000 mg PO daily
  • Drug: Prednisone
    5 mg PO daily on chemotherapy completion
Study Arms  ICMJE Experimental: Carboplatin, Cabazitaxel and Abiraterone
Interventions:
  • Drug: Cabazitaxel
  • Drug: Carboplatin
  • Drug: Abiraterone
  • Drug: Prednisone
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: April 30, 2019)
61
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE May 2025
Estimated Primary Completion Date May 2025   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Willing and able to provide, or have a legally authorized representative provide, written informed consent and HIPAA authorization for the release of personal health information. A signed informed consent must be obtained before screening procedures are performed.
  • Histologically confirmed prostate cancer.
  • High volume metastatic disease (defined as the presence of visceral metastases or ≥3 bone lesions).
  • ADT for ≤3 months by day 1 of study chemotherapy; Prior episodes of ADT are allowed (i.e. ADT used previously in courses of radiation).
  • Testosterone <50 ng/dL. Patients must continue primary ADT with an LHRH analogue if they have not undergone orchiectomy.
  • ECOG Performance Status 0 or 1 (see Appendix A)
  • Patient has adequate bone marrow and organ function as defined by the following laboratory values:

    • Absolute neutrophil count ≥ 1.5 × 10^9/L
    • Platelets ≥ 100 × 10^9/L
    • Hemoglobin ≥ 9 g/dl
    • Serum creatinine ≤ 1.5mg/dL or estimated creatinine clearance ≥ 50 ml/min
    • In the absence of liver metastases, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) <2.5 x ULN. If the patient has liver metastases, ALT and AST <5 x ULN
    • Total bilirubin < ULN; or total bilirubin ≤3.0 x ULN or direct bilirubin ≤1.5 x ULN in patients with well-documented Gilbert's Syndrome.
  • Sexually active males must use a condom during intercourse while taking study drugs and for 30 days after stopping treatment and should not father a child in this period. A condom is required to be used also by vasectomized men in order to prevent delivery of the drug via seminal fluid. Fertile males must use a condom with spermicide (double barrier method).
  • Age ≥ 18 years

Exclusion Criteria:

  • Prior exposure to any chemotherapy, PARPi, or immunotherapy for prostate cancer.
  • Prior abiraterone or enzalutamide, unless therapy was for < 2 weeks
  • Radiation therapy (including palliative radiotherapy to a metastatic lesion) within 14 days or major surgery (e.g., open abdominal, pelvic, thoracic, orthopedic or neurosurgery) within 28 days of the date of the first dose.
  • Other systemic therapies for prostate cancer within 28 days or 5 half-lives, whichever is shorter, prior to day 1 of chemotherapy (with the exception of anti-androgens like bicalutamide).
  • PSA <2.0 ng/mL at diagnosis.
  • If present, peripheral neuropathy must be ≤ Grade 1
  • Patients with an active second malignancy that could, in the investigator's opinion, potentially interfere with the patient's ability to participate and/or complete this trial.
  • Patients with central nervous system (CNS) involvement unless they meet ALL of the following criteria:

    • At least 4 weeks from prior therapy completion (including radiation and/or surgery) prior to starting the study treatment
    • Clinically stable CNS tumor at the time of screening.
    • Baseline screening for CNS metastases is not required unless presence of signs and/or symptoms of involvement
  • Patients with severe psychiatric illness/social situations that would limit compliance with study requirements in the judgment of treating investigator.
  • Patient has a history of non-compliance to medical regimen or inability to grant consent.
Sex/Gender  ICMJE
Sexes Eligible for Study: Male
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Tamy Grainger 612 273 2800 tgraing1@fairview.org
Contact: Charles Ryan, MD 6126249487 ryanc@umn.edu
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03934840
Other Study ID Numbers  ICMJE 2018LS158
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Masonic Cancer Center, University of Minnesota
Study Sponsor  ICMJE Masonic Cancer Center, University of Minnesota
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Charles Ryan, MD University of Minnesota, Division of Hematology, Oncology and Transplantation
PRS Account Masonic Cancer Center, University of Minnesota
Verification Date May 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

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