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A Study of Sipuleucel-T With Administration of Enzalutamide in Men With Metastatic Castrate-Resistant Prostate Cancer

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Dendreon
ClinicalTrials.gov Identifier:
NCT01981122
First received: October 29, 2013
Last updated: August 22, 2014
Last verified: August 2014
  Purpose

This is a randomized, open-label study designed to assess the effects of sipuleucel-T when administered concurrently or sequentially with enzalutamide.


Condition Intervention Phase
Metastatic Prostate Cancer
Biological: sipuleucel-T
Drug: enzalutamide
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Basic Science
Official Title: A Randomized, Open-label, Phase 2 Study of Sipuleucel-T With Concurrent Versus Sequential Administration of Enzalutamide in Men With Metastatic Castrate-Resistant Prostate Cancer

Resource links provided by NLM:


Further study details as provided by Dendreon:

Primary Outcome Measures:
  • To evaluate peripheral PA2024-specific T cell immune response to sipuleucel-T over time via a T cell stimulation index from a proliferation assay. [ Time Frame: One year after the last subject completes 52 weeks of enzalutamide dosing. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To evaluate time to prostate-specific antigen (PSA) progression. [ Time Frame: One year after the last subject experiences PSA progression. ] [ Designated as safety issue: No ]
  • To estimate the percent of subjects who are PSA progression-free at 12 months. [ Time Frame: One year after the last subject completes 52 weeks of enzalutamide dosing. ] [ Designated as safety issue: No ]
  • To evaluate overall survival. [ Time Frame: One year after the last subject expires. ] [ Designated as safety issue: No ]
  • To evaluate the number of participants with Adverse Events and Serious Adverse Events [ Time Frame: One year after the last subject completes 52 weeks of enzalutamide dosing. ] [ Designated as safety issue: Yes ]
  • To determine the magnitude of peripheral immune response over time. [ Time Frame: One year after the last subject completes 52 weeks of enzalutamide dosing. ] [ Designated as safety issue: No ]

    To determine the magnitude of peripheral immune response over time as determined by the following:

    • Peripheral PAP-specific T cell immune response to sipuleucel-T over time via a T cell stimulation index from a proliferation assay.
    • T cell interferon-γ enzyme-linked immunosorbent spot assay (ELISPOT) response to PA2024 and PAP.
    • Humoral response to PA2024 and PAP by enzyme-linked immunosorbent assay (ELISA).
    • Chemokine and cytokine production via fluorescent immunoassay (Luminex® assay).


Estimated Enrollment: 100
Study Start Date: September 2013
Estimated Primary Completion Date: September 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Concurrent Arm
Subjects will receive sipuleucel-T concurrently with enzalutamide (160 mg orally once daily). Enzalutamide treatment will start 2 weeks prior to the first leukapheresis and continue for 52 weeks or until disease progression or unacceptable toxicity, whichever occurs first.
Biological: sipuleucel-T
Sipuleucel-T is an autologous cell product consisting of antigen presenting cells (APCs) loaded with PA2024, a recombinant fusion protein composed of prostatic acid phosphatase (PAP), linked to granulocyte-macrophage colony-stimulating factor (GM-CSF).
Other Names:
  • PROVENGE(R)
  • APC8015
Drug: enzalutamide
Enzalutamide is an androgen receptor inhibitor. It is indicated for the treatment of patients with mCRPC who have previously received docetaxel. The enzalutamide dose used in this study will be 160 mg orally once daily.
Other Name: Xtandi
Experimental: Sequential Arm
Subjects will receive sipuleucel-T followed by enzalutamide (160 mg orally once daily). Enzalutamide treatment will start approximately 10 weeks after the first infusion of sipuleucel-T and continue for 52 weeks or until disease progression or unacceptable toxicity, whichever occurs first.
Biological: sipuleucel-T
Sipuleucel-T is an autologous cell product consisting of antigen presenting cells (APCs) loaded with PA2024, a recombinant fusion protein composed of prostatic acid phosphatase (PAP), linked to granulocyte-macrophage colony-stimulating factor (GM-CSF).
Other Names:
  • PROVENGE(R)
  • APC8015
Drug: enzalutamide
Enzalutamide is an androgen receptor inhibitor. It is indicated for the treatment of patients with mCRPC who have previously received docetaxel. The enzalutamide dose used in this study will be 160 mg orally once daily.
Other Name: Xtandi

Detailed Description:

This is a randomized, open-label study designed to assess the effects of sipuleucel-T when administered concurrently or sequentially with enzalutamide. This study consists of 3 phases. The screening phase will begin at the completion of the informed consent process and continue through registration. The active phase will begin at registration and continue through the post-treatment visit (30 to 37 days following the last study treatment). The long term follow-up (LTFU) phase will begin after the post-treatment visit and will continue until the subject's death or until Dendreon terminates the study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written informed consent provided prior to the initiation of study procedures.
  • Age ≥ 18 years.
  • Histologically documented adenocarcinoma prostate cancer confirmed by a pathology report from prostate biopsy or a radical prostatectomy specimen.
  • Metastatic disease as evidenced by bone metastasis or lymph node metastasis.
  • Castrate-resistant prostate cancer as demonstrated by one of the following:

    • Prostate specific antigen progression.
    • Progression of measurable disease.
    • Progression of non-measurable disease by soft tissue disease or bone disease.
  • Castration levels of testosterone (≤ 50 ng/dL) achieved via medical or surgical castration.
  • Serum PSA ≥ 2.0 ng/mL.
  • Screening ECOG performance status ≤ 1
  • Adequate screening hematologic, renal, and liver function as evidenced by laboratory test results obtained ≤ 28 days prior to registration.
  • Negative serology test for human immunodeficiency virus 1 and 2.
  • Resides within driving distance (round trip within 1 day) of the clinical trial site for the duration of the active phase.

Exclusion Criteria:

  • The presence of known lung, liver, or brain metastases, malignant pleural effusions, or malignant ascites.
  • Spinal cord compression, imminent long bone fracture, or any other condition that is likely to require radiation therapy and/or steroids for pain control during the active phase.
  • History of stage 3 or greater cancer, excluding prostate cancer. Basal or squamous cell skin cancers must have been adequately treated and the subject must be disease free at the time of registration. Subjects with a history of stage 1 or 2 cancer must have been adequately treated and been disease free for ≥ 3 years at the time of registration.
  • History of seizures or of predisposing factors for seizures.
  • Child-Pugh Class C hepatic insufficiency.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to sipuleucel-T, GM-CSF or granulocyte colony stimulating factor (G-CSF).
  • Previous treatment with sipuleucel-T or enrollment in a sipuleucel-T trial, regardless of whether the subject received sipuleucel-T or control.
  • Previous treatment with enzalutamide.
  • Previous treatment with abiraterone acetate.
  • Previous treatment with ipilimumab.
  • Previous treatment with ketoconazole other than topical use or for treatment of infections (e.g., oral thrush); most recent use must have been ≥ 7 days prior to registration.
  • Previous treatment with any immunotherapy or investigational vaccine.
  • A requirement for ongoing systemic immunosuppressive therapy. Use of inhaled, intranasal, intra-articular, and topical steroids is allowed. Oral or IV steroids to prevent or treat IV contrast reactions are allowed.
  • Previous treatment with chemotherapy for mCRPC, or chemotherapy for any reason ≤ 2 years prior to registration.
  • Use of concomitant medications that may lower the seizure threshold or the use of antiseizure medications ≤ 1 year prior to registration.
  • Received GM-CSF or G-CSF ≤ 90 days prior to registration.
  • Ongoing non-steroidal antiandrogen withdrawal response.
  • Any of the following medications or interventions ≤ 28 days prior to registration:

    • Radiation therapy, either via external beam or brachytherapy.
    • Any systemic steroid. Use of inhaled, intra-nasal, intra-articular, and topical steroids is allowed. Oral or IV steroids to prevent or treat IV contrast reactions are allowed.
    • Any systemic therapy for prostate cancer, except for ADT.
    • Any investigational product for prostate cancer.
    • Major surgery requiring general anesthesia, with the exception of placement of central venous catheters.
    • Inducers and inhibitors of cytochrome P450 (CYP) enzyme CYP2C8 (gemfibrozil and rifampin).
    • Medications that are metabolized by CYP3A4, CYP2C9, or CYP2C19 that have a narrow therapeutic index.
    • Inducers of CYP3A4 (including but not limited to phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, and phenobarbital).
  • A requirement for treatment with opioid analgesics for cancer-related pain ≤ 21 days prior to registration.
  • An active infection requiring parenteral antibiotic therapy or causing fever (temperature > 100.5˚ F or 38.1˚ C) ≤ 1 week prior to registration.
  • Any medical intervention, any other condition, or any other circumstance which could compromise adherence with study requirements or otherwise compromise the study's objectives.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01981122

  Show 19 Study Locations
Sponsors and Collaborators
Dendreon
Investigators
Study Director: Andy Sandler, MD Dendreon
  More Information

No publications provided

Responsible Party: Dendreon
ClinicalTrials.gov Identifier: NCT01981122     History of Changes
Other Study ID Numbers: P12-2
Study First Received: October 29, 2013
Last Updated: August 22, 2014
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Diseases, Male
Genital Neoplasms, Male
Neoplasms
Neoplasms by Site
Prostatic Diseases
Urogenital Neoplasms

ClinicalTrials.gov processed this record on October 21, 2014