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PROvenge Treatment and Early Cancer Treatment (PROTECT)

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ClinicalTrials.gov Identifier: NCT00779402
Recruitment Status : Completed
First Posted : October 24, 2008
Results First Posted : January 29, 2018
Last Update Posted : January 29, 2018
Sponsor:
Information provided by (Responsible Party):
Dendreon

Brief Summary:
The PROTECT-PROvenge Treatment and Early Cancer Treatment trial was a Phase III trial for patients with hormone sensitive prostate cancer. The study was conducted at over 15 participating centers throughout the US. The purpose of the study was to determine if sipuleucel-T was effective for treatment of early stage, non-metastatic prostate cancer. The study compared the active vaccine to control to determine whether the product delayed the time until cancer progression.

Condition or disease Intervention/treatment Phase
Prostate Cancer Other: Control Biological: Sipuleucel-T Phase 3

Detailed Description:

This was a prospective, double blind, controlled, randomized trial of immunotherapy with prostatic acid phosphatase (PAP)-loaded autologous antigen presenting cells (APCs), in subjects with non metastatic prostate cancer. Subjects that qualified for this study were men who had previously undergone a prostatectomy and whose only sign of disease recurrence was a rise in serum prostate specific antigen (PSA).

The primary objectives were to compare the time to biochemical failure (BF, PSA greater than or equal to 3 ng/mL) between sipuleucel-T (treatment group) and control, and to study the safety of sipuleucel-T.

Following short-term open-label treatment with a luteinizing hormone-releasing hormone-analogue (LHRH-a), Subjects completed a checklist designed to compare androgen suppression-related side effects during periods with and without androgen suppression.

Subjects who achieved a PSA of < 1 ng/ml were randomized to blinded treatment assignments of either sipuleucel-T or control in a 2:1 ratio. Following randomization, subjects underwent 3 leukapheresis procedures on alternate weeks (Weeks 0, 2, and 4). Approximately three days following each leukapheresis procedure, subjects received an infusion of either sipuleucel-T or control.

At the time BF was confirmed, subjects were eligible for a booster infusion. The booster process consisted of 1 leukapheresis procedure followed by 1 infusion of sipuleucel-T. The booster process, in effect under protocol amendment 5, differed from the previous booster process that consisted of 1 infusion of the same treatment assigned at randomization (sipuleucel-T or control).

Subjects continued to be observed until DF was confirmed by bone scan or computed tomography (CT) scan, or other imaging modalities as clinically indicated. After confirmed DF, subjects were followed by telephone every 6 months for safety and survival, treatment-related AEs, any CVEs, or new therapies for prostate cancer.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 176 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Autologous PAP-loaded Dendritic Cell Vaccine (Sipuleucel-T, APC8015, Provenge®) in Patients With Non-metastatic Prostate Cancer Who Experience PSA Elevation Following Radical Prostatectomy: a Randomized, Controlled, Double-blind Trial
Study Start Date : October 2001
Actual Primary Completion Date : August 2006
Actual Study Completion Date : May 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Sipuleucel-T
Subjects received infusion of Sipuleucel-T, at 2-week intervals, for a total of 3 infusions.
Biological: Sipuleucel-T
Sipuleucel-T is an autologous cellular product consisting of antigen presenting cells (APCs) activated with PA2024, a recombinant fusion protein composed of prostatic acid phosphatase (PAP), linked to granulocyte-macrophage colony-stimulating factor (GM-CSF).
Other Names:
  • Provenge®
  • APC8015
Placebo Comparator: Control
Subjects received infusion of control (autologous cellular product consisting of antigen presenting cells (APCs) prepared in the absence of PA2024 antigen) at 2-week intervals, for a total of 3 infusions.
Other: Control
Autologous cellular product consisting of antigen presenting cells (APCs) prepared in the absence of PA2024 antigen.



Primary Outcome Measures :
  1. Time to Biochemical Failure Cumulative Incidence Percentile [ Time Frame: Every 3 months post-infusion ]
    Time to Biochemical Failure (TTBF) was the pre-specified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL

  2. Number of Subjects That Met Biochemical Failure Status [ Time Frame: Every 3 months post-infusion ]
    time to biochemical Failure (TTBF) was the pre-scpecified primary endpoint of this trial. The biochemical failure threshold was based on evidence that prostate specific antigen (PSA) had become ≥ 3 ng/mL.



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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria for the Run-In Phase (Week -13)

  • Histologic diagnosis of adenocarcinoma of the prostate.
  • Within at least 3 months, but not more than 10 years, prior to initiation of the run-in phase with LHRH-a depot, the subject has undergone a radical prostatectomy for Stage T1b - T3c, N0 - N1, Nx, or M0 disease Subjects who experienced their first PSA recurrence within 2 years post completion of initial therapy of curative intent was eligible without consideration of the Gleason score of the tumor specimen. Subjects who experienced their first PSA relapse between 2 and 10 years post completion of initial therapy of curative intent was eligible only if the Gleason score of the tumor specimen was ≥ 7.
  • Therapeutic PSA response to primary therapy was below 0.4 ng/mL.
  • Tumor specimen positive for PAP.
  • PSA relapse while not currently receiving androgen ablation therapy.
  • If androgen ablation was given for a previous PSA relapse, PSA must have increased to a level at least 25% above the nadir observed while on this therapy, and to an absolute level of at least 3 ng/mL.
  • Subjects who had been treated with adjuvant or salvage radiation following radical prostatectomy, or with either LHRH-a (e.g., leuprolide acetate or goserelin acetate) or non-steroidal anti-androgen therapy (e.g., bicalutamide 150 mg/day) for a prior PSA relapse, may enter the study provided: Post-prostatectomy PSA was never ≥ 20 ng/mL; PSA was not rising while subject received hormonal therapy, and; For any hormonal therapy received, the last effective day of androgen deprivation was at least 6 months prior to the date of LHRH-a depot placement.
  • Confirmed Stage M0 disease.
  • Estimated life expectancy of at least 1 year.
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
  • Ability to understand the trial procedures and requirements.
  • ≥ 18 and ≤ 80 years of age.
  • Ability to understand and willingness to sign an informed consent form.

Exclusion Criteria:

Exclusion Criteria for Entry into the Run-In Phase (Week -13)

  • Metastasis.
  • Clinical evidence of local recurrence other than PSA elevation (e.g., palpable induration or mass in the prostatic fossa).
  • Any surgery within 4 weeks prior to the date of LHRH-a depot placement.
  • Prior orchiectomy.
  • PSA ≥ 20 ng/mL at any time after radical prostatectomy.
  • Current systemic steroid therapy (inhaled or topical steroids are acceptable).
  • Any chemotherapy within 4 months prior to the LHRH-a depot placement.
  • Prior immunotherapy or therapy with other experimental agents for prostate cancer.
  • Treatment with radioactive seeds within 12 months prior to the LHRH a depot placement.
  • History of any other prior malignancy other than resected basal or squamous cell carcinoma of the skin within 5 years of entry.
  • Concurrent participation in another clinical trial involving experimental medication.
  • Any disease, condition, social, or geographical constraint that in the opinion of the Investigator or medical monitor reduced the probability that the subject will complete the trial or affects the evaluation of study end points

Exclusion Criteria for Randomization (Week 0):

  • Central laboratory value of PSA ≥ 1 ng/mL at the end of the LHRH-a run-in phase.
  • Randomized more than 3 weeks following the last effective date of testicular androgen suppression (as described in the package insert).
  • Any use of herbal preparations (e.g., Prostate Cancer (PC) -SPES or saw palmetto) within 4 weeks prior to randomization.
  • Any contraindication to leukapheresis or infusion of sipuleucel-T or control.
  • Positive serology for human immunodeficiency virus (HIV)-1 or 2, human lymphotropic virus (HTLV)-1 or 2, or evidence of active Hepatitis B or C infection.
  • Any ongoing active bacterial, viral, or fungal infection.

Exclusion Criteria During the Trial:

  • The use of any systemic therapy for prostate cancer following randomization and prior to BF (PSA ≥ 3 ng/mL).
  • Placement of radioactive seeds or salvage radiation before BF (PSA ≥ 3 ng/mL) documented.
  • Initiation of systemic corticosteroids at doses greater than the equivalent of 40 mg hydrocortisone per day (inhaled steroids are allowed) before BF.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00779402


Locations
United States, California
Alta Bates Comprehensive Cancer Center
Berkeley, California, United States, 94704
South Orange County Medical Research
Laguna Hills, California, United States, 92653
United States, Colorado
University of Colorado Health Sciences Center
Aurora, Colorado, United States, 80045-3206
United States, Illinois
Oncology Specialists, SC
Park Ridge, Illinois, United States, 60068-1174
United States, New York
Mount Sinai School of Medicine
New York, New York, United States, 10029
University of Rochester Medical Center
Rochester, New York, United States, 14642-0001
United States, North Carolina
McKay Urology
Charlotte, North Carolina, United States, 28207
United States, Ohio
AKSM Clinical Research Group
Columbus, Ohio, United States, 43214
United States, Oregon
Providence Medical Center
Portland, Oregon, United States, 97213
Oregon Health and Sciences University
Portland, Oregon, United States, 97239
Oregon Urology Institute
Springfield, Oregon, United States, 97477
United States, Pennsylvania
Urology Health Specialists - Bryn Mawr
Bryn Mawr, Pennsylvania, United States, 19010
Albert Einstein Medical Building
Philadelphia, Pennsylvania, United States, 19141
Bryn Mawr Urology Group
Rosemont, Pennsylvania, United States, 19010
United States, Tennessee
University of Tennessee
Memphis, Tennessee, United States, 38163
United States, Virginia
Urology of Virginia, PC
Virginia Beach, Virginia, United States, 23462
United States, Washington
Virginia Mason Medical Center
Seattle, Washington, United States, 98101
Swedish Medical Center
Seattle, Washington, United States, 98104
Sponsors and Collaborators
Dendreon
Investigators
Study Director: Robert Israel, MD Valeant Pharmaceuticals North America LLC

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Dendreon
ClinicalTrials.gov Identifier: NCT00779402     History of Changes
Other Study ID Numbers: P-11
First Posted: October 24, 2008    Key Record Dates
Results First Posted: January 29, 2018
Last Update Posted: January 29, 2018
Last Verified: June 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Dendreon:
cancer
prostate cancer
prostatectomy
PSA
sipuleucel-T
PROVENGE
APC8015
non-metastatic
nonmetastatic
androgen-sensitive
androgen sensitive
biochemical recurrence
biochemically recurrent
immune therapy
immunotherapy
vaccine
dendritic cells
antigen-presenting cells
antigen presenting cells
cancer vaccine
therapeutic vaccine
therapeutic cancer vaccine
biologic
booster

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Prostatic Diseases
Vaccines
Androgens
Immunologic Factors
Physiological Effects of Drugs
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists