Provenge With or Without pTVG-HP DNA Booster Vaccine in Prostate Cancer

This study is currently recruiting participants. (see Contacts and Locations)
Verified April 2015 by University of Wisconsin, Madison
Sponsor:
Collaborator:
Dendreon
Information provided by (Responsible Party):
University of Wisconsin, Madison
ClinicalTrials.gov Identifier:
NCT01706458
First received: October 9, 2012
Last updated: April 2, 2015
Last verified: April 2015
  Purpose

This randomized pilot clinical trial studies sipuleucel-T with or without deoxyribonucleic acid (DNA) vaccine therapy in treating patients with prostate cancer that has not responded to previous treatment with hormones and has spread to other places in the body. Vaccines may help the body build an effective immune response to kill tumor cells. It is not yet known whether giving sipuleucel-T vaccine works better with or without DNA vaccine therapy in treating prostate cancer.


Condition Intervention Phase
Prostate Cancer
Biological: sipuleucel-T
Biological: DNA Vaccine
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pilot Trial of Sipuleucel-T, With or Without pTVG-HP DNA Booster Vaccine, in Patients With Castrate-Resistant, Metastatic Prostate Cancer

Resource links provided by NLM:


Further study details as provided by University of Wisconsin, Madison:

Primary Outcome Measures:
  • Measure immune responses following treatment [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Progression-free Survival [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Time to radiographic disease progression [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Measure prostate-specific antigen (PSA) doubling time [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Other Outcome Measures:
  • Overall Survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • Number of Circulating Tumor Cells [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  • PAP-specific antibody and T-cell immune responses following treatment with sipuleucel-T and DNA vaccine will be summarized in tabular format. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Logistic regression analysis will be conducted to evaluate whether PAP-specific immune response is associated with prolonged (1-year) progression-free survival. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Logistic regression analysis will be conducted to evaluate whether baseline immune responses predict for immune responses elicited/augmented following treatment with sipuleucel-T +/- DNA vaccine. [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • The detection of antigen spread to other prostate associated antigens, and the identification of specific antigens recognized, will be analyzed descriptively. [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 30
Study Start Date: February 2013
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: sipuleucel-T
Patients receive sipuleucel-T IV on weeks 0, 2, and 4.
Biological: sipuleucel-T
Given IV
Other Name: Provenge
Experimental: sipuleucel-T with DNA Vaccine
Patients receive sipuleucel-T as patients in arm I and pTVG-HP plasmid DNA vaccine ID on weeks 6, 8, 10, and 12, and then at 6 and 9 months.
Biological: sipuleucel-T
Given IV
Other Name: Provenge
Biological: DNA Vaccine
Given ID
Other Name: pTVG-HP with rhGM-CSF

  Eligibility

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

Inclusion Criteria:

  • Histologically confirmed diagnosis of prostate cancer (adenocarcinoma of the prostate)
  • Metastatic disease as evidenced by the presence of soft tissue and/or bone metastases on imaging studies (computed tomography [CT] of abdomen/pelvis, bone scintigraphy)
  • Castrate-resistant disease, defined as follows:

    • All patients must have received standard of care androgen deprivation treatment before trial entry (surgical castration versus gonadotropin-releasing hormone [GnRH] analogue or antagonist treatment), and subjects receiving GnRH analogue or antagonist must continue this treatment throughout the time on this study
    • Patients may have been treated previously with a nonsteroidal antiandrogen, with evidence of disease progression subsequently; subjects must be off use of anti-androgen for at least 4 weeks (for flutamide) or 6 weeks (for bicalutamide or nilutamide) prior to registration

      ** Subjects who demonstrate an anti-androgen withdrawal response, defined as a >= 25% decline in PSA within 4-6 week of stopping a nonsteroidal antiandrogen are not eligible until the PSA rises above the nadir observed after antiandrogen withdrawal

    • Castration levels of testosterone (< 50 ng/dL) within 2 weeks of registration
  • Progressive disease while receiving androgen deprivation therapy defined by any one of the following as per the Prostate Cancer Clinical Trials Working Group 2 (PCWG2) bone scan criteria or Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 during or after completing last therapy:

    • PSA: at least two consecutive rises in serum PSA, obtained at a minimum of 1-week intervals, and each value >= 2.0 ng/mL
    • Measurable disease: >= 50% increase in the sum of the cross products of all measurable lesions or the development of new measurable lesions; the short axis of a target lymph node must be at least 15 mm by spiral CT to be considered a target lesion
    • Non-measurable (bone) disease: the appearance of two or more new areas of uptake on bone scan consistent with metastatic disease compared to previous imaging during castration therapy; the increased uptake of pre-existing lesions on bone scan will not be taken to constitute progression, and ambiguous results must be confirmed by other imaging modalities (e.g. X-ray, CT or magnetic resonance imaging [MRI])
  • Must have >= 3 serum PSA values obtained over at least a 12 week period of time prior to registration, including the day of screening, to calculate a PSA doubling time; Note: PSA's are not required to be obtained at the same laboratory; use all PSA values that have been done in last 6 months to calculate PSA doubling time
  • Life expectancy of at least 6 months
  • Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
  • White blood cell >= 2000/mm^3
  • Absolute neutrophil count >= 1000/mm^3
  • Hemoglobin (HgB) >= 9.0 mg/dL
  • Platelets >= 100,000/mm^3
  • Creatinine =< 2.0 mg/dL
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) =< 2.5 x institutional upper limit of normal
  • Negative serology tests for human immunodeficiency virus (HIV) 1 and 2, and for active hepatitis B or hepatitis C, within 14 days of first peripheral blood collection for sipuleucel-T
  • Patients must be at least 4 weeks from any prior treatments and have recovered (to < grade 2) from acute toxicity attributed to this prior treatment
  • Patients must be informed of the experimental nature of the study and its potential risks, and must sign an Institutional Review Board (IRB)-approved written informed consent form indicating such an understanding

Exclusion Criteria:

  • Small cell or other variant prostate cancer histology
  • Patients may not be receiving other investigational agents or be receiving concurrent anticancer therapy other than androgen deprivation
  • Symptomatic metastatic disease, as defined by the need for opioid analgesics for the treatment of pain attributed to a prostate cancer metastatic lesion; patients receiving opioids must receive approval from the principal investigator (PI) for eligibility
  • Patients may not have been treated with prior sipuleucel-T
  • Treatment with any of the following medications within 28 days of registration, or while on study, is prohibited:

    • Systemic corticosteroids (at doses over the equivalent of 1 mg prednisone daily); inhaled, intranasal or topical corticosteroids are acceptable
    • Prostate cancer (PC)-SPES
    • Saw palmetto
    • Megestrol
    • Ketoconazole
    • 5-alpha-reductase inhibitors-patients already taking 5-alpha-reductase inhibitors prior to 28 days prior to registration may stay on these agents throughout the course of therapy, but these should not be started while patients are on study
    • Diethyl stilbestrol
    • Abiraterone
    • Any other hormonal agent or supplement being used with the intent of cancer treatment
  • External beam radiation therapy within 4 weeks of registration is prohibited, or anticipated need for radiation therapy (e.g. imminent pathological fracture or spinal cord compression) within 3 months of registration
  • Major surgery within 4 weeks of registration is prohibited
  • Prior cytotoxic chemotherapy (e.g. docetaxel, mitoxantrone, cabazitaxel) within 6 months of registration is prohibited
  • Patients with a history of life-threatening autoimmune disease
  • Patients who have undergone splenectomy
  • Patients must not have other active malignancies other than non-melanoma skin cancers or carcinoma in situ of the bladder; subjects with a history of other cancers who have been adequately treated and have been recurrence-free for >= 3 years are eligible
  • Patients with known brain metastases
  • Any antibiotic therapy or evidence of infection within 1 week of registration
  • Any other medical intervention or condition, which, in the opinion of the PI could compromise patient safety or adherence with the study requirements
  • Patients cannot have concurrent enrollment on other phase I, II, or III investigational treatment studies
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01706458

Contacts
Contact: Cancer Connect 800-622-8922 cancerconnect@uwcarbone.wisc.edu

Locations
United States, Wisconsin
University of Wisconsin Carbone Cancer Center Recruiting
Madison, Wisconsin, United States, 53792
Principal Investigator: Glenn Liu, M.D..         
Sponsors and Collaborators
University of Wisconsin, Madison
Dendreon
Investigators
Principal Investigator: Douglas McNeel, M.D., PhD University of Wisconsin, Madison
  More Information

Additional Information:
No publications provided

Responsible Party: University of Wisconsin, Madison
ClinicalTrials.gov Identifier: NCT01706458     History of Changes
Other Study ID Numbers: CO11816
Study First Received: October 9, 2012
Last Updated: April 2, 2015
Health Authority: United States: Food and Drug Administration
United States: Data and Safety Monitoring Board

Keywords provided by University of Wisconsin, Madison:
Vaccine
pTVG-HP
Prostate Cancer
Castrate Resistant

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 September 03, 2015