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Platform Study for Prostate Researching Translational Endpoints Correlated to Response to Inform Use of Novel Combinations (PORTER)

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ClinicalTrials.gov Identifier: NCT03835533
Recruitment Status : Recruiting
First Posted : February 8, 2019
Last Update Posted : November 18, 2019
Sponsor:
Collaborators:
Bristol-Myers Squibb
Celldex Therapeutics
Cancer Research Institute, New York City
Inovio Pharmaceuticals
Oncovir, Inc.
Information provided by (Responsible Party):
Parker Institute for Cancer Immunotherapy

Tracking Information
First Submitted Date  ICMJE February 7, 2019
First Posted Date  ICMJE February 8, 2019
Last Update Posted Date November 18, 2019
Actual Study Start Date  ICMJE June 21, 2019
Estimated Primary Completion Date March 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: February 7, 2019)
Incidence and severity of adverse events [ Time Frame: Up to 2.5 years ]
Original Primary Outcome Measures  ICMJE Same as current
Change History Complete list of historical versions of study NCT03835533 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: February 7, 2019)
  • Objective response rate (ORR) [ Time Frame: Up to 2.5 years ]
    ORR is a composite endpoint where response is defined as a participant meeting at least one of the following: circulating tumor cells change from unfavorable to favorable ; ≥ 50% reduction in Prostate-Specific Antigen (PSA) from baseline; confirmed complete response (CR) or partial response (PR)
  • Disease control rate [ Time Frame: At 9 months ]
    Defined as CR, PR, or stable disease (SD) for 9 months as best response by Prostate Cancer Clinical Trials Working Group 3 (PCWG3)-modified Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
  • Radiographic progression-free survival (rPFS) [ Time Frame: Up to 2.5 years ]
    Defined as time from initiation of study intervention to the first objective evidence of radiographic progression, or death due to any cause (whichever occurs first)
  • Overall survival (OS) [ Time Frame: Up to 2.5 years ]
    Defined as the time from initiation of study invention until death due to any cause
  • Overall survival (OS) at 12 months [ Time Frame: At 12 months ]
    Defined as the time from initiation of study invention until death due to any cause
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 Platform Study for Prostate Researching Translational Endpoints Correlated to Response to Inform Use of Novel Combinations
Official Title  ICMJE A Multicenter, Open-Label, Exploratory Platform Study to Evaluate Biomarkers and Immunotherapy Combinations for the Treatment of Patients With Metastatic Castration-resistant Prostate Cancer
Brief Summary This study is designed to evaluate multiple clinical hypotheses and mechanistically-defined combinations to evaluate the safety and efficacy of immunotherapy combinations in participants with mCRPC who have received prior secondary androgen receptor signaling inhibitor therapy (eg, abiraterone, enzalutamide, apalutamide).
Detailed Description

This is an open-label, non-randomized, exploratory platform protocol designed to assess the safety and antitumor activity of multiple immunotherapy combinations in participants with mCRPC who have received prior therapy. The platform study will consist of 2 stages: Stage 1, an initial stage to evaluate safety, biomarkers, and clinical activity of a combination and Stage 2, an expanded cohort, when warranted, based on the safety, clinical activity, and/or biomarker results from Stage 1. The Sponsor intends to modify and/or add new combinations to the protocol as data emerge from this and other trials.

Participants must provide consent for archival tissue from a prior biopsy or surgery for prostate cancer and must consent to baseline and on-treatment biopsies, if medically feasible. Participants will be assigned to receive one of the enrolling combination study interventions and will be monitored for safety and response.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Metastatic Castration-resistant Prostate Cancer
Intervention  ICMJE
  • Drug: NKTR-214 (Cohort A)
    NKTR-214 will be administered intravenously every 3 weeks for up to 2 years
  • Drug: Nivolumab (Cohort A, B and C)
    Nivolumab will be administered intravenously every 3 weeks for up to 2 years to cohort A, every 4 weeks for up to 2 years for cohort B and C.
    Other Name: Opdivo
  • Radiation: Stereotactic body radiation therapy (SBRT) (Cohort B)
    Radiation therapy will be administered at 30 - 50 Gy in 1 - 5 doses, starting on Day 1 or 2 of Cycle 1
  • Drug: CDX-301 (Cohort B and C)
    CDX-301 will be subcutaneously once a day for 5 days for cohort B. CDX-301 will be subcutaneously once a day for 10 days of immune-priming lead-in for cohort C.
  • Drug: Poly-ICLC (Cohort B)
    Poly-ICLC will be administered intramuscularly twice weekly for 3 weeks starting on Day 1 of Cycle 1
  • Drug: INO-5151 (Cohort C)
    INO-5151 will be administered intramuscularly on Day 8 of the Immune-priming Lead-in, and on day 1 of Cycle 1, 2 and 3, then every 12 weeks thereafter
  • Device: Cellectra 2000
    Electroporation device
Study Arms  ICMJE
  • Experimental: Cohort A: NKTR-214 + Nivolumab
    Interventions:
    • Drug: NKTR-214 (Cohort A)
    • Drug: Nivolumab (Cohort A, B and C)
  • Experimental: Cohort B: SBRT + CDX-301 + Poly-ICLC + Nivolumab
    Interventions:
    • Drug: Nivolumab (Cohort A, B and C)
    • Radiation: Stereotactic body radiation therapy (SBRT) (Cohort B)
    • Drug: CDX-301 (Cohort B and C)
    • Drug: Poly-ICLC (Cohort B)
  • Experimental: Cohort C: CDX-301 + INO-5151 + Nivolumab
    Interventions:
    • Drug: Nivolumab (Cohort A, B and C)
    • Drug: CDX-301 (Cohort B and C)
    • Drug: INO-5151 (Cohort C)
    • Device: Cellectra 2000
Publications *

*   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: July 15, 2019)
45
Original Estimated Enrollment  ICMJE
 (submitted: February 7, 2019)
30
Estimated Study Completion Date  ICMJE March 2023
Estimated Primary Completion Date March 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Key Inclusion Criteria:

  1. Metastatic castration resistant prostate cancer with castrate-level testosterone (< 50 ng/dL) at screening.
  2. Disease progression per Prostate Cancer Working Group 3 (PCWG3) criteria.
  3. Provide fresh pre-treatment core needle or incisional biopsy of a metastatic tumor lesion not previously irradiated. Fine needle aspiration is not acceptable.

    1. Additionally, if a pre-treatment biopsy is not medically feasible for participants with bone only disease, formalin-fixed paraffin-embedded (FFPE) tumor specimen in a paraffin block (preferred) or at least 10 slides containing unstained, freshly cut, serial sections must be provided.
    2. For all participants, in addition to fresh pre-treatment biopsy, consent for archival tissue is required.
  4. Must be willing to undergo tumor biopsy(ies) on treatment, if medically feasible.
  5. Have received and progressed on prior secondary androgen receptor signaling inhibitor therapy (eg, abiraterone, enzalutamide, apalutamide).
  6. Participants must discontinue antiandrogen therapy (ie, bicalutamide, flutamide, nilutamide) at least 4-6 weeks prior to registration with no evidence of PSA decline after washout.

    1. Bicalutamide: Washout period at least 6 weeks
    2. Flutamide and nilutamide: Washout period at least 4 weeks
  7. Participants must discontinue therapies for mCRPC for 5 half-lives or 28 days, whichever is shorter.

    1. Participants will remain on gonadotropin-releasing hormone (GnRH) agents throughout this study.
    2. Prior chemotherapy is allowed if no progression of disease on chemotherapy as defined by PCWG3-modified RECIST 1.1.
    3. Prior treatment with sipuleucel-T, radium-223, or poly ADP ribose polymerase (PARP) inhibitor (eg, olaparib) is allowed.
    4. Tissue biopsy may be performed during washout period.

Key Exclusion Criteria:

  1. Has a diagnosis of immunodeficiency or conditions that need systemic corticosteroid replacement therapy > 10 mg/day prednisone (or equivalent) or other immunosuppressive medications within 28 days prior to the first dose of study intervention. Inhaled steroids are permitted if necessary.
  2. Has any active known or suspected autoimmune disease. Participants with vitiligo, type I diabetes mellitus, controlled autoimmune hypothyroidism, psoriasis not requiring systemic treatment, or other conditions under control are permitted to enroll.
  3. Has a known history of active TB (Bacillus Tuberculosis).
  4. Has known history of, or any evidence of active, non-infectious pneumonitis.
  5. Known history of testing positive for human immunodeficiency virus (HIV), known acquired immunodeficiency syndrome (AIDS), or any positive test for hepatitis B or hepatitis C virus representing acute or chronic disease.
  6. Has received a live vaccine within 30 days of planned start of study intervention.

    Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (eg, Flu-Mist®) are live attenuated vaccines, and are not allowed.

  7. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least 4 weeks prior to the first dose of study intervention and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to study intervention. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability.
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: Recruiting sites have contact information. Please contact the site directly. If there is no contact info, please email porter0033@parkerici.org
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03835533
Other Study ID Numbers  ICMJE PICI0033
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: Undecided
Responsible Party Parker Institute for Cancer Immunotherapy
Study Sponsor  ICMJE Parker Institute for Cancer Immunotherapy
Collaborators  ICMJE
  • Bristol-Myers Squibb
  • Celldex Therapeutics
  • Cancer Research Institute, New York City
  • Inovio Pharmaceuticals
  • Oncovir, Inc.
Investigators  ICMJE
Study Director: Ramy Ibrahim, MD Parker Institute for Cancer Immunotherapy
PRS Account Parker Institute for Cancer Immunotherapy
Verification Date November 2019

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