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Open Label Phase I/Randomised,Double Blind Phase II Study in mCRPC of AZD5363 In Combination With DP Chemotherapy (ProCAID)

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ClinicalTrials.gov Identifier: NCT02121639
Recruitment Status : Active, not recruiting
First Posted : April 23, 2014
Last Update Posted : August 9, 2019
Sponsor:
Collaborators:
AstraZeneca
Cancer Research UK
Information provided by (Responsible Party):
University Hospital Southampton NHS Foundation Trust

Brief Summary:
The aim of the ProCAID study is to determine if the addition of the AKT inhibitor AZD5363 to docetaxel and prednisolone (DP) prolongs progression free survival (PFS) in Metastatic castration resistant prostate cancer to a degree worthy of further investigation

Condition or disease Intervention/treatment Phase
Prostate Cancer Drug: Placebo Drug: AZD5363 Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 168 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: An Open Label Phase I/Randomised, Double Blind Phase II Study in Metastatic Castration Resistant Prostate Cancer of AZD5363 In Combination With Docetaxel and Prednisolone Chemotherapy (ProCAID)
Actual Study Start Date : January 29, 2014
Estimated Primary Completion Date : October 31, 2019
Estimated Study Completion Date : February 2, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer

Arm Intervention/treatment
Experimental: AZD5363
AZD5363
Drug: AZD5363
Placebo Comparator: Placebo
Placebo
Drug: Placebo



Primary Outcome Measures :
  1. Phase I:Determination of a suitable dose of AZD5363 [ Time Frame: Up to 18 months ]
    Phase I:Determination of a suitable dose of AZD5363 using a 4 days on/3 days off continuous schedule, in combination with Docetaxol and prednisolone chemotherapy

  2. Phase II: Progression free survival [ Time Frame: 5 years ]
    Phase II: Progression free survival (PFS) in patients receiving AZD5363 versus placebo when combined with Docetaxol and prednisolone chemotherapy (DP) in metastic castration resistant prostate cancer (mCRPC)


Secondary Outcome Measures :
  1. Phase I: Safety and tolerability profiles [ Time Frame: Up to 18 months ]
    Phase I: Safety and tolerability profiles using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03

  2. Phase I: AZD5363 pharmacokinetics Area Under Curve (AUC) Time Frame: predose, 2, 4, 8, 24,144 hours post-dose [ Time Frame: Up to 18 months ]
    Phase I: AZD5363 pharmacokinetics in combination with Docetaxol and prednisolone chemotherapy

  3. Phase II: Bone Pain [ Time Frame: 5 years ]
    Phase II: Bone pain changes using the brief pain inventory

  4. Phase II: Progression Free Survival [ Time Frame: 5 years ]
    Phase II: Progression Free Survival excluding biochemical (Prostate Specific Antigen - PSA) alone progression

  5. Phase II: Biochemical (PSA) response rates according to PCWG2 criteria [ Time Frame: 5 years ]
    Phase II: Biochemical (Prostate Specific Antigen - PSA) response rates according to Prostate Cancer Working Gourp (PCWG2) criteria

  6. Phase II: Safety and tolerability profiles using CTCAE version 4.03 [ Time Frame: 5 years ]
    Phase II: Safety and tolerability profiles using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03



Information from the National Library of Medicine

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

Inclusion Criteria:

  1. Histologically or cytologically proven mCRPC with documented metastases (measurable or evaluable disease is acceptable) now eligible for treatment with docetaxel chemotherapy
  2. Disease progression since the last change in therapy defined by one or more of the following according to the Prostate Cancer Working Group (PCWG2) criteria (J Clin Oncol 2008;26:1148-1159):

    i. PSA progression as defined by the prostate cancer working group (2) (PCWG2) criteria (Scher et al. 2008 J Clin Oncol. 26; 1148). This must be based on a series of at least 3 readings at least 7 days apart. The 3rd reading must be >= 2ng/ml. In the event where an intermediate reading is lower than a previous reading, then the patient will still be eligible (ie. the 3 readings do not need to be consecutive). The first of the three readings must have been obtained after commencing the previous systemic therapy, or, in the case of androgen receptor antagonists, after discontinuing.

    ii. Radiographic progression of nodal or visceral metastases as defined by RECIST version 1.1 (Eur J Cancer 2009;45:228). See Appendix 5 iii. The appearance of two or more new bony metastases

  3. Serum testosterone <1.7 nmol/L (ongoing LHRH analogue or antagonist therapy is permitted to maintain a castrate state)
  4. Discontinuation of prior therapies for prostate cancer ≥ 4 weeks prior to commencing study treatment (with the exception of an LHRH agonist or antagonist where required for ongoing testosterone suppression)
  5. No current anti-androgen withdrawal response from bicalutamide or flutamide. Consistent with PCWG2 guidelines, investigators should evaluate patients to exclude withdrawal response for 6 weeks after stopping bicalutamide or flutamide. Investigators need not wait to assess for withdrawal response in patients who did not respond, or who showed a PSA decline for ≤ 3 months, after bicalutamide or flutamide was administered as a second-line or later intervention.
  6. ECOG performance status 0 or 1
  7. Hb ≥ 9g/dL; platelets ≥ 100 x 109/L; neutrophils ≥ 1.5 x109/L
  8. Bilirubin ≤ ULN ; ALT and AST ≤ 1.5 x ULN
  9. Sodium and potassium within the normal range for the site
  10. Able to swallow study drugs (without crushing/opening in the case of AZD5363)
  11. Life expectancy > 3 months
  12. Aged 18 years or over
  13. Provision of written informed consent

Exclusion Criteria:

  1. Previous treatment with cytotoxic chemotherapy for castrate resistant prostate cancer. Patients may have received previous docetaxel for up to 6 cycles given in the 'hormone sensitive setting' or ongoing bisphosphonates or denosumab. There are no restrictions on prior use of second generation hormonal therapies e.g. abiraterone, enzalutamide as long as they have been discontinued ≥ 2 weeks prior to commencing study treatment.
  2. Prior malignancy with an estimated ≥ 30% chance of relapse within 2 years following curative treatment
  3. Previously identified brain metastases, or spinal cord compression unless treated with full functional recovery
  4. Prior radiotherapy to > 30% of bone marrow
  5. Administration of an investigational agent within 30 days of first dose of study medication
  6. Patients will be excluded with any of:

    i. Diabetes mellitus type I ii. Fasting plasma glucose [fasting is defined as no calorific intake for at least 8 hours] of either ≥ 7.0mmol/L (126 mg/dL) for those patients without a pre-existing diagnosis of Type 2 diabetes mellitus or ≥ 9.3 mmol/L (167mg/dL) for those patients with a pre-existing diagnosis of Type 2 diabetes mellitus iii. Glycosylated haemoglobin (HbA1C) ≥8.0% (63.9 mmol/mol) iv. Requirement for insulin for routine diabetic management and control v. Requirement for more than two oral hypoglycaemic medications for routine diabetic management and control.

  7. Malabsorption syndrome, previous gastrointestinal surgery, or other gastrointestinal condition that may affect drug absorption
  8. Coronary artery bypass graft, angioplasty, vascular stent, myocardial infarction, angina pectoris or congestive heart failure (NYHA ≥ grade 2) within the last 6 months
  9. Abnormal echocardiogram or MUGA (LVEF should be normal according to the criteria used within the treating institution
  10. Uncontrolled hypotension (systolic blood pressure <90 mmHg and/or diastolic blood pressure <50 mmHg)
  11. QTc interval of >480 msec at two or more time points within a 24 hour period
  12. Proteinuria (either 3+ on dipstick analysis or >500 mg/24 hours) or creatinine >1.5 x ULN concurrent with creatinine clearance <50 mL/min (assessed as per local practice e.g. by Cockcroft and Gault estimation)
  13. Exposure to potent inhibitors or inducers of CYP3A4 or CYP2D6 or substrates of CYP3A4 within 2 weeks before the first dose of study treatment (3 weeks for St John's Wort)
  14. Unresolved toxicity ≥ grade 2 (except alopecia) from previous cancer therapy
  15. Patients with a partner of child-bearing potential who are not using a highly effective method of contraception, who are unwilling to use condoms during the study and for 30 days after the last dose of study drug
  16. Known hypersensitivity to AZD5363, its excipients, or drugs in its class
  17. Previous exposure to agents with the following mechanisms of action:

    • inhibition of AKT (e.g., MK2206, GDC0068, GSK2110183, GSK2141795)any inhibitor with PI3K pharmacology (e.g., GDC0941, XL147, BKM120, PX866, BYL719, AMG319, GDC0032, INK1117, INK119)
    • any compound with mixed PI3K and mammalian target of rapamycin (mTOR) kinase pharmacology (e.g., BEZ235, GDC0980, PF04691502, PF05212384, GSK2126458, XL765)
    • or any mTOR kinase inhibitor (e.g., AZD8055, AZD2014, OSI027, INK128) Note: Do not exclude patients previously treated with a rapalogue (allosteric inhibitor of mTOR; mTORC1 complex inhibitor) - including temisirolimus (Torisel; Pfizer), everolimus (Affinitor; Novartis), ridoforolimus (Ariad).

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): NCT02121639


Locations
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United Kingdom
Southampton General Hospital
Southampton, Hampshire, United Kingdom, SO16 6YD
Sponsors and Collaborators
University Hospital Southampton NHS Foundation Trust
AstraZeneca
Cancer Research UK

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University Hospital Southampton NHS Foundation Trust
ClinicalTrials.gov Identifier: NCT02121639     History of Changes
Other Study ID Numbers: RHMCAN0935
First Posted: April 23, 2014    Key Record Dates
Last Update Posted: August 9, 2019
Last Verified: August 2019
Keywords provided by University Hospital Southampton NHS Foundation Trust:
Metastatic Castration Resistant Prostate Cancer
AZD5363
Docetaxel
Prednisolone
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Prostatic Diseases
Prednisolone
Docetaxel
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Anti-Inflammatory Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents, Hormonal