A Study Evaluating the Pain Palliation Benefit of Adding Custirsen to Docetaxel Retreatment or Cabazitaxel as Second Line Therapy in Men With Metastatic Castrate Resistant Prostate Cancer (mCRPC)

A Randomized, Placebo-Controlled, Double-Blind, Phase 3 Study Evaluating the Pain Palliation Benefit of Adding Custirsen to a Taxane for Second-Line Chemotherapy in Men With Castrate Resistance Prostate Cancer

The purpose of this study is to determine if the addition of study drug (custirsen) can provide durable pain palliation for castrate resistant prostate cancer patients receiving docetaxel retreatment or cabazitaxel as a second line therapy.

Study Overview

• Status: Terminated
• Conditions: Hormone Refractory Prostate Cancer; Castrate-Resistant Prostate Cancer
• Intervention / Treatment: Drug: docetaxel; Drug: prednisone; Drug: custirsen sodium; Drug: cabazitaxel; Drug: isotonic, 0.9% sodium chloride

Detailed Description

This is a randomized, double-blind, placebo-controlled, multicenter, international trial enrolling patients with metastatic CRPC who had a response to first-line docetaxel therapy and have prostate cancer-related pain with progression of disease. The intended intervention is second-line treatment with docetaxel retreatment or cabazitaxel plus study agent, where custirsen is to be administered in the investigational arm and placebo is to be administered in the control arm.

Selection of the chemotherapy (docetaxel re-treatment or cabazitaxel) is to be determined by the treating physician, based on the patient's first-line response.

The study will primarily assess pain and analgesic use for evaluation of durable pain palliation in response to study treatment. Pain and analgesic use will be obtained via a 3rd party contact center (direct contact with patient).

Study treatment starts with a Loading Dose Period during which three infusions of study agent (custirsen vs. placebo) will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel or cabazitaxel on a 21-day cycle with weekly study agent (custirsen vs. placebo) infusions on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID.

Patients will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol. If study treatment is completed or discontinued prior to pain progression, 6-day assessments will continue every 3 weeks until pain progression is documented. Follow-up after study treatment will occur for safety parameters for 3 weeks after the last study agent infusion in all patients. Survival status updates are to be reported every 12 weeks following documentation of pain progression. The amount of time that patients remain on the study will vary; but the average survival of these patients who receive second line taxane treatment is expected to be 14 to 15 months.

• Study Type: Interventional
• Enrollment (Actual): 14
• Phase: Phase 3

Contacts and Locations

Study Locations

• Canada
  • Manitoba
    • Winnipeg, Manitoba, Canada, R3E 0V9
  • Ontario
    • Hamilton, Ontario, Canada, L8V 5C2
• France
  • Lyon, France
  • Paris, France
  • Saint Herblain, France
  • Villejuif, France
• Spain
  • Barcelona, Spain
  • Madrid, Spain
  • Pamplona, Spain
  • Sabadell, Spain
  • Valencia, Spain
• United Kingdom
  • Cambridge, United Kingdom
  • Sutton, United Kingdom
• United States
  • California
    • La Verne, California, United States, 91705
  • Florida
    • Ft. Lauderdale, Florida, United States, 33308
    • Tampa, Florida, United States, 33612
  • Hawaii
    • Honolulu, Hawaii, United States, 96813
  • Illinois
    • Urbana, Illinois, United States, 61801
  • Louisiana
    • Metairie, Louisiana, United States, 70006
  • Maryland
    • Baltimore, Maryland, United States, 21201
  • Massachusetts
    • Burlington, Massachusetts, United States, 01805
  • Michigan
    • Detroit, Michigan, United States, 48201
  • Missouri
    • Kansas City, Missouri, United States, 64132
  • Nebraska
    • Omaha, Nebraska, United States, 68130
  • Nevada
    • Las Vegas, Nevada, United States, 89169
  • New York
    • Syracuse, New York, United States, 13210
  • North Carolina
    • Raleigh, North Carolina, United States, 27607
  • Ohio
    • Canton, Ohio, United States, 44718
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73120
  • Oregon
    • Portland, Oregon, United States, 97239
  • South Carolina
    • Columbia, South Carolina, United States, 29209
  • Tennessee
    • Memphis, Tennessee, United States, 38120
  • Texas
    • Tyler, Texas, United States, 75701

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 99 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria

1. Age ≥ 18 years on the date of consent.
2. Histological or cytological diagnosis of adenocarcinoma of the prostate.
3. Metastatic disease at screening on a chest, abdomen or pelvic CT or bone scan.
4. Concurrent pain and analgesic use that is viewed by the Investigator to be related to prostate cancer.
5. Received at least 4 cycles of prior docetaxel-based first-line chemotherapy for metastatic disease based on a q3 week schedule of docetaxel. Patients treated on a weekly or alternate schedule for first-line docetaxel must have received an accumulated dose of docetaxel of at least 300 mg/M2.
6. Current progressive disease during or after completing first-line docetaxel treatment.
7. Baseline laboratory values at screening visit within protocol defined limits.
8. Must be willing to continue primary androgen suppression with luteinizing hormone releasing hormone (LHRH) analogues throughout the study, if not treated with bilateral orchiectomy.
9. Adequate bone marrow function.
10. Karnofsky score ≥ 70% at screening visit.
11. At least 21 days have passed since completing radiotherapy at the time of randomization.
12. At least 21 days have passed since completing any cytotoxic agent or investigational agent given in combination with the docetaxel-based first-line therapy, including ASOs (except custirsen which is an exclusion criterion), at the time of randomization.
13. Has recovered from all therapy related toxicity to ≤ grade 2 (except alopecia, anemia and any signs or symptoms of androgen deprivation therapy).
14. Patient can tolerate a starting dose of docetaxel of 75 mg/M2 or cabazitaxel at 25 mg/M2.
15. Patient must have remained on the same bisphosphonate or denosumab usage for a minimum of 12 weeks prior to randomization.
16. Written informed consent must be obtained prior to any protocol-specific procedures being performed.

Exclusion Criteria

1. More than two interruptions in first-line docetaxel therapy. An interruption will be defined as more than 6 weeks between doses.
2. Life expectancy less than 12 weeks.
3. Previously participated in any clinical trial evaluating custirsen.
4. Received any other cytotoxic chemotherapy as a second-line treatment after first-line docetaxel-based therapy.
5. Not on any opioid analgesic regimen for their prostate cancer-related pain.
6. Receiving more than one drug within each of the separate categories of long-acting opioid, short-acting opioid, and non-opioid.
7. Receiving any analgesic specified in the protocol as unacceptable for this study.
8. Planned concomitant participation in another clinical trial of an experimental agent, vaccine or device. Concomitant participation in observational studies is acceptable.
9. Inability to communicate and read in English, Spanish or French.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Custirsen; Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of custirsen will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly custirsen infusions (640 mg total dose) on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.	Drug: docetaxel; Drug: prednisone; Drug: custirsen sodium; An antisense oligonucleotide that blocks production of clusterin; Other Names: OGX-011; Drug: cabazitaxel
Placebo Comparator: Placebo; Study treatment starts with a Loading Dose Period (1 week) during which 3 infusions of placebo (isotonic, 0.9% sodium chloride) will be administered. Following the Loading Dose Period, study treatment will consist of docetaxel (75 mg/m2 total dose) or cabazitaxel (25 mg/m2 total dose) on a 21-day cycle with weekly placebo infusions on Day 1, 8 and 15 of each 21-day cycle and oral prednisone BID. Participants will continue study treatment until pain progression, unacceptable toxicity, completion of 10 cycles or other specific criteria for withdrawal identified in the protocol.	Drug: docetaxel; Drug: prednisone; Drug: cabazitaxel; Drug: isotonic, 0.9% sodium chloride; Placebo for custirsen sodium

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
To ascertain whether the investigational arm has a greater proportion of patients with durable pain palliation as compared to the control arm.	3 to 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To ascertain whether patients randomized to the investigational arm have a longer time to pain progression as compared to patients randomized to the control arm.		6 months.
Safety	Comparison of treatment arms with respect to the incidence of serious adverse events and the incidence of grade 3 or higher adverse events.	6 months

Collaborators and Investigators

• Sponsor: Achieve Life Sciences
• Collaborators: Teva Pharmaceuticals USA
• Investigators: Principal Investigator: Tomasz M Beer, M.D., Oregon Health and Science University; Principal Investigator: Sebastien J Hotte, M.D., Juravinski Cancer Centre, McMaster University; Principal Investigator: Karim Fizazi, M.D., Ph.D., Institut Gustave Roussy, University of Paris

Study record dates

Study Major Dates

• Study Start: March 1, 2010
• Primary Completion (Actual): March 1, 2013
• Study Completion (Actual): March 1, 2013

Study Registration Dates

• First Submitted: February 26, 2010
• First Submitted That Met QC Criteria: March 8, 2010
• First Posted (Estimate): March 10, 2010

Study Record Updates

• Last Update Posted (Estimate): October 12, 2016
• Last Update Submitted That Met QC Criteria: October 7, 2016
• Last Verified: October 1, 2016

More Information

Terms related to this study

• Keywords: CRPC; HRPC; CRPC patients with cancer related pain
• Additional Relevant MeSH Terms: Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Genital Neoplasms, Male; Prostatic Diseases; Prostatic Neoplasms; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Inflammatory Agents; Antineoplastic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Glucocorticoids; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Antineoplastic Agents, Hormonal; Docetaxel; Prednisone
• Other Study ID Numbers: OGX-011-10