Activity of TroVax® Alone vs. TroVax® Plus GM-CSF in Patients With Prostate Cancer

This study has been completed.
Sponsor:
Collaborator:
Oxford BioMedica
Information provided by:
The Methodist Hospital System
ClinicalTrials.gov Identifier:
NCT00448409
First received: March 14, 2007
Last updated: August 21, 2008
Last verified: August 2008
  Purpose

To evaluate the efficacy and safety of Trovax and GM-CSF in patients with prostate cancer.


Condition Intervention Phase
Prostatic Neoplasms
Biological: TroVax
Drug: GM-CSF
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Trial to Assess the Activity of TroVax® Alone vs. TroVax® Plus Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) in Patients With Progressive Hormone Refractory Prostate Cancer

Resource links provided by NLM:


Further study details as provided by The Methodist Hospital System:

Primary Outcome Measures:
  • PSA response rate to TroVax® and TroVax® in combination with GM-CSF [ Time Frame: restaging every 8 weeks ] [ Designated as safety issue: No ]
  • Anti-5T4 antibody levels [ Time Frame: 1st 2 cycles every 2 wks; thereafter about every 4 wks ] [ Designated as safety issue: No ]
  • CD8+ve cellular response to 5T4 antigen as measured by Elispot [ Time Frame: at end of study ] [ Designated as safety issue: No ]
  • Assessment of the number of adverse events and serious adverse events in both groups [ Time Frame: AEs as occur ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Objective response rate [ Time Frame: restaging every 8 weeks ] [ Designated as safety issue: No ]
  • Overall survival of the patients [ Time Frame: restaging every 8 weeks ] [ Designated as safety issue: No ]
  • Progression-free survival [ Time Frame: restaging every 8 weeks ] [ Designated as safety issue: No ]
  • Time to progression [ Time Frame: restaging every 8 weeks ] [ Designated as safety issue: No ]

Enrollment: 27
Study Start Date: May 2006
Study Completion Date: May 2007
Primary Completion Date: April 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
TroVax alone
Biological: TroVax
11 Intramuscular injection of TroVax® over 45 weeks. A single dose of 5 x 108 pfu/ml, will be given by an intramuscular injection into the deltoid muscle of the upper arm.
Experimental: 2
TroVax plus GM-CSF
Biological: TroVax
11 Intramuscular injection of TroVax® over 45 weeks. A single dose of 5 x 108 pfu/ml, will be given by an intramuscular injection into the deltoid muscle of the upper arm.
Drug: GM-CSF
168 subcutaneous GM-CSF injections over 45 weeks. Administered every day as a subcutaneous injection at a dose of 250mcg/m2/d (maximum 500 mcg) in weeks 1 and 2 of each 28 day cycle (total of 14 days per cycle with a total of 12 cycles).
Other Name: Leukine

Detailed Description:

Prostate cancer is the second leading cause of cancer death in American men. Hormonal ablation, in the form of medical or surgical castration is the cornerstone of management for metastatic prostate cancer however, treatment options for a patient in whom androgen ablation fails are limited. Second-line hormonal agents are generally associated with low response rates and no documented survival benefit.

Historically, chemotherapy was not considered to have significant activity in hormone refractory prostate cancer (HRPCa). This view has changed within the past 10 years, partly because of the availability of prostate-specific antigen (PSA) measurements to monitor tumor burden. Although it seems that chemotherapy, either as a single agent or combination of agents may lead to clinical responses, reduction in PSA measurements, pain control, or improved quality of life, no benefit in overall survival has been definitively proven. The current standard of care for the treatment of metastatic prostate cancer is hormone therapy (androgen blockade).3,4 When this strategy is no longer effective, few good treatment options are left. For this reason, prostate cancer research has aimed to identify new therapeutic modalities to increase the impact of these parameters as well as prolong patient survival.

A total of 24 men with prostate cancer ranging from non-metastatic rising PSA only disease to bony metastatic disease will be enrolled in the study. All patients will have failed androgen treatment and at least one prior taxane chemotherapy or have refused chemotherapy.

Out of the 24 patients, 12 patients will be treated using TroVax® and 12 will be treated using TroVax® plus GM-CSF.

  Eligibility

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

Inclusion Criteria:

  • Histologically confirmed adenocarcinoma of the prostate.
  • Stable or progressive disease after androgen deprivation.
  • Karnofsky Performance Status ≥ 60%.
  • At least one prior taxane based chemotherapy for prostate cancer therapy (or patient refusal of chemotherapy)
  • At least four weeks have lapsed since prior chemotherapy (if administered)
  • Patients on stable doses of bisphosphonates that show subsequent tumor progression may continue on this medication; however, patients are not allowed to initiate bisphosphonate therapy within one month prior to starting therapy or throughout the study.
  • Major surgery or radiation therapy completed ≥ 4 weeks prior to enrollment.
  • Clinically immunocompetent. All patients are assumed to be immunocompetent unless they have been diagnosed as being immunosuppressed, are receiving oral steroids, immunosuppressive chemotherapy for oncology disorders or are receiving immunosuppressive therapy following transplant.
  • Free of clinically apparent autoimmune disease (no prior confirmed diagnosis or treatment for autoimmune disease including Systemic Lupus Erythematosis, Grave's disease, Hashimoto's thyroiditis, multiple sclerosis, insulin dependant diabetes mellitus or systemic (non-joint) manifestations of rheumatoid disease).
  • Absolute Lymphocyte Count ≥ 500/µl, ANC >1200/µl, Platelet count >100,000/µl, Hemoglobin > 8 mg/dl
  • No evidence of active ischemia on ECG

Exclusion Criteria:

  • Patients receiving any other hormonal therapy, including any dose of megestrolacetate (Megace), Proscar (finasteride), any herbal product known to decrease PSA levels (e.g., Saw Palmetto and PC-SPES), or any systemic corticosteroid must discontinue the agent for at least 4 weeks prior to enrollment. Progressive disease (as defined above) must be documented after discontinuation of the hormonal therapy.
  • Patients that initiate bisphosphonate therapy within one month prior to starting therapy or throughout the study.
  • No supplements or complementary medicines/botanicals are permitted during the study
  • Major surgery or radiation therapy completed ≤ 4 weeks prior to enrollment.
  • Prior radiopharmaceuticals (strontium, samarium) within 8 weeks prior to enrollment.
  • "Currently active" second malignancy, other than non-melanoma skin cancer. Patients are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at least less than 30% risk of relapse.
  • Serious intercurrent infections or nonmalignant medical illnesses that are uncontrolled.
  • Psychiatric illnesses/social situations that would limit compliance with protocol requirements.
  • Liver function tests (ALT, AST) more than 1.5 x upper limit of normal (ULN). The bilirubin must be within normal limits.
  • Renal function creatinine ≥1.5 x ULN.
  • Known allergy to egg proteins.
  • Known allergy to neomycin.
  • History of allergic response to previous vaccinia vaccinations.
  • Chronic oral corticosteroid use (especially anti-emetics) unless prescribed as replacement therapy in the case of adrenal insufficiency.
  • Known to test positive for HIV or hepatitis B or C.
  • Clinical indication of reduced cardiac function or an ejection fraction of ≤ 40%.
  • Requirement for radiotherapy (this is a sign of disease progression and is classed as a withdrawal criterion).
  • Concurrent chemotherapy, immunotherapy and radiation therapy
  • No investigational or commercial agents or therapies other than those included in protocol treatment may be administered with the intent to treat the patient's malignancy.
  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: NCT00448409

Locations
United States, Texas
The Methodist Hospital Research Institute
Houston, Texas, United States, 77030
Sponsors and Collaborators
The Methodist Hospital System
Oxford BioMedica
Investigators
Principal Investigator: Robert J Amato, DO The Methodist Hospital Research Institute
  More Information

No publications provided

Responsible Party: Robert J. Amato, DO, The Methodist Hospital Research Institute
ClinicalTrials.gov Identifier: NCT00448409     History of Changes
Other Study ID Numbers: TV/PHRPC-001/06, 0106-0009
Study First Received: March 14, 2007
Last Updated: August 21, 2008
Health Authority: United States: Food and Drug Administration

Keywords provided by The Methodist Hospital System:
Prostate cancer
hormone refractory prostate cancer
androgen resistant prostate cancer

Additional relevant MeSH terms:
Neoplasms
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Genital Diseases, Male
Prostatic Diseases

ClinicalTrials.gov processed this record on July 29, 2014