Abiraterone Acetate and Prednisone With or Without Veliparib in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer
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Purpose
This randomized phase II trial studies abiraterone acetate and prednisone together with veliparib to see how well it works compared to abiraterone acetate and prednisone alone in treating patients with metastatic hormone-resistant prostate cancer. Androgens can cause the growth of prostate cancer cells. Antiandrogen drugs, such as abiraterone acetate, may lessen the amount of androgens made by the body. Veliparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether giving abiraterone acetate together with prednisone and veliparib is more effective than abiraterone acetate and prednisone alone in treating prostate cancer
| Condition | Intervention | Phase |
|---|---|---|
|
Hormone-resistant Prostate Cancer Recurrent Prostate Cancer Stage IV Prostate Cancer |
Drug: abiraterone acetate Drug: prednisone Drug: veliparib Other: laboratory biomarker analysis |
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: | A Randomized Gene Fusion Stratified Phase 2 Trial of Abiraterone With or Without ABT-888 for Patients With Metastatic Castration-Resistant Prostate Cancer |
- Confirmed PSA response rate [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]The corresponding binomial confidence intervals will be reported for each arm. A logistic model including treatment group, fusion status, and prior ketoconazole use will be used to determine the interaction between the rates of PSA response between abiraterone and abiraterone + ABT-888 and ETS fusion status.
- Rates of PSA decline [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]Will be exhibited using waterfall plots of 12 week PSA decline and maximum PSA decline by treatment arm. Additionally, the rate of PSA decline will be explored using a repeated measures mixed model with the natural log of PSA as the outcome.
- Objective response rates [ Time Frame: Up to 2 years ] [ Designated as safety issue: No ]Will be reported by treatment with corresponding binomial confidence intervals.
- Progression-free survival [ Time Frame: From start of treatment to time of progression or death, whichever occurs first, assessed up to 2 years ] [ Designated as safety issue: No ]Kaplan-Meier methods will be used to describe progression free survival by arm.
- Grade 4 or greater toxicity of abiraterone acetate and abiraterone acetate + veliparib [ Time Frame: 30 days after completion of study treatment ] [ Designated as safety issue: Yes ]Will be described by type, grade, and frequency for each treatment and arm.
| Estimated Enrollment: | 148 |
| Study Start Date: | March 2012 |
| Estimated Primary Completion Date: | February 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Arm I (abiraterone acetate and prednisone)
Patients receive abiraterone acetate PO QD and prednisone PO BID on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
|
Drug: abiraterone acetate
Given PO
Other Names:
Drug: prednisone
Given PO
Other Names:
Other: laboratory biomarker analysis
Correlative studies
|
|
Experimental: Arm II (abiraterone acetate, prednisone, and veliparib)
Patients receive veliparib PO BID on days 1-28. Patients also receive abiraterone acetate PO QD and prednisone PO BID on day 1 (day 8 of course 1). Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
|
Drug: abiraterone acetate
Given PO
Other Names:
Drug: prednisone
Given PO
Other Names:
Drug: veliparib
Given PO
Other Name: ABT-888
Other: laboratory biomarker analysis
Correlative studies
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Have a histologic or cytologic diagnosis of prostate cancer
Have progressive metastatic castration-resistant prostate cancer, on androgen-deprivation therapy, based on at least one of the following criteria:
- Prostate-specific antigen (PSA) progression defined as 25% increase over baseline value with an increase in the absolute value of at least 2 ng/mL that is confirmed by another PSA level with a minimum of a 1-week interval with a minimum PSA of 2 ng/mL
- Progression of bidimensionally measurable soft tissue (nodal metastasis) assessed within one month prior to registration by a computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen and pelvis
- Progression of bone disease (evaluable disease) (new bone lesion[s]) by bone scan
Agree to undergo a biopsy of >= 1 metastatic site for gene-fusion status
- Adequate archival metastatic tissue can be used if available in lieu of a biopsy; patients will only be eligible for protocol therapy if the biopsy has tumor and the tissue is evaluable for ETS fusion status
- Have testosterone < 50 ng/dL; patients must continue primary androgen-deprivation with a luteinizing hormone-releasing hormone (LHRH) analogue if they have not undergone orchiectomy
- Patients with known brain metastases should be excluded from this clinical trial
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- White blood cells >= 3,000/uL
- Absolute neutrophil count >= 1,500/uL
- Platelet count >= 100,000/uL
- Creatinine within the institutional limits of normal
- Potassium >= 3.5 mmol/L
- Bilirubin within the institutional limits of normal
- Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 2 times upper limit of normal
- Serum glutamic pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 2 times upper limit of normal
- Must agree to use effective contraception during treatment and for at least 1 week after the last administration of therapy
- Patients must be able to take oral medication without crushing, dissolving, or chewing tablets
- Ability to understand and the willingness to sign a written informed-consent document that is approved by the local institutional review board
- Patients with history of active seizures are not eligible
- Patients with a history of pituitary or adrenal dysfunction, active or symptomatic viral hepatitis, or chronic liver disease are not eligible
- No history of allergic reactions attributed to compounds of similar chemical or biologic composition to ABT-888 or abiraterone
- No uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure (New York Heart Association class III and IV heart failure), unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements or concurrent medications that alter cardiac conduction
- Patients with a "currently active" second malignancy other than non-melanoma skin cancers are not eligible; patients are not considered to have a "currently active" malignancy if they have completed all therapy and are now considered without evidence of disease for 1 year
- Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible
- Patients must discontinue antiandrogen therapy for at least 4 weeks (e.g., flutamide, bicalutamide, nilutamide) prior to registration with no evidence of a falling PSA after washout; patients on steroids are eligible as long as they will be switched to prednisone
- Have no prior exposure to cytochrome P450, family 17, subfamily A, polypeptide 1 (CYP-17) or poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors
- Patients with up to 2 prior chemotherapy regimens are eligible
- Patients may have received prior radiation therapy or surgery; however, at least 21 days must have elapsed since completion of radiation therapy or surgery and patient must have recovered from all side effects at the time of registration
- Patients may not be receiving any other investigational agents; any prior investigational products must be stopped at least 14 days (2-week washout) prior to registration
- No patients who have had chemotherapy or antifungal agents (itraconazole, fluconazole) within 3 weeks prior to entering the study or those who have not recovered (e.g., back to baseline or grade 1) from adverse events due to agents administered more than 3 weeks earlier
- Patients may continue on a daily multivitamin, calcium, and vitamin D, but all other herbal, alternative, and food supplements (i.e., PC-SPES, saw palmetto, St. John wort, etc.) must be discontinued before registration
- Patients must not be planning to receive any concurrent cytotoxic chemotherapy, surgery, or radiation therapy during protocol treatment
- Hormonal-acting agents (including diethylstilbestrol [DES], aldosterone, and spironolactone) are forbidden during the trial and must be stopped prior to registration; no washout period will be required for any of these agents
- Patients on stable doses of bisphosphonates or denosumab which have been started prior to registration may continue on this medication, patients who are not on bisphosphonates or denosumab are eligible as long as they initiate therapy prior to registration
Contacts and Locations| United States, California | |
| City of Hope Medical Center | Not yet recruiting |
| Duarte, California, United States, 91010 | |
| Contact: Przemyslaw W. Twardowski 626-256-4673 ptwardowski@coh.org | |
| Principal Investigator: Przemyslaw W. Twardowski | |
| University of Southern California | Not yet recruiting |
| Los Angeles, California, United States, 90033-0804 | |
| Contact: David I. Quinn 323-865-3956 diquinn@usc.edu | |
| Principal Investigator: David I. Quinn | |
| UC Davis Comprehensive Cancer Center | Not yet recruiting |
| Sacramento, California, United States, 95817 | |
| Contact: Primo N. Lara 916-734-3771 primo.lara@ucdavis.edu | |
| Principal Investigator: Primo N. Lara | |
| United States, Illinois | |
| University of Chicago | Recruiting |
| Chicago, Illinois, United States, 60637 | |
| Contact: Walter M. Stadler 773-702-4150 wstadler@medicine.bsd.uchicago.edu | |
| Principal Investigator: Walter M. Stadler | |
| Evanston CCOP-NorthShore University HealthSystem | Recruiting |
| Evanston, Illinois, United States, 60201 | |
| Contact: Daniel H. Shevrin 847-570-2515 DShevrin@northshore.org | |
| Principal Investigator: Daniel H. Shevrin | |
| United States, Indiana | |
| Indiana University Medical Center | Recruiting |
| Indianapolis, Indiana, United States, 46202 | |
| Contact: Noah M. Hahn 317-948-1186 nhahn@iupui.edu | |
| Principal Investigator: Noah M. Hahn | |
| United States, Maryland | |
| Johns Hopkins University | Recruiting |
| Baltimore, Maryland, United States, 21287-8936 | |
| Contact: Emmanuel S. Antonarakis 410-502-7528 eantona1@jhmi.edu | |
| Principal Investigator: Emmanuel S. Antonarakis | |
| United States, Michigan | |
| University of Michigan University Hospital | Recruiting |
| Ann Arbor, Michigan, United States, 48109 | |
| Contact: Maha H. Hussain 734-936-8906 mahahuss@umich.edu | |
| Principal Investigator: Maha H. Hussain | |
| United States, New Jersey | |
| UMDNJ - Robert Wood Johnson University Hospital | Not yet recruiting |
| New Brunswick, New Jersey, United States, 08903 | |
| Contact: Mark N. Stein 732-235-3336 steinmn@umdnj.edu | |
| Principal Investigator: Mark N. Stein | |
| United States, North Carolina | |
| University of North Carolina | Recruiting |
| Chapel Hill, North Carolina, United States, 27599 | |
| Contact: Young E. Whang 919-843-9983 ywhang@med.unc.edu | |
| Principal Investigator: Young E. Whang | |
| United States, Texas | |
| M D Anderson Cancer Center | Not yet recruiting |
| Houston, Texas, United States, 77030 | |
| Contact: Paul G. Corn 713-792-2830 pcorn@mdanderson.org | |
| Principal Investigator: Paul G. Corn | |
| United States, Washington | |
| University of Washington Medical Center | Not yet recruiting |
| Seattle, Washington, United States, 98195 | |
| Contact: Robert B. Montgomery 206-598-0860 rbmontgo@u.washington.edu | |
| Principal Investigator: Robert B. Montgomery | |
| United States, Wisconsin | |
| University of Wisconsin Cancer Center Riverview | Not yet recruiting |
| Wisconsin Rapids, Wisconsin, United States, 54494 | |
| Contact: Glenn Liu 608-265-8689 gxl@medicine.wisc.edu | |
| Principal Investigator: Glenn Liu | |
| Principal Investigator: | Maha Hussain | University of Chicago Comprehensive Cancer Center |
More Information
No publications provided
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT01576172 History of Changes |
| Other Study ID Numbers: | NCI-2012-01149, 12-0109, N01CM00071, U01CA070095 |
| Study First Received: | April 11, 2012 |
| Last Updated: | February 12, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms Genital Diseases, Male Prostatic Diseases Prednisone Glucocorticoids |
Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents, Hormonal Antineoplastic Agents Therapeutic Uses Anti-Inflammatory Agents |
ClinicalTrials.gov processed this record on May 19, 2013