MedPath

A Study of Rucaparib in Patients With Metastatic Castration-resistant Prostate Cancer and Homologous Recombination Gene Deficiency

Phase 2
Completed
Conditions
Metastatic Castration Resistant Prostate Cancer
Interventions
Registration Number
NCT02952534
Lead Sponsor
pharmaand GmbH
Brief Summary

The purpose of this study is to determine how patients with metastatic castration-resistant prostate cancer, and evidence of a homologous recombination gene deficiency, respond to treatment with rucaparib.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
277
Inclusion Criteria
  • Be 18 years old at the time the informed consent form is signed
  • Have a histologically or cytologically confirmed adenocarcinoma or poorly differentiated carcinoma of the prostate
  • Be surgically or medically castrated, with serum testosterone levels of ≤ 50 ng/dL (1.73 nM)
  • Experienced disease progression after having received at least 1 but no more than 2 prior next-generation androgen receptor-targeted therapies, and 1 prior taxane-based chemotherapy, for castration-resistant disease
  • Have a deleterious mutation in BRCA1/2 or ATM, or molecular evidence of other homologous recombination deficiency
Exclusion Criteria
  • Active second malignancy, with the exception of curatively treated non-melanoma skin cancer, carcinoma in situ, or superficial bladder cancer
  • Prior treatment with any PARP inhibitor, mitoxantrone, cyclophosphamide or any platinum-based chemotherapy
  • Symptomatic and/or untreated central nervous system metastases
  • Pre-existing duodenal stent and/or any gastrointestinal disorder or defect that would, in the opinion of the investigator, interfere with absorption of rucaparib

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
RucaparibRucaparibOral rucaparib (monotherapy)
Primary Outcome Measures
NameTimeMethod
Confirmed Objective Response Rate (ORR) by Gene in Patients With Measurable Disease at Baseline Per Central Independent Radiology Review (IRR)Assessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

The primary efficacy endpoint is confirmed radiographic ORR by central IRR. ORR is defined as the percentage of patients with a confirmed CR (complete response) or PR (partial response) by mRECIST (modified Response Evaluation Criteria in Solid Tumors) v1.1/PCWG3 (Prostate Cancer Working Group 3) criteria. The confirmed response is defined as a CR or PR on subsequent tumor assessment at least 28 days after first response documentation in the absence of confirmed progression in bone. CR is disappearance of all target and non-target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR is at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.

Secondary Outcome Measures
NameTimeMethod
Duration of Response (DOR) by Gene in Patients With Confirmed Response Per Central Independent Radiology Review (IRR)Assessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is DOR by central IRR. The DOR is defined as the time from the date that a confirmed response per modified RECIST Version 1.1/PCWG3 is first reported to the time that progressive disease (PD) is first documented. Progressive disease is defined using RECIST v1.1, as at least a 20% increase in the sum of the diameters of target lesions, or an unequivocal increase in non-target lesions, or the appearance of new lesions. PCWG3 criteria is used to document evidence of disease progression in bone lesions.

Confirmed Objective Response Rate (ORR) by Gene in Patients With Measurable Disease at Baseline Per Investigator (INV)Assessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A supportive efficacy endpoint is confirmed radiographic ORR by INV. ORR is defined as the percentage of patients with a confirmed CR (complete response) or PR (partial response) by mRECIST (modified Response Evaluation Criteria in Solid Tumors) v1.1/PCWG3 (Prostate Cancer Working Group 3) criteria. The confirmed response is defined as a CR or PR on subsequent tumor assessment at least 28 days after first response documentation in the absence of confirmed progression in bone. CR is disappearance of all target and non-target lesions; any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. PR is at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum of diameters.

Confirmed PSA Response (≥ 90% Decrease) by Gene as Assessed by Local LaboratoryPSA assessments were done at baseline, Week 5, Week 9, every 4 weeks thereafter, and at Treatment Discontinuation. Total follow-up was up to approximately 39 months.

A secondary endpoint is confirmed PSA (prostate-specific antigen) response (≥ 90% reduction) as assessed by local laboratory. Confirmed PSA response is analyzed for all patients who had PSA value at baseline and is defined as the percentage of patients having 2 consecutive PSA values (at least 3 weeks apart) that are at least 90% lower than baseline and that occur prior to PSA progression. PSA progression is defined as a ≥ 25% increase and absolute increase of ≥ 2 ng/mL above the nadir in PSA.

Radiologic Progression-free Survival (rPFS) by Gene in All Patients Per Central Independent Radiology Review (IRR)Assessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is Radiologic Progression-free Survival (rPFS) assessed by IRR. rPFS is defined as the time from first dose of rucaparib to the date of first objective evidence of radiographic progression (soft tissue or bone lesion) or death due to any cause, whichever occurs first, plus 1 day. Radiographic disease progression includes confirmed bone disease progression and soft tissue disease progression adjudicated by IRR using the PCWG3 guidelines for bone disease and modified RECIST Version 1.1 for soft tissue disease.

Radiologic Progression-free Survival (rPFS) by Gene in All Patients Per InvestigatorAssessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is Radiologic Progression-free Survival (rPFS) assessed by Investigator. rPFS is defined as the time from first dose of rucaparib to the date of first objective evidence of radiographic progression (soft tissue or bone lesion) or death due to any cause, whichever occurs first, plus 1 day. Radiographic disease progression includes confirmed bone disease progression and soft tissue disease progression using the PCWG3 guidelines for bone disease and modified RECIST Version 1.1 for soft tissue disease.

Clinical Benefit Rate (CBR) by Gene Per Central Independent Radiology Review (IRR)Assessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is Clinical Benefit Rate (CBR) assessed by IRR. CBR is defined as the number of patients without radiographic progression (defined by modified RECIST Version 1.1/ PCWG3 criteria) who were continuing with study drug treatment through the given time interval divided by the number of patients who had the given amount of follow-up. Clinical benefit rates are summarized at 6 and 12 months.

Time to PSA Progression by GenePSA assessments were done at baseline, Week 5, Week 9, every 4 weeks thereafter, and at Treatment Discontinuation. Total follow-up was up to approximately 39 months.

A secondary efficacy endpoint is time to PSA progession. Time to PSA progression is defined as the time from first dose of rucaparib to the date that a ≥ 25% increase and absolute increase of ≥ 2 ng/mL above the nadir (or baseline if there was no PSA decline after baseline) in PSA was measured, plus 1 day. The increase must be confirmed by a second consecutive assessment conducted at least 3 weeks later (unless the PSA progression occurred at the last recorded PSA assessment). If confirmed, the date used for time of PSA progression is the earlier of the 2 PSA dates.

Duration of Response (DOR) by Gene in Patients With Confirmed Response Per InvestigatorAssessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is DOR as assessed by the investigator. The DOR is defined as the time from the date that a confirmed response per modified RECIST Version 1.1/PCWG3 is first reported to the time that progressive disease (PD) is first documented. Progressive disease is defined using RECIST v1.1, as at least a 20% increase in the sum of the diameters of target lesions, or an unequivocal increase in non-target lesions, or the appearance of new lesions. PCWG3 criteria is used to document evidence of disease progression in bone lesions.

Clinical Benefit Rate (CBR) by Gene Per InvestigatorAssessments every 8 weeks from study day 1 for the first 24 weeks, and then every 12 weeks until disease progression, death, or initiation of subsequent treatment. Total follow-up was up to approximately 3 years.

A secondary efficacy endpoint is Clinical Benefit Rate (CBR) assessed by Investigator. CBR is defined as the number of patients without radiographic progression (defined by modified RECIST Version 1.1/ PCWG3 criteria) who were continuing with study drug treatment through the given time interval divided by the number of patients who had the given amount of follow-up. Clinical benefit rates are summarized at 6 and 12 months.

Steady State Trough (Cmin) Level Rucaparib ConcentrationsParticipants were assessed at Study Day 29, Day 57, Day 85 and Day 113

Trough (Cmin) concentrations of rucaparib are summarized for all patients with at least one PK sample collected. The absolute values of rucaparib plasma concentration at each time point are presented by gene.

Confirmed PSA Response (≥ 50% Decrease) by Gene as Assessed by Local LaboratoryPSA assessments were done at baseline, Week 5, Week 9, every 4 weeks thereafter, and at Treatment Discontinuation. Total follow-up was up to approximately 39 months.

A secondary endpoint is confirmed PSA (prostate-specific antigen) response (≥ 50% reduction) as assessed by local laboratory. Confirmed PSA response is analyzed for all patients who had PSA value at baseline and is defined as the percentage of patients having 2 consecutive PSA values (at least 3 weeks apart) that are at least 50% lower than baseline and that occur prior to PSA progression. PSA progression is defined as a ≥ 25% increase and absolute increase of ≥ 2 ng/mL above the nadir in PSA.

Overall Survival (OS) by GeneFrom date of first dose until event, loss to follow-up, withdrawal of consent, or study closure: an overall median of approximately 33.1 months

A secondary efficacy endpoint is Overall Survival (OS). OS is defined as the date from first dose of rucaparib to the date of death due to any cause, +1 day.

Trial Locations

Locations (147)

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

University of Southern California

🇺🇸

Los Angeles, California, United States

Atlanta Urological Group

🇺🇸

Atlanta, Georgia, United States

University of Chicago Comprehensive Cancer Center

🇺🇸

Chicago, Illinois, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Comprehensive Cancer Centers of Nevada

🇺🇸

Las Vegas, Nevada, United States

Minnesota Oncology Hematology, P.A.

🇺🇸

Minneapolis, Minnesota, United States

Minnesota Veterans Research Institute

🇺🇸

Minneapolis, Minnesota, United States

Premier Urology Associates dba/AdvanceMed Research

🇺🇸

Lawrenceville, New Jersey, United States

4701 Ogletown Stanton Rd.

🇺🇸

Newark, Delaware, United States

NYU Perlmutter Cancer Center

🇺🇸

New York, New York, United States

Weill Cornell Medical College/NewYork-Presbyterian Hospital

🇺🇸

New York, New York, United States

Alliance Research Centers

🇺🇸

Laguna Hills, California, United States

Consultants in Medical Oncology Hematology

🇺🇸

Horsham, Pennsylvania, United States

Boca Raton Community Hospital, Inc.

🇺🇸

Boca Raton, Florida, United States

Clinical Research Solutions

🇺🇸

Middleburg Heights, Ohio, United States

Roswell Park

🇺🇸

Buffalo, New York, United States

The Urology Group

🇺🇸

Cincinnati, Ohio, United States

VA Puget Sound

🇺🇸

Seattle, Washington, United States

Virginia Oncology Associates

🇺🇸

Norfolk, Virginia, United States

Memorial Sloan Kettering CC

🇺🇸

New York, New York, United States

SUNY Upstate Medical University

🇺🇸

Syracuse, New York, United States

Charite Universitatsmedizin Berlin

🇩🇪

Berlin, Germany

Urologische Gemeinschaftspraxis

🇩🇪

Emmendingen, Germany

Premier Medical Group of the Hudson Valley PC

🇺🇸

Poughkeepsie, New York, United States

Cabrini Hospital

🇦🇺

Malvern, Victoria, Australia

Cork University Hospital

🇮🇪

Cork, Ireland

IEO Instituto Europeo di Oncologia

🇮🇹

Milano, Italy

Azienda Opsedaliera S. Maria di Terni

🇮🇹

Terni, Italy

Hospital Puerta de Hierro-Majadahonda

🇪🇸

Madrid, Spain

Hospital Clínic i Provincial de Barcelona-Oncology

🇪🇸

Barcelona, Spain

Hadassah University Hospital

🇮🇱

Jerusalem, Israel

Texas Oncology Medical City Dallas

🇺🇸

Dallas, Texas, United States

Marques de Valdecilla University Hospital (HUMV)

🇪🇸

Santander, Spain

Universitaetsklinikum Heidelberg

🇩🇪

Heidelberg, Germany

Universitatsklinikum Jena

🇩🇪

Jena, Germany

Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Wexham Park Hospital

🇬🇧

Slough, Berkshire, United Kingdom

Hospital Universitario Central de Asturias

🇪🇸

Oviedo, Spain

Royal Liverpool Hospital

🇬🇧

Liverpool, United Kingdom

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Universitätsklinik Köln

🇩🇪

Köln, Germany

Ospedale San Donato, Azienda USLSUDEST

🇮🇹

Arezzo, Italy

Hospital Universitari Germans Trias i Pujol

🇪🇸

Barcelona, Spain

Instituto Catalan de Oncologia

🇪🇸

Barcelona, Spain

Mount Vernon Cancer Centre

🇬🇧

Northwood, England, United Kingdom

Azienda Ospedaliera San Camillo-Forlanini

🇮🇹

Rome, Italy

Hospital General Universitario de Guadalajara

🇪🇸

Guadalajara, Spain

Sarah Cannon Research Institutute - UK

🇬🇧

London, United Kingdom

Copenhagen University Hospital

🇩🇰

Copenhagen, Denmark

St. Vincent's University Hospital

🇮🇪

Dublin, Ireland

St James's Hospital

🇮🇪

Dublin, Ireland

University of Rochester

🇺🇸

Rochester, New York, United States

Mater Misericordiae University Hospital

🇮🇪

Dublin, Ireland

Adelaide & Meath Hospital, Incorporating the National Children's Hospital

🇮🇪

Dublin, Ireland

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Mayo Clinc

🇺🇸

Phoenix, Arizona, United States

VA Portland Health Care System

🇺🇸

Portland, Oregon, United States

Pacific Hematology Oncology Associates

🇺🇸

San Francisco, California, United States

San Francisco VA Health Care System

🇺🇸

San Francisco, California, United States

SCRI - Tennessee Oncology

🇺🇸

Nashville, Tennessee, United States

Southampton General Hospital

🇬🇧

Southampton, United Kingdom

Hôpital Privé des Côtes d'Armor

🇫🇷

Plérin, France

Institut Curie

🇫🇷

Paris, France

MD Anderson Cancer Center - Madrid

🇪🇸

Madrid, Spain

Instituto Valenciano de Oncologia IVO

🇪🇸

Valencia, Spain

Hospital Universitario Lucus Augusti.

🇪🇸

Lugo, Spain

Hospital 12 de Octubre

🇪🇸

Madrid, Spain

Die Gesundhehitsunion DGU

🇩🇪

Wuppertal, Germany

Rocky Mountain Cancer Centers

🇺🇸

Aurora, Colorado, United States

Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Walter Reed Hospital

🇺🇸

Bethesda, Maryland, United States

Alegent Health Bergan Mercy Hospital , GU Research Network

🇺🇸

Omaha, Nebraska, United States

Nebraska Cancer Specialists

🇺🇸

Omaha, Nebraska, United States

Universitätsklinikum Schleswig-Holstein

🇩🇪

Lübeck, Germany

VA Greater Los Angeles Healthcare System

🇺🇸

Los Angeles, California, United States

Arizona Oncology Associates

🇺🇸

Tucson, Arizona, United States

UCSF Helen Diller Family Comprehensive Cancer Center

🇺🇸

San Francisco, California, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

Stanford University

🇺🇸

Palo Alto, California, United States

Kaiser Permanente Medical Center (Vallejo)

🇺🇸

Vallejo, California, United States

Redwood Regional Medical Group

🇺🇸

Santa Rosa, California, United States

Georgetown University Medical Center

🇺🇸

Washington, District of Columbia, United States

Yale School of Medicine

🇺🇸

New Haven, Connecticut, United States

Florida Cancer Specialists

🇺🇸

Fort Myers, Florida, United States

University of Florida Health Cancer Center

🇺🇸

Orlando, Florida, United States

Ochsner Medical Center

🇺🇸

New Orleans, Louisiana, United States

University of Maryland Greenebaum Cancer Center

🇺🇸

Baltimore, Maryland, United States

Fairview Hospital

🇺🇸

Edina, Minnesota, United States

VA Ann Arbor Healthcare System

🇺🇸

Ann Arbor, Michigan, United States

HCA Midwest Division - Kansas City

🇺🇸

Kansas City, Missouri, United States

Carolina Urology Partners

🇺🇸

Concord, North Carolina, United States

Kettering Cancer Center

🇺🇸

Kettering, Ohio, United States

UT Health Science Center

🇺🇸

Houston, Texas, United States

Texas Oncology - Tyler

🇺🇸

Tyler, Texas, United States

Royal Hobart Hospital

🇦🇺

Hobart, Tasmania, Australia

Peninsula & Southeast Oncology

🇦🇺

Frankston, Victoria, Australia

Northern Cancer Insitute, St. Leonards

🇦🇺

Saint Leonards, New South Wales, Australia

Barwon Health, University Hospital Geelong

🇦🇺

Geelong, Victoria, Australia

Southside Cancer Care Centre

🇦🇺

Miranda, Australia

Orange Health Services

🇦🇺

Orange, Australia

St John of God Hospital, Subiaco

🇦🇺

Subiaco, Australia

Riverina Cancer Care Centre

🇦🇺

Wagga Wagga, Australia

ZNA Middelheim

🇧🇪

Antwerp, Belgium

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

AZ Groeninge

🇧🇪

Kortrijk, Belgium

Equipe de Recherche Clinique, Département d'Oncologie/Hématologie

🇧🇪

Liège, Belgium

CHU Sart-Tilman

🇧🇪

Liège, Belgium

AZ DELTA

🇧🇪

Roeselare, Belgium

Juravinski Cancer Centre Hamilton Health Services

🇨🇦

Hamilton, Ontario, Canada

Vejle Sygehus

🇩🇰

Vejle, Denmark

The Ottawa Hospital

🇨🇦

Ottawa, Ontario, Canada

London Health Science Center - Victoria Hospital

🇬🇧

London, United Kingdom

Herlev Hospital

🇩🇰

Herlev, Denmark

Princess Margaret Hospital

🇨🇦

Toronto, Canada

Polyclinique de Gentilly (Centre D'Oncologie De Gentilly)

🇫🇷

Nancy, France

Centre Georges François Leclerc

🇫🇷

Dijon, France

Clinique Victor Hugo Centre Jean Bernard

🇫🇷

Le Mans, France

Centre François Baclesse

🇫🇷

Caen, France

Hôpital Privé La Louvière

🇫🇷

Lille, France

Gemeinschaftspraxis fur Hamatologie & Onkologie

🇩🇪

Augsburg, Germany

CRLCC Eugene Marquis

🇫🇷

Rennes, France

Universitatsklinikum Carl Gustav Carus

🇩🇪

Dresden, Germany

Universitatsklinikum Dusseldorf

🇩🇪

Dusseldorf, Germany

Universitaetsklinikum Hamburg-Eppendorf (UKE)

🇩🇪

Hamburg, Germany

Medizinischen Fakultät Mannheim der Universität Heidelberg

🇩🇪

Mannheim, Germany

University of Tuebingen

🇩🇪

Tuebingen, Germany

Studienpraxis Urologie

🇩🇪

Nürtingen, Germany

Rambam Health Care Campus (RHCC), Rambam Medical Center

🇮🇱

Haifa, Israel

Rabin Medical Center-Beilinson Campus

🇮🇱

Petach Tikva, Israel

Meir Medical Center

🇮🇱

Kfar Saba, Israel

The Tel Aviv Sourasky Medical Center (Ichilov Hospital)

🇮🇱

Tel Aviv, Israel

Ospedale Santa Maria delle Croci

🇮🇹

Faenza, Italy

IRCCS Istituto Nazionale dei Tumori (INT)

🇮🇹

Milano, Italy

University of Modena and Reggio Emilia Medical Oncology

🇮🇹

Modena, Italy

Santa Chiara Hospital, Dept Medical Oncology

🇮🇹

Trento, Italy

Hospital del Mar, Servicio de Oncología

🇪🇸

Barcelona, Spain

Hospital Universitario Ramón y Cajal

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Corporacio Sanitaria Parc Tauli

🇪🇸

Sabadell, Spain

Royal Marsden Hospital

🇬🇧

Sutton, Surrey, United Kingdom

Oxford University Hospitals

🇬🇧

Headington, United Kingdom

Musgrove Park Hospital

🇬🇧

Taunton, United Kingdom

The Clatterbridge Cancer Centre NHS Foundation Trust

🇬🇧

Wirral, United Kingdom

Guy's Hospital

🇬🇧

London, United Kingdom

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