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A Randomized, Double-blind, Phase 3 Efficacy Trial of PROSTVAC-V/F +/- GM-CSF in Men With Asymptomatic or Minimally Symptomatic Metastatic Castrate-Resistant Prostate Cancer

Phase 3
Completed
Conditions
Prostate Cancer Metastatic
Interventions
Biological: PROSTVAC-V
Biological: PROSTVAC-F
Biological: Placebo
Other: GM-CSF Placebo
Registration Number
NCT01322490
Lead Sponsor
Bavarian Nordic
Brief Summary

The purpose of this study is to determine whether PROSTVAC alone or in combination with GM-CSF is effective in prolonging overall survival in men with few or no symptoms from metastatic, castrate-resistant prostate cancer.

Detailed Description

BNIT-PRV-301 is a randomized, placebo-controlled, multi-center, global Phase 3 efficacy trial of PROSTVAC in men with asymptomatic or minimally symptomatic, metastatic, castrate-resistant prostate cancer. It is a 3-arm study and will evaluate overall survival in two separate comparisons, PROSTVAC plus adjuvant dose GM-CSF versus controls, and PROSTVAC without GM-CSF versus controls.

Patients will be randomized with equal probability into one of three double-blind arms. The intended interventions for randomized patients are:

1. (Arm V+G) PROSTVAC-V/F plus adjuvant dose GM-CSF

2. (Arm V) PROSTVAC-V/F plus GM-CSF placebo

3. (Arm P) Double placebo

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
1297
Inclusion Criteria

Men, ≥18years of age with documented asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer.

Documented progressive disease post surgical castration or during androgen suppression therapy, or during complete androgen blockade therapy and withdrawal. Documented by either criterion a (Radiological progression), OR criterion b (PSA progression).

  1. Radiological progression defined as any new/enlarging bone metastases or new/enlarging lymph node disease, consistent with prostate cancer.

    OR

  2. PSA progression defined by sequence of rising values separated by > 1 week (2 separate increasing values) over a threshold minimum of 2.0 ng/ml. (PCWG2 PSA eligibility criteria).

Chemotherapy naïve and Vaccinia-experienced (previous smallpox vaccination). Currently using a GnRH agonist or antagonist (unless surgically castrated).

Exclusion Criteria

Cancer-related pain requiring scheduled opioid narcotics for control (as needed, ≤ 2x per week is allowed).

Metastasis to organ systems other than lymph nodes and/or bone. Estimated PSA doubling time of <1 month as established within 6 months of the anticipated first dose of vaccine or placebo.

Concurrent or prior Provenge (sipuleucel-T) immunotherapy for prostate cancer. Receipt of an investigational agent within 30 days (or 60 days for an antibody-based therapy) of the first planned dose of PROSTVAC-V/F.

History of prior malignancies other than prostate cancer within the past 3 years, excluding successfully resected basal or squamous cell carcinoma of the skin.

Congestive heart failure (NYHA Class II, III, or IV), unstable angina, ventricular or hemodynamically significant atrial arrhythmia, or cardiovascular disease such as stroke or myocardial infarction (current or within the past 6 months) Confirmed positive for HIV, hepatitis B, and /or hepatitis C. Immunodeficiency or splenectomy. History of or active autoimmune disease, persons with vitiligo are not excluded. Diabetics are not excluded if the condition is well controlled.

History of atopic dermatitis or active skin condition (acute, chronic, exfoliative) that disrupts the epidermis.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PROSTVAC-V/F-TRICOM + GM-CSFPROSTVAC-V* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF
PROSTVAC-V/F-TRICOM + GM-CSFPROSTVAC-F* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF
PROSTVAC-V/F-TRICOM + GM-CSF placeboGM-CSF Placebo* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF placebo
Placebo ControlGM-CSF PlaceboPROSTVAC V/F Placebo + GM-CSF Placebo
Placebo ControlPlaceboPROSTVAC V/F Placebo + GM-CSF Placebo
PROSTVAC-V/F-TRICOM + GM-CSF placeboPROSTVAC-V* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF placebo
PROSTVAC-V/F-TRICOM + GM-CSF placeboPROSTVAC-F* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF placebo
PROSTVAC-V/F-TRICOM + GM-CSFGM-CSF* PROSTVAC-V-TRICOM * PROSTVAC-F-TRICOM * GM-CSF
Primary Outcome Measures
NameTimeMethod
Overall SurvivalRandomization through the date of death due to any cause. Subjects were followed up for approximately 6 years from the first subject randomized to the completion of the study.

The time between the date of randomization and the date of death due to any cause. Subjects who did not experience death or the competing events of "definite" loss to follow-up or withdrawal of consent were right censored at the date of last contact. OS was calculated using the formula: OS = Date of death/competing event/censoring - date of randomization + 1.

Secondary Outcome Measures
NameTimeMethod
Number of Subjects Alive Without Event at 6 MonthsRandomization through Week 25/End of Treatment visit.

A binary assessment that was performed for the 6-months timepoint for the categories of radiographic progression, pain progression, initiation of chemotherapy or death. Subjects without an event prior to 6-months were evaluated at 6-months. Subjects without event by 6-months and were not evaluated at 6-months were assumed to have had an event and analyzed as such.

Progression events were defined as: (1) Two new lesions on bone scan, new metastases on CT scans, or an increased size of nodal lesions per RECIST 1.1. Bone or CT scans occurring prior to calendar month 6 were used to determine radiographic progression. (2) Introduction of scheduled opioid narcotics for cancer-related pain control. (3) Initiation of chemotherapy for prostate cancer was assessed as collected on progression forms as well as in cancer treatment and concomitant medications logs. (4) Death.

Trial Locations

Locations (219)

Alaska Clinical Research Center, Llc

🇺🇸

Anchorage, Alaska, United States

Scottsdale Healthcare

🇺🇸

Scottsdale, Arizona, United States

Alta Bates Summit Medical Center

🇺🇸

Berkeley, California, United States

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Prostate Oncology Specialists, Inc.

🇺🇸

Marina Del Rey, California, United States

Desert Hematology-Oncology

🇺🇸

Rancho Mirage, California, United States

San Bernardino Urological Associates

🇺🇸

San Bernardino, California, United States

San Diego Clinical Trials

🇺🇸

San Diego, California, United States

Sharp Memorial Hospital

🇺🇸

San Diego, California, United States

VA San Diego Healthcare System

🇺🇸

San Diego, California, United States

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Alaska Clinical Research Center, Llc
🇺🇸Anchorage, Alaska, United States

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