Docetaxel and Prostvac for Metastatic Castration Sensitive Prostate Cancer
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 74
- 试验地点
- 1
- 主要终点
- Antigen Spreading (i.e., a Broader Immune Response) With Greater Associated Response Score Compared to Docetaxel Alone After 19 Weeks
研究概览
简要总结
Background:
Metastatic castrate-sensitive prostate cancer is cancer that has spread beyond the prostate area. It can be controlled by lowering the amount of testosterone in the body. This is called androgen deprivation therapy (ADT). The vaccine PROSTVAC might help the immune system kill cancer cells. Researchers want to add PROSTVAC and docetaxel chemotherapy to ADT. They think this may work better against prostate cancer than ADT alone.
Objective:
To test if adding PROSTVAC and docetaxel to ADT works better against prostate cancer than ADT alone.
Eligibility:
Men ages 18 years and over with metastatic castrate-sensitive prostate cancer
Design:
Participants will be screened with:
Physical exam
Medical history
Blood tests
Possible computed tomography (CT), magnetic resonance imaging (MRI), or bone scan: Participants lie in a machine. The machine takes pictures of the body.
Electrocardiogram: Soft electrodes are stuck to the skin to record heart signals.
Participants will have 2 optional tumor biopsies during the study.
Participants will join 1 of 2 groups. Both groups will get:
ADT
Docetaxel by vein
Steroids by mouth or vein before each docetaxel infusion
PROSTVAC injection
Both groups first have ADT. One to 4 months after, they have:
Group A:
Docetaxel every 3 weeks for 6 cycles
PROSTVAC 3 weeks after the last infusion
Booster injections 2 weeks later and then every 3 weeks, for 6 boosters total
Group B:
PROSTVAC
Booster 2 weeks later
Docetaxel hours later
Docetaxel and the booster every 3 weeks for 6 cycles
Participants will have a visit 4-5 weeks after the last treatment. They will then have visits every 12 weeks.
Participants will be followed for up to 15 years. This includes physical exams every year for 5 years.
详细描述
Background:
- A phase III trial demonstrated that combining docetaxel and androgen deprivation therapy (ADT) significantly improved survival (57.6 vs 44.0 months (hazard ration (HR)=0.56, (0.44-0.70), p <0.0001) for men with metastatic castration sensitive prostate cancer (mCSPC).
- PROSTVAC (developed by the National Cancer Institute [NCI] and licensed to Bavarian Nordic Immunotherapeutics, Mountain View, California (CA) is a therapeutic cancer vaccine for prostate cancer.
- Preclinical and clinical studies support the potential synergy in the combination of docetaxel and PROSTVAC. The potential to combine docetaxel with vaccine in mCSPC could improve upon the survival advantage that has been previously seen.
Objectives:
Primary
-To determine if PROSTVAC combined with docetaxel is able to induce greater antigen spreading (i.e. a broader immune response) with greater associated response score compared to docetaxel alone after 19 weeks.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
研究组 & 干预措施
Arm B/ Combined Docetaxel with PROSTVAC
Standard androgen deprivation therapy (ADT) followed by combined docetaxel + prostvac
干预措施: Docetaxel (Drug)
Arm A/Sequential Docetaxel followed by PROSTVAC
Standard androgen deprivation therapy (ADT) followed by sequential docetaxel + prostvac
干预措施: PROSTVAC-V (Biological)
Arm A/Sequential Docetaxel followed by PROSTVAC
Standard androgen deprivation therapy (ADT) followed by sequential docetaxel + prostvac
干预措施: PROSTVAC-F (Biological)
Arm A/Sequential Docetaxel followed by PROSTVAC
Standard androgen deprivation therapy (ADT) followed by sequential docetaxel + prostvac
干预措施: Docetaxel (Drug)
Arm B/ Combined Docetaxel with PROSTVAC
Standard androgen deprivation therapy (ADT) followed by combined docetaxel + prostvac
干预措施: PROSTVAC-V (Biological)
Arm B/ Combined Docetaxel with PROSTVAC
Standard androgen deprivation therapy (ADT) followed by combined docetaxel + prostvac
干预措施: PROSTVAC-F (Biological)
Arm C/ PROSTVAC Prior to Docetaxel
Standard androgen deprivation therapy (ADT) followed by prostvac, then docetaxel. No ADT for less than 28 days, prostvac prior to docetaxel.
干预措施: PROSTVAC-V (Biological)
Arm C/ PROSTVAC Prior to Docetaxel
Standard androgen deprivation therapy (ADT) followed by prostvac, then docetaxel. No ADT for less than 28 days, prostvac prior to docetaxel.
干预措施: PROSTVAC-F (Biological)
Arm C/ PROSTVAC Prior to Docetaxel
Standard androgen deprivation therapy (ADT) followed by prostvac, then docetaxel. No ADT for less than 28 days, prostvac prior to docetaxel.
干预措施: Docetaxel (Drug)
结局指标
主要结局
Antigen Spreading (i.e., a Broader Immune Response) With Greater Associated Response Score Compared to Docetaxel Alone After 19 Weeks
时间窗: After 19 Weeks
Antigen spreading as measured by antigen spread score. The antigen spreading score denotes the presence of a T-cell (cluster of differentiation(CD8)+ and/or cluster of differentiation 4(CD4+) immune response against 2 tumor associated antigens that were not targeted by PROSTVAC:Mucin 1(MUC-1) \& carcinoembryonic antigen(CEA). Antigen-specific T-cell responses were determined using intracellular cytokine staining of 4 established markers (Lysosome-associated membrane proteins h-LAMP1, interferon gamma, interleukin-2\& tumor necrosis factor) in both CD4+\& CD8+T-cells, giving a total of 8 measures of activation per antigen. Numbers of activation markers per antigen were totaled \& multiplied by 1.5 to give higher weighting to T-cell responses to antigens that were not targeted by PROSTVAC;\& the scores for both MUC-1 \& CEA were totaled per participant, with a possible range of 0-24 (0 is a negative result whereas 1.5-24 are positive results). The higher level of response, the better outcome.
次要结局
- Antigen Specific T-cell Immune Composite Response Scores Between All Arms at 39 Weeks and 1 Year(39 weeks and 1 year)
- Number of Participants With T-cell Response to Prostate-specific Antigen (PSA)(39 weeks and 1 year)
研究者
Ravi A. Madan, M.D.
Principal Investigator
National Cancer Institute (NCI)
