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Phase Ib of Abiraterone Acetate Plus BEZ235 or BKM120 in Castration-resistant Prostate Cancer (CRPC) Patients

Phase 1
Completed
Conditions
Castration-resistant Prostate Cancer
Interventions
Registration Number
NCT01634061
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

This is an open label study of abiraterone acetate in combination with BEZ235 and abiraterone acetate in combination with BKM120 in CRPC patients with abiraterone acetate failure.

Detailed Description

A dose-escalation part will first determine the maximum tolerated dose (MTD) and/or recomended dose for expansion (RDE) of abiraterone acetate in combination with BEZ235 and abiraterone acetate in combination with BKM120 in CRPC patients with abiraterone acetate failure.

Subsequently, the MTD and/or RDE of each combination will be investigated in two expansion treatment groups of CRPC patients who have failed abiraterone acetate therapy.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
43
Inclusion Criteria
  • Adult males ≥ 18 years old
  • Eastern Cooperative Oncology Group Performance Status ≤ 2
  • Patient must have a castrate level of testosterone (<= 50 ng/dL or 1.7 nmol/L). ( Castrate status must be maintained by continued GnRH analogues unless patient has undergone surgical orchiectomy).
  • Histologically or cytologically confirmed diagnosis of advanced or metastatic prostate cancer.
  • Advanced or metastatic castration-resistant prostate cancer progression after abiraterone acetate failure
  • Patients should have no more than 2 lines of prior chemotherapies including cytotoxic agents
  • Discontinuation of all anti-androgen, anti-neoplastic or investigational treatment >= 4 weeks (6 weeks for bicalutamide).
Exclusion Criteria
  • Previous treatment with PI3K pathway inhibitors (e.g. PI3K, AKT, mTOR inhibitor), ketoconazole, CYP17 inhibitors (exception of AA), or enzalutamide.
  • Patient has active uncontrolled or symptomatic CNS metastases
  • Inadequately controlled hypertension (e.g. systolic blood pressure >=160 mmHg or diastolic blood pressure >=95 mmHg)
  • Patient has a QTcF > 480 msec on the screening ECG (using the QTcF formula), has a short/long QT syndrome, or history of QT prolongation/Torsades de Pointes
  • Patient has impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drugs
  • Patient has a medically documented history of or active major depressive episode, bipolar disorder (I or II), obsessive-compulsive disorder, schizophrenia, a history of suicidal attempt or ideation, or homicidal ideation (e.g. risk of doing harm to self or others)
  • Patients who experienced dose reductions and/or treatment interruptions due to abiraterone acetate related toxicities (i.e. serious AEs, AEs, liver toxicities during abiraterone acetate treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dose escalation: BEZ235 + Zytiga®BEZ235BEZ235 oral twice daily: 200 mg, 300 mg, and 400 mg dose levels to be tested in the dose escalation part in combination with abiraterone acetate Zytiga® abiraterone acetate oral once daily: 1000 mg taken with low dose prednisone as per the label
Dose escalation: BKM120 + Zytiga®BKM120BKM120 oral once daily: 60 mg, 80 mg and 100 mg dose levels to be tested in the dose escalation part in combination with abiraterone acetate Zytiga® abiraterone acetate oral once daily: 1000 mg taken with low dose prednisone as per the label
Dose Expansion: BKM120 + Zytiga®BKM120BKM120 oral once daily: 60 mg, 80 mg and 100 mg dose levels to be tested in the dose escalation part in combination with abiraterone acetate Zytiga® abiraterone acetate oral once daily: 1000 mg taken with low dose prednisone as per the label
Dose expansion: BEZ235 + Zytiga®BEZ235BEZ235 oral twice daily: 200 mg, 300 mg, and 400 mg dose levels to be tested in the dose escalation part in combination with abiraterone acetate Zytiga® abiraterone acetate oral once daily: 1000 mg taken with low dose prednisone as per the label
Primary Outcome Measures
NameTimeMethod
Incidence of dose limiting toxicities (DLTs)from days 1-35 in BEZ235/abiraterone acetate arm and from days 1-28 in BKM120/abiraterone acetate arm

Dose escalation part: Determine MTD and /or RDE of the combinations abiraterone acetate + BEZ235 and abiraterone acetate + BKM120 by assessing the incidence of DLTs in cycle 1

Prostate specific antigen (PSA) decline ≥ 30%At week 12 or later after treatment discontinuation

Dose expansion part: Assess anti-tumor activity of the combinations (abiraterone acetate + BEZ235 and abiraterone acetate + BKM120) in castration-resistant prostate cancer patients with abiraterone acetate failure as on treatment PSA progression according to prostate cancer working group criteria 2 (PCWG2) by assessing PSA decline ≥ 30% at Week 12 or later.

Secondary Outcome Measures
NameTimeMethod
radiological Progression Free Survival as per RECIST 1.1 and PCWG2Every 12 weeks until disease progression
radiological Response Rate according to RECIST 1.1Every 12 weeks until disease progression
Overall SurvivalFrom treatment start until 75% of deaths from any cause have occurred
Changes in ECG (electrocardiogram)Treatment start until 30 days after the last dose
Changes in mood scalesTreatment start until 30 days after the last dose
Number and percentage of patients with laboratory abnormalitiesTreatment start until 30 days after the last dose
Changes in vital signsTreatment start until 30 days after the last dose
Number of patients with at least one adverse eventTreatment start until 30 days after the last dose

Trial Locations

Locations (3)

Cedars Sinai Medical Center SC

🇺🇸

Los Angeles, California, United States

Hackensack University Medical Center Hackensack Univ

🇺🇸

Hackensack, New Jersey, United States

Novartis Investigative Site

🇬🇧

Sutton, United Kingdom

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