Detection of ARv7 in the Plasma of Men With Advanced Metastatic Castrate Resistant Prostate Cancer (MCRP)
试验速览
- 阶段
- 不适用
- 状态
- 暂停
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Detection of ARv7 splice variant in the circulation of MCRPC patients. PSA response rate in ARv7 positive patients.
研究概览
简要总结
Demonstrate detection of ARv7 splice variant transcripts from exosomes in the circulation of MCRPC patients pre and post treatment with selective Androgen pathway inhibitors (i.e. abiraterone and enzalutamide)
详细描述
Primary Objective
-Demonstrate detection of ARv7 splice variant transcripts from exosomes in the circulation of MCRPC patients pre and post treatment with selective Androgen pathway inhibitors (i.e. abiraterone and enzalutamide)
Secondary and Exploratory Objectives
- Correlate ARv7 status with PSA response (>/=50% decline in PSA level from baseline, maintained for >/=4 weeks) at any time after the initiation of therapy.
- Comparison of median progression free survival (PFS) and overall survival (OS).
- Determine additional molecular lesions in exoRNA and cfDNA in MCRPC patients post-treatment with androgen pathway inhibitors.
- Correlate other AR-variants (non ARv7) with clinical outcomes including PSA response.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 是
入选标准
- •Participants must have histologically confirmed diagnosis of adenocarcinoma of the prostate.
- •Clinical or radiographic evidence of metastatic disease.
- •Planned therapy with either enzalutamide or abiraterone acetate within the coming 6 weeks.
- •Evidence of disease progression on or following most recent therapy as evidenced by the following:
- •Radiographic evidence of disease progression as defined by one or more new bone scan lesions.
- •Growth of soft tissue / visceral metastases to greater than one centimeter in longest diameter.
- •Progressive disease despite 'castration levels' of serum testosterone (<50ng/dL with continued androgen deprivation therapy.
- •At least two of the following high risk features during screening for rapid disease progression:
- •Anemia with a hemoglobin <12.0 g/dL
- •Elevated alkaline phosphatase
- •High lactate dehydrogenase (LDH)
- •Presence of visceral metastasis on imaging
- •Presence of clinically significant pain requiring opioid analgesics.
- •PSA doubling time under 3 months on most recent therapy
- •PSA values obtained 2 or more weeks apart, with last value being 2.0ng/mL or higher.
- •Ability to understand and willingness to sign a written informed consent document.
排除标准
- •Receiving or intend to receive concurrent chemotherapy
- •Hepatitis (all types) in patient's medical record
- •HIV documented in patient's medical record
- •History of intercurrent or past medical history or psychiatric illness that would make participation in a blood drawing protocol difficult or not feasible.
结局指标
主要结局
Detection of ARv7 splice variant in the circulation of MCRPC patients. PSA response rate in ARv7 positive patients.
时间窗: Two years
The detection of ARv7 splice variants in samples will be considered both binary: positive or negative/not assessable and level based. ARv7 splice variants from exosomes will be detectable from baseline in 50% of both API; PSA response rates will be 10% or less in ARv7 positive patients. With a sample of 30 patients (as reported in the NEJM study) per cohort would allow the study to have an 85% power to detect a difference of 50 percentage points in PSA response rates, with the use of a two-sided test at an alpha level of 0.1.
次要结局
- Detection of ARv7 splice variant in the circulation of MCRPC patients. PSA response rate in ARv7 negative patients.(Two years)