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Cabazitaxel Versus the Switch to Alternative AR Targeted Therapy Enzalutamide or Abiraterone in Metastatic Castration-Resistant Prostate Cancer (mCRPC) Primary Resistant Patients to Abiraterone or Enzalutamide

Phase 2
Terminated
Conditions
Prostate Cancer Metastatic
Interventions
Registration Number
NCT02379390
Lead Sponsor
Sanofi
Brief Summary

Primary Objective:

To demonstrate the superiority in term of radiographic Progression-Free Survival (rPFS) of cabazitaxel at at 25 milligram per meter square (mg/m\^2) plus prednisone (Arm A) versus either enzalutamide at 160 milligram (mg) once daily or abiraterone acetate at 1000 mg once daily plus prednisone (Arm B) in chemotherapy-naïve participants with metastatic Castration-Resistant Prostate Cancer (mCRPC) who have disease progression while receiving androgen receptor (AR) targeted therapy (abiraterone plus prednisone or enzalutamide) within 12 months of treatment initiation (≤12 months).

Secondary Objective:

* To compare efficacy for:

* Prostate-specific antigen (PSA) response rate and Time to PSA progression (TTPP).

* Progression Free Survival (PFS).

* Overall Survival (OS).

* Tumor response rate in participants with measurable disease (RECIST 1.1)

* Pain response and time to pain progression.

* Symptomatic skeletal events (SSE) rate and time to occurrence of any SSE.

* To analyze messenger ribonucleic acids (mRNAs) including androgen-receptor splice variant 7 messenger RNA (AR-V7) as a biomarker in Circulating Tumor Cells (CTCs).

* To evaluate safety in the 2 treatment arms.

Detailed Description

The duration of the study per participant was approximately 2 years. Each participant was treated until radiographic disease progression, unacceptable toxicity, or participants refusal of further study treatment, and each participant was followed after completion of study treatment until death, study cutoff date, or withdrawal of participant consent.

Recruitment & Eligibility

Status
TERMINATED
Sex
Male
Target Recruitment
8
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Abiraterone acetate or EnzalutamideEzalutamideParticipants received abiraterone acetate 1000 mg (4 tablets of 250 mg), orally once daily along with prednisone 5 mg, orally twice daily from Day 1 to 21 in each treatment cycle (each cycle was of 3 weeks) or enzalutamide 160 mg, orally, until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
CabazitaxelCabazitaxel XRP6258Participants received Cabazitaxel 25 mg/m\^2, intravenously for 1 hour along with prednisone 10 mg orally on Day 1 of every treatment cycle (each cycle was of 3 weeks) until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
CabazitaxelPrednisoneParticipants received Cabazitaxel 25 mg/m\^2, intravenously for 1 hour along with prednisone 10 mg orally on Day 1 of every treatment cycle (each cycle was of 3 weeks) until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
Abiraterone acetate or EnzalutamideAbiraterone acetateParticipants received abiraterone acetate 1000 mg (4 tablets of 250 mg), orally once daily along with prednisone 5 mg, orally twice daily from Day 1 to 21 in each treatment cycle (each cycle was of 3 weeks) or enzalutamide 160 mg, orally, until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
Abiraterone acetate or EnzalutamidePrednisoneParticipants received abiraterone acetate 1000 mg (4 tablets of 250 mg), orally once daily along with prednisone 5 mg, orally twice daily from Day 1 to 21 in each treatment cycle (each cycle was of 3 weeks) or enzalutamide 160 mg, orally, until disease progression, unacceptable toxicity, or participant's refusal of further study treatment.
Primary Outcome Measures
NameTimeMethod
Radiographic Progression-Free Survival (rPFS)Baseline until tumor progression or bone lesion progression or death due to any cause (maximum duration: 1059 days)

rPFS was defined as the time from randomization to the first occurrence of radiological tumor progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 or progression of bone lesions using prostate cancer working group 2 (PCWG2) criteria or death due to any cause.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Symptomatic Skeletal Event (SSE)Baseline until the end of study (maximum duration: 1059 days)

SSE was the occurrence of a new symptomatic pathological fracture, or the use of external beam radiation to relieve bone pain, or the occurrence of spinal cord compression, or tumor-related orthopedic surgical intervention.

Number of Participants With Prostate Specific Antigen (PSA) ResponseBaseline up to PSA progression or death due to any cause (maximum duration: 1059 days)

PSA response was defined as decline of serum PSA from baseline by \>= 50 percent (%).

Time to Occurrence of Any Symptomatic Skeletal Events (SSE)Baseline up to occurrence of the first event defining a SSE (maximum duration: 1059 days)

Time to SSE was defined as the time interval between the date of randomization and the date of the occurrence of the first event defining a SSE, whichever is earlier.

Duration of Tumor ResponseBaseline up to disease progression or death due to any cause (maximum duration: 1059 days)

Duration of tumor response was defined as the time between the first evaluation at which the tumor response criteria were met and the first documentation of tumor progression.

Pain Response Using Brief Pain Inventory-Short Form (BPI-SF) for Pain Intensity ScoreBaseline until the end of study (maximum duration: 1059 days)

Pain response was analyzed using the brief pain inventory-short form (BPI-SF).

Time to Pain ProgressionBaseline until disease progression, start of another anticancer therapy or study cut off, whichever came first (maximum duration: 1059 days)

Time to pain progression was defined as the time interval between the date of randomization and the date of the first documented pain progression.

Overall SurvivalBaseline until death or study cut-off date, whichever was earlier (maximum duration: 1059 days)

Overall Survival was defined as the time interval from the date of randomization to the date of death due to any cause.

Time to PSA ProgressionBaseline up to PSA progression or death due to any cause (maximum duration: 1059 days)

Time to PSA progression was defined as the time interval between the date of randomization and the date of first documented PSA progression as per PCWG2 criteria.

Number of Participants Achieving Tumor ResponseBaseline up to disease progression or death due to any cause (maximum duration: 1059 days)

Tumor response was defined as either a partial response (PR) or complete response (CR) according to the RECIST 1.1.

Progression-free Survival (PFS)Baseline upto progression or death due to any cause (maximum duration: 1059 days)

PFS: time interval between date of randomization to first documentation of tumor progression as per RECIST 1.1.

Trial Locations

Locations (24)

Investigational Site Number 124005

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Hamilton, Canada

Investigational Site Number 124002

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Montreal, Canada

Investigational Site Number 124009

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Quebec, Canada

Investigational Site Number 840024

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Anchorage, Alaska, United States

Investigational Site Number 840030

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Muscle Shoals, Alabama, United States

Investigational Site Number 840028

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Anaheim, California, United States

Investigational Site Number 840004

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Sacramento, California, United States

Investigational Site Number 840002

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Boca Raton, Florida, United States

Investigational Site Number 840017

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Metairie, Louisiana, United States

Investigational Site Number 840027

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Lakeland, Florida, United States

Investigational Site Number 840015

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Ottawa, Illinois, United States

Investigational Site Number 840006

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Port Saint Lucie, Florida, United States

Investigational Site Number 840012

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Rockville, Maryland, United States

Investigational Site Number 840026

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Omaha, Nebraska, United States

Investigational Site Number 840022

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Canton, Ohio, United States

Investigational Site Number 124010

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Greenfield Park, Canada

Investigational Site Number 840016

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Myrtle Beach, South Carolina, United States

Investigational Site Number 124003

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Edmonton, Canada

Investigational Site Number 124006

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Montreal, Canada

Investigational Site Number 124004

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London, Canada

Investigational Site Number 124007

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Ottawa, Canada

Investigational Site Number 124001

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Vancouver, Canada

Investigational Site Number 124008

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Saskatoon, Canada

Investigational Site Number 840001

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Covington, Louisiana, United States

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