3-arm Study of Abiraterone Acetate Alone, Abiraterone Acetate Plus Degarelix, a GnRH Antagonist, and Degarelix Alone for Patients With Prostate Cancer With a Rising PSA or a Rising PSA and Nodal Disease Following Definitive Radical Prostatectomy



Status:Active, not recruiting
Conditions:Prostate Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:4/17/2018
Start Date:December 2012
End Date:October 2019

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A Phase 2, Randomized, 3-arm Study of Abiraterone Acetate Alone, Abiraterone Acetate Plus Degarelix, a GnRH Antagonist, and Degarelix Alone for Patients With Prostate Cancer With a Rising PSA or a Rising PSA and Nodal Disease Following Definitive Radical Prostatectomy

In April 2011, the United States Food and Drug Administration (FDA) approved the oral drug
abiraterone acetate (Zytiga ®) in combination with prednisone (a steroid) to treat patients
with metastatic castration-resistant prostate cancer who have received prior docetaxel
(chemotherapy). In December 2012, the FDA approved Zytiga ® in combination with prednisone to
treat patients with metastatic castration-resistant prostate cancer who have not received
prior chemotherapy. Degarelix (Firmagon ®), a testosterone lowering agent given as a monthly
injection, is FDA approved for the treatment of patients with advanced prostate cancer. The
purpose of this study is to evaluate abiraterone acetate and prednisone in combination with
degarelix as a possible treatment for PSA recurrent prostate cancer as compared to
abiraterone acetate alone and degarelix alone. This will be the first time these drugs will
be used together.


Inclusion Criteria:

- Willing and able to provide written informed consent and Authorization for Use and
Release of Health and Research Study Information (HIPAA authorization) NOTE: HIPAA
authorization may be either included in the informed consent or obtained separately.

- Male aged 18 years and above

- Patients must have undergone local treatment via radical prostatectomy

- Patients who have received primary radiation therapy followed by a salvage radical
prostatectomy are eligible.

- Patients who have had post-operative radiation therapy for presumed locally recurrent
disease are eligible

- Histologically confirmed prostate cancer (per standards at Institution of participant
registration) currently with progressive disease, defined as:

- Rising PSA (50% or more increase to a level of 1 ng/mL or more, based on at least 3
PSA determinations obtained at least 1 week apart). The 50% rise in PSA is across the
3 determinations, and these determinations do not need to be sequential AND

- PSADT ≤ 9 months as calculated according to the Memorial Sloan-Kettering Cancer Center
nomogram (http://www.mskcc.org/mskcc/html/10088.cfm) OR

- Rising PSA as defined above AND

- Metastatic disease limited to the presence of pelvic and/or retroperitoneal nodes < 2
cm in short axis.

- Patients must have a serum testosterone of 150 ng/dL or greater

- ECOG performance status of ≤ 2 (Appendix A)

- Adequate bone marrow, hepatic, and renal function, as evidenced within 14 days prior
to treatment initiation by:

- Absolute neutrophil count (ANC) ≥ 1500/mm3

- Platelet count ≥ 100,000/mm3

- Hemoglobin ≥ 9 g/dL without need for hematopoietic growth factor or transfusion
support within 30 days prior to treatment initiation

- Aspartate aminotransferase (AST) ≤ 1.5 times the upper limit of the normal range (x
ULN)

- Alanine aminotransferase (ALT) ≤ 1.5 x ULN

- Total bilirubin ≤ 1.5 x ULN

- Serum creatinine of ≤ 1.5 mg/dl or Calculated creatinine clearance of ≥ 60 mL/min

- Serum albumin ≥ 3.0 g/dL

- Serum potassium ≥ 3.5 mEq/L

- Prothrombin time (PT) ≤ 1.5 x ULN (or international normalized ratio [INR] ≤ 1.3)
unless the patient is receiving anticoagulant therapy

- Partial thromboplastin time (PTT) ≤ 1.5 x ULN unless the patient is receiving
anticoagulant therapy At least 4 weeks and recovery to Grade 0-1 from reversible
effects of prior surgery (i.e., incisional pain, wound drainage)

- Able to swallow the study drug whole as a tablet

- Willing to take abiraterone acetate on an empty stomach; no food should be consumed at
least two hours before and for at least one hour after the dose of abiraterone acetate
is taken

- Patients who have partners of childbearing potential must be willing to use a method
of birth control with adequate barrier protection as determined to be acceptable by
the principal investigator during the study and for 1 week after last dose of
abiraterone acetate.

Exclusion Criteria:

- Prior cytotoxic chemotherapy or biologic therapy for prostate cancer

- More than 8 months of prior hormonal therapy (e.g., gonadotropin-releasing hormone
analogs, megestrol acetate, or Casodex) Note: Patients who have been on prior hormonal
therapy must wait at least 1 year after the drug is fully metabolized to start
treatment on protocol.

- Prior ketoconazole, abiraterone acetate, or enzalutamide for the treatment of prostate
cancer.

- Known brain metastasis or evidence of metastatic disease by CT scan, physical exam, or
bone scan within 4 weeks of registration

- Patients with equivocal uptake on a bone scan that in the clinician's opinion do not
definitively constitute metastatic disease are eligible

- Currently active second malignancy

Significant medical condition other than cancer, that would prevent consistent and
compliant participation in the study that would, in the opinion of the investigator, make
this protocol unreasonably hazardous including but not limited to:

- Active infection or other medical condition that would make prednisone/prednisolone
(corticosteroid) use contraindicated

- Severe hepatic impairment (Child-Pugh Class C)

- History of gastrointestinal disorders (medical disorders or extensive surgery) that
may interfere with the absorption of the study agents

- Uncontrolled hypertension (systolic BP ≥ 160 mmHg or diastolic BP ≥ 95 mmHg); patients
with a history of hypertension are allowed provided blood pressure is controlled by
anti-hypertensive treatment

- Active or symptomatic viral hepatitis or chronic liver disease

- History of pituitary or adrenal dysfunction

- Clinically significant heart disease as evidenced by myocardial infarction, or
arterial thrombotic events in the past 6 months, severe or unstable angina, or New
York Heart Association (NYHA) Class III or IV heart disease or cardiac ejection
fraction measurement of < 50 % at baseline

- Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy

- Uncontrolled diabetes mellitus

- Active psychiatric condition Use of any prohibited concomitant medications (Section
5.5) within 30 days prior to Cycle 1, Day 1

- Pre-existing condition that warrants long-term corticosteroid use in excess of study
dose

- Grade > 2 treatment-related toxicity from prior therapy

- Known allergies, hypersensitivity or intolerance to abiraterone acetate, prednisone or
degarelix

- Administration of an investigational therapeutic within 30 days of Cycle 1, Day1

- Any condition which, in the opinion of the investigator, would preclude participation
in this trial
We found this trial at
16
sites
1000 N Village Ave
Rockville Centre, New York 11570
(516) 256-3600
Principal Investigator: Howard Scher, MD
Phone: 646-422-4330
Memorial Sloan-Kettering at Mercy Medical Center Memorial Sloan Kettering Cancer Center Rockville Centre provides state-of-the-art...
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Rockville Centre, NY
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Baltimore, Maryland 21231
410-955-6190
Principal Investigator: Emmanuel Antonarakis, MD
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins The name Johns Hopkins has become synonymous...
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Baltimore, MD
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Basking Ridge, New Jersey
Principal Investigator: Howard Scher, MD
Phone: 646-422-4330
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Chapel Hill, North Carolina 27599
(919) 962-2211
Principal Investigator: Matthew Milowsky, MD
Univ of North Carolina Carolina’s vibrant people and programs attest to the University’s long-standing place...
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Chapel Hill, NC
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303 E Chicago Ave
Chicago, Illinois 60611
(312) 503-8194
Principal Investigator: Timothy Kuzel, MD
Northwestern University Feinberg School of Medicine Northwestern University Feinberg School of Medicine, founded in 1859,...
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Commack, New York 11725
Phone: 646-422-4330
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Commack, NY
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Detroit, Michigan
Principal Investigator: Ulka Vaishampayan, MD
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2301 Erwin Rd
Durham, North Carolina 27710
919-684-8111
Principal Investigator: Michael Harrison, MD
Duke Univ Med Ctr As a world-class academic and health care system, Duke Medicine strives...
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500 Westchester Avenue
Harrison, New York 10604
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Long Island City, New York
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New Brunswick, New Jersey 08901
Principal Investigator: Tina Mayer, MD
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1275 York Ave
New York, New York 10021
(212) 639-2000
Principal Investigator: Howard I Scher, MD
Phone: 646-422-4330
Memorial Sloan Kettering Cancer Center Memorial Sloan Kettering Cancer Center — the world's oldest and...
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New York, New York 10065
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Omaha, NE
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Portland, Oregon 97239
Principal Investigator: Julie Graff, MD
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Sleepy Hollow, New York
Phone: 646-422-4330
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