An Observational Study of Continuous Oral Dosing of an Irreversible CYP17 Inhibitor, Abiraterone Acetate (CB7630), in Castration-Resistant Prostate Cancer Patients Evaluating Androgens and Steroid Metabolites in Bone Marrow Plasma
Inclusion Criteria:
- Histologically proven adenocarcinoma of the prostate
- Eastern Cooperative Oncology Group (ECOG) performance status <=2 (Karnofsky
Performance Status >=50%)
- Serum testosterone levels <50ng/ml
- Ongoing gonadal androgen deprivation therapy with luteinizing hormone-releasing
hormone (LHRH) analogues or orchiectomy (patients, who have not had an orchiectomy,
must be maintained on effective LHRH analogue therapy for the duration of the study)
- Progression of disease despite androgen ablation (either documented osseous or soft
tissue metastatic disease progression or by prostate specific antigen [PSA] criteria
progression)
- Progressive disease is defined by PSA evidence (PSA level of at least 5 ng/ml which
has risen on at least 2 successive occasions, at least 2 weeks apart)
- Presence of metastatic bone disease
- Discontinue diethylstilbestrol or steroids treatment for >=4 weeks and for
antiandrogens >6 weeks
- Antiandrogen withdrawal: patients who are receiving an antiandrogen as part of
primary androgen ablation must demonstrate disease progression following
discontinuation of antiandrogen (disease progression after antiandrogen withdrawal is
defined as 2 consecutive rising PSA values, obtained at least 2 weeks apart, or
documented osseous or soft tissue progression)
- For patients receiving flutamide, at least one of the PSA values must be obtained 4
weeks or more after flutamide discontinuation
- For patients receiving bicalutamide or nilutamide, at least one of the PSA values
must be obtained 6 weeks or more after antiandrogen discontinuation
- Adequate adrenal function
- Laboratory values within protocol -defined parameters
- No evidence of chronic or acute disseminated intravascular coagulation or bleeding
tendency and no angina at rest
- Agrees to protocol-defined use of effective contraception
Exclusion Criteria:
- Histologic variants other than adenocarcinoma in the primary tumor
- More then 2 different prior chemotherapeutic regimens for metastatic prostate cancer
- Abnormal liver function
- Therapy with other hormonal therapy, including any dose of megestrol acetate
(Megace), Ketoconazole, finasteride (Proscar), dutasteride (Avodart) any herbal
product known to decrease PSA levels (eg, Saw Palmetto and PC-SPES), or any systemic
corticosteroid within 4 weeks prior to first dose of study drug
- Active infection or intercurrent illness that are not controlled
- Unstable angina, myocardial infarction within the previous 6 months, or use of
ongoing maintenance therapy for life-threatening ventricular arrhythmia, uncontrolled
hypertension, New York Heart Association (NYHA) Class III or IV congestive heart
failure
- Prior radiation therapy completed <4 weeks or single fraction of palliative
radiotherapy within 14 days prior to first dose of study drug
- Any currently active second malignancy, other than non-melanoma skin cancer
- Active psychiatric illnesses/social situations that would limit compliance with
protocol requirements
- Active or uncontrolled autoimmune disease that may require corticosteroid therapy
during study
- Severely compromised immunological state, including being positive for the human
immunodeficiency virus (HIV)
- Acute or chronic hepatitis B or C
- Initiation of bisphosphonate therapy within 4 weeks prior to first dose of study drug
- Long QT syndrome or bundle branch block or hemiblock or other history of
life-threatening arrhythmia (unless the patient has been effectively treated for it
and is considered stable)
- Known brain metastasis
- History of pituitary or adrenal dysfunction
- History of gastrointestinal disorders (medical disorders or extensive surgery) which
may interfere with the absorption of the study drug
- Prior therapy with abiraterone acetate
- Any acute toxicities due to prior chemotherapy and/or radiotherapy that have not
resolved to a NCI CTCAE (version 3) grade of <=1
- Condition or situation which, in the investigator's opinion, may put the patient at
significant risk, may confound the study results, or may interfere significantly with
the patient's participation in the study