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A Randomized Phase 3 Study Comparing Cabazitaxel/Prednisone in Combination With Custirsen (OGX-011) to Cabazitaxel/Prednisone for Second-Line Chemotherapy in Men With Metastatic Castrate Resistant Prostate Cancer (AFFINITY)


Phase 3
N/A
N/A
Open (Enrolling)
Male
Prostate Cancer

Thank you

Trial Information

A Randomized Phase 3 Study Comparing Cabazitaxel/Prednisone in Combination With Custirsen (OGX-011) to Cabazitaxel/Prednisone for Second-Line Chemotherapy in Men With Metastatic Castrate Resistant Prostate Cancer (AFFINITY)


Until recently, options for second-line chemotherapy in CRPC have included docetaxel
retreatment, mitoxantrone, or other chemotherapies, without proven clinical benefit. In
2010, a Phase 3 second-line chemotherapy trial (TROPIC) showed a survival advantage for
cabazitaxel, a semi-synthetic taxane selected to overcome the emergence of taxane
resistance, when compared to mitoxantrone.

Clusterin is a stress-activated cytoprotective chaperone up-regulated by a variety of
anti-cancer therapies that confers treatment resistance when over-expressed. Inhibition of
clusterin expression using custirsen has been shown to enhance tumor cell death following
treatment with chemotherapy.

The clinical activity of custirsen in combination with the taxane docetaxel has been shown
in two Phase 2 studies. Given the results observed using a taxane as either first-line or
second-line chemotherapy in CRPC, combination with custirsen may decrease taxane resistance
and enhance the survival benefit of taxane therapy. Thus, a combination of custirsen with
cabazitaxel may further enhance survival in second-line taxane chemotherapy for CRPC.


Inclusion Criteria:



- Histological or cytological diagnosis of adenocarcinoma of the prostate

- Metastatic disease on chest, abdominal, or pelvic CT scan and/or bone scan

- Previous first-line treatment for CRPC with a docetaxel-containing regimen

- Current progressive disease

- Increasing serum PSA level (for patients who progress based only on increasing serum
PSA level, a minimum starting value of 5.0 ng/mL is required)

- Baseline laboratory values as defined

- Willing to continue primary androgen suppression with gonadotropin-releasing hormone
(GnRH) analogues (unless treated with bilateral orchiectomy)

- Karnofsky score ≥70%

- At least 21 days have passed since completing radiotherapy

- At least 21 days have passed since receiving any investigational agent at the time of
randomization

- At least 21 days have passed since major surgery

- Recovered from any docetaxel therapy-related neuropathy to ≤grade 1 at the time of
randomization

- Recovered from all therapy related toxicity to ≤grade 2 (except alopecia, anemia, and
any signs or symptoms of androgen deprivation therapy) at the time of randomization

- Able to tolerate a starting dose of 25 mg/m² cabazitaxel

- Willing to not add, delete, or change current bisphosphonate or denosumab usage

- Able to tolerate oral prednisone at 10 mg per day

- Competent to provide written informed consent

Exclusion Criteria:

- Received any other cytotoxic chemotherapy beyond the first-line docetaxel-containing
regimen as treatment for prostate cancer

- Received prior radioisotope with strontium 89 or samarium 153

- Received any cycling, intermittent, or continuous hormonal treatment within 21 days
prior to randomization with the exception of the continuous GnRH analogues (prior
treatment with abiraterone or MDV3100 is allowed as long as 21 days have passed since
last dose)

- Participated in a prior Phase 3 clinical study evaluating custirsen regardless of
study arm assignment

- Requiring ongoing treatment during the study with medications known to be either
strong CYP3A inhibitors or strong CYP3A inducers

- History of or current documented brain metastasis or carcinomatous meningitis,
treated or untreated

- Current symptomatic cord compression requiring surgery or radiation therapy

- Active second malignancy (except non melanomatous skin or superficial bladder cancer)
defined in general as requiring anticancer therapy or at high risk of recurrence
during the study

- Uncontrolled medical condition or significant concurrent illness that in the opinion
of the Investigator would preclude protocol therapy

- Known severe hypersensitivity to taxanes or polysorbate 80-containing drugs

- Planned concomitant participation in another clinical trial of an experimental agent,
vaccine, or device

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Survival

Outcome Description:

To determine whether the survival for patients randomized to the investigational arm (cabazitaxel/prednisone plus custirsen) is consistent with longer survival as compared to patients randomized to the control arm (cabazitaxel/prednisone).

Outcome Time Frame:

3.4 years

Safety Issue:

No

Principal Investigator

Thomasz Beer, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Oregon Health & Science University, Portland, Oregon

Authority:

United States: Food and Drug Administration

Study ID:

OGX-011-12

NCT ID:

NCT01578655

Start Date:

August 2012

Completion Date:

December 2015

Related Keywords:

  • Prostate Cancer
  • custirsen sodium
  • prostate cancer
  • metastatic castrate resistant prostate cancer
  • overall survival
  • Prostatic Neoplasms

Name

Location

H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida  33612
Washington University School of Medicine Saint Louis, Missouri  63110
University of California Davis Medical Center Sacramento, California  95817
Hartford Hospital Hartford, Connecticut  06102-5037
Cooper University Hospital Camden, New Jersey  08103
Rocky Mountain Cancer Center Denver, Colorado  80218
Cancer Centers of the Carolinas Greenville, South Carolina  29605
Florida Cancer Specialists Fort Myers, Florida  33901
Georgia Cancer Specialists, P.C. East Point, Georgia  30344
South Carolina Oncology Associates Columbia, South Carolina  29201
SUNY Upstate Medical University Syracuse, New York  13210
Helen F. Graham Cancer Center Newark, Delaware  19713
California Pacific Medical Center Research Institute San Francisco, California  94115
Oncology Hematology Care, Inc. Cincinnati, Ohio  45219
Blumenthal Cancer Center Charlotte, North Carolina  28203
Virginia Cancer Institute Richmond, Virginia  23230
Oregon Health and Science University Portland, Oregon  97201
Sharp Health Care San Diego, California  92123
The West Clinic Memphis, Tennessee  38120
The Center for Hematology-Oncology Boca Raton, Florida  33486
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Chattanooga Oncology and Hematology Associates Chattanooga, Tennessee  37404
Cancer Center of Kansas Wichita, Kansas  67214
Tennessee Oncology, PLLC Clarksville, Tennessee  37043
Prostate Oncology Specialists Marina Del Rey, California  32589
Baptist Hospital East Louisville, Kentucky  40207
Monter Cancer Center Lake Success, New York  11042
Boston University Medical Center Boston, Massachusetts  02118
University of Michigan Health System Ann Arbor, Michigan  
Moses Cone Regional Cancer Center Greensboro, North Carolina  27403
The Mark H. Zangmeister Center Columbus, Ohio  43219
Virginia Cancer Specialists, PC Fairfax, Virginia  22031
Frontier Cancer Center and Blood Institute Billings, Montana  59102
Urology Cancer Center and GU Research Network Omaha, Nebraska  
Center for Cancer and Blood Disorders, PC Fort Worth, Texas  
Piedmont Healthcare Research Institute Atlanta, Georgia  
Albert Einstein Medical Center Bronx, New York