A Phase II Study of Increased-Dose Abiraterone Acetate in Patients With Castration Resistant Prostate Cancer (CRPC)
This is a phase II multicenter trial of Abiraterone Acetate in patients with progressive
prostate cancer despite androgen deprivation with a particular focus on the pharmacokinetic,
pharmacodynamic, and pharmacogenomic events occurring at the time of apparent drug
resistance. All eligible patients will have baseline (prior to taking the first dose of
Abiraterone Acetate 1000mg/daily) measures of routine clinical variables along with
measurements of baseline and treatment related changes in testosterone, androgen, and
endocrine levels, genotyping of SNPs in the selected enzymes known to be directly inhibited
by Abiraterone Acetate, and collection of circulating tumor cells. All patients will be
requested to consent for biopsies which will be performed prior to treatment and at the time
of disease progression on standard dose Abiraterone Acetate therapy. These biopsies will be
analyzed for expression of an AR-signature as well as for microarray analysis to explore
changes in methylation, and expression of CYP17A1 and other androgen synthesis genes.
Subjects will then begin daily oral therapy with Abiraterone Acetate 1000mg po daily with
physiologic prednisone 5mg BID replacement. No food should be consumed for at least 2 hours
before the dose of Abiraterone Acetate and for at least 1 hour after the dose of Abiraterone
Acetate is taken. PSA will be followed monthly. Abiraterone Acetate will be supplied by
Janssen Services. At the end of the first month, the third month, and then every three
months thereafter, Abiraterone Acetate, testosterone, and androgen levels will be followed.
Subjects not achieving a greater than or equal to 30% PSA decline at 12 weeks will be taken
off study. At the time of progression (defined by RECIST criteria OR by the Prostate Cancer
Working Group 2 (PCWG) criteria as a 25% increase in PSA above the nadir and an increase in
the absolute value PSA of at least 2ng/dl or back to baseline confirmed at least 2 weeks
afterward) for subjects who achieved an initial greater than or equal to 30% PSA decline
(referred to as Progressive Disease (PD) #1), subjects will begin taking Abiraterone Acetate
1000 mg po BID. Patients will continue to take prednisone 5mg BID and will continue this
therapy until a second progression at which point they will be withdrawn from the study.
While 1000 mg po BID is not the FDA recommended dose, it is the dose to be investigated in
this study.
Interventional
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
PSA response proportion to increased-dose Abiraterone Acetate for patients who experienced disease progression following standard dose Abiraterone Acetate therapy
Evaualtion at 12 weeks post increased dose therapy initiation and then every 4 weeks until PD#2.
Estimated up to 24 months
No
Terence Friedlander, MD
Study Chair
University of California, San Francisco
United States: Food and Drug Administration
UCSF Protocol No. 12551
NCT01637402
March 2013
December 2017
Name | Location |
---|---|
UCSF Helen Diller Family Comprehensive Cancer Center | San Francisco, California 94115 |