Prostatic Neoplasms
Conditions
Keywords
randomized, non-comparative, efficacy
Brief summary
To test the efficacy of CP-751,871 combined with docetaxel and prednisone in the treatment of prostate cancer that is refractory to hormone therapy
Interventions
CP-750,871 is administered intravenously at a dose of 20 mg/kg on day 1 of each 21-day cycle (for patient convenience and logistical management, the dose of CP-751,871 may be deferred up to 7 days).
Docetaxel is administered IV on day 1 of each 21-day cycle, at a dose of 75 mg/m2.
Prednisone is administered at a dose of 5 mg twice daily.
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of metastatic, progressive hormone refractory prostate cancer * Adequate bone marrow, liver and kidney function
Exclusion criteria
* Previous treatment with chemotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Prostate Specific Antigen (PSA) Best Response | Baseline, Day 1 and Day 15 of each cycle, end of treatment (up to 28 days post last dose) and follow-up (monthly, up to 150 days post last dose) | Percentage of participants with PSA best response of either PSA normalization (PN) or partial PSA response (PR) relative to the total number of participants evaluable for response. PN was defined as PSA =\< 0.2 nanogram/milliliter (ng/ml) on 2 successive evaluations at least 3 weeks apart and no imaging or clinical evidence of disease progression. PP was defined as \>= 50% decrease in PSA from baseline on 2 successive evaluations at least 3 weeks apart and no imaging or clinical evidence of disease progression. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Human Anti-human Antibody (HAHA) at Baseline (Day 1 of Cycle 1) | Baseline (Day 1 of Cycle 1) | Levels of HAHA in serum were detected at baseline. |
| Human Anti-human Antibody (HAHA) at the Last Follow-up Visit | The last follow-up visit (150 days post last dose) | Levels of HAHA in serum were detected at the last follow-up visit. |
| Population PK Parameters of CP-751,871 | Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose) | Population pharmacokinetic analysis involved mixed effects modeling using nonlinear mixed effects modeling (NONMEM) software. The intent of this analysis was to establish a basic population pharmacokinetic model for CP-751,871 and to determine inter-individual and residual variability in population clearance, and volume of distribution of drug. Relationship of demographic variables (gender, age, body weight, height and ethnicity), concomitant medications and measures of altered hepatic and renal function were examined by fitting measured CP-751,871 concentrations |
| Total Number of Circulation Tumor Cells (CTCs) | Baseline, prior to dosing in odd numbered cycles (ie. Cycle 1, 3, 5, etc) and end of treatment (up to 28 days post last dose) | Blood samples were collected and processed to enumerate the number of total CTCs via Veridex CellSearch technology in which CTCs were identified based on cell surface positive epithelial cell adhesion molecule (EpCAM) and cytokeratin staining. |
| Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Baseline, prior to dosing in odd numbered cycles (ie. Cycle 1, 3, 5, etc) and end of treatment (up to 28 days post last dose) | Blood samples were collected to enumerate the number of total IGF-1R positive CTCs via Veridex CellSearch technology in which CTCs were identified based on cell surface positive EpCAM and cytokeratin staining. A separate CellSave tube of cells was also collected and processed with cell surface staining of IGF-1R to enumerate surfaces of IGF-1R-positive CTCs. |
| Progression Free Survival (PFS) | Baseline, Day 15 of each cycle and follow-up (monthly, up to 150 days post last dose) | PFS was defined as the time from randomization to first event of disease progression. Disease progression events were defined as the following: PSA progression,objective disease progression as per RECIST, death, and discontinuation of treatment due to symptomatic deterioration. PSA progression was defined as the time-point of PSA progression on 2 successive evaluations taken 1 week apart after dosing in cycle 3. |
| Pain Measured by the Modified Brief Pain Inventory-Short Form (mBPI-sf Modified Pfizer) | Baseline, Cycle 1 to Cycle 10 before drug administration and end of treatment (up to 28 days post last dose) | The mBPI-sf was a self administered questionnaire developed to assess pain severity and pain interference with functional activities during a 24-hour period prior to evaluation. For the worst pain item of the mBPI-sf scale (11 point Likert scale; range: 0 \[no pain\] to 10 \[pain as bad as you can imagine\]), participants were asked to rate their pain by marking an X in one of the 10 boxes that best described their pain at its worst in the last 24 hours post surgery and at least 12 hours after discontinuation of the peripheral nerve block or neuraxial block. |
| Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUC0-t) for CP-751,871 | Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose) | Area under the plasma concentration versus time curve from time zero to time of last quantifiable concentration. |
| Maximum Observed Plasma Concentration (Cmax) for CP-751,871 | Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose) | — |
| Minimum Observed Plasma Trough Concentration (Cmin) for CP-751,871 | Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose) | — |
| Area Under the Curve From Time Zero to End of Dosing Interval (AUC0-tau) for CP-751,871 | Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose) | — |
| Quality of Life Measured by the Functional Assessment of Cancer Treatment-Prostate (FACT-P) | Baseline, Cycle 1 to Cycle 10 before drug administration and end of treatment (up to 28 days post last dose) | The FACT-P was a 39-item participant questionnaire which assesses physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), functional well-being (7 items), and additional prostate cancer specific concerns (12 items). All items were scored from 0 (not at all) to 4 (very much). The total FACT-P score ranged from 0-156, with higher scores representing a better QoL with fewer symptoms. A score of 156 represented the best outcome. |
Countries
Canada, Germany, Spain, Switzerland, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| CP-751,871+Docetaxel+Prednisone Participants received docetaxel 75 milligram(mg)/square meter(m\^2) infusion IV over 1 hour on Day 1, followed by CP-751,871 20 mg/kilogram (kg) infusion IV on Day 1 along with prednisone 5 mg twice daily (BID) in a 21-days cycle, up to 17 cycles. | 102 |
| Docetaxel+Prednisone Participants received docetaxel 75 mg/m\^2 infusion IV over 1 hour on Day 1 along with prednisone 5 mg BID in a 21 days cycle, up to 17 cycles. | 102 |
| Total | 204 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| After Crossover | Death | 0 | 0 | 6 |
| After Crossover | Other | 0 | 0 | 18 |
| After Crossover | Withdrawal by Subject | 0 | 0 | 3 |
| Before Crossover | Crossover | 0 | 37 | 0 |
| Before Crossover | Death | 22 | 8 | 0 |
| Before Crossover | Lost to Follow-up | 0 | 3 | 0 |
| Before Crossover | Other | 45 | 30 | 0 |
| Before Crossover | Randomized, not treated | 5 | 0 | 0 |
| Before Crossover | Withdrawal by Subject | 3 | 1 | 0 |
Baseline characteristics
| Characteristic | CP-751,871+Docetaxel+Prednisone | Total | Docetaxel+Prednisone |
|---|---|---|---|
| Age, Customized 18 to 44 years | 0 Participants | 1 Participants | 1 Participants |
| Age, Customized 45 to 64 years | 26 Participants | 58 Participants | 32 Participants |
| Age, Customized Greater than or equal to (>=) 65 years | 76 Participants | 145 Participants | 69 Participants |
| Age, Customized Less than (<) 18 years | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 102 Participants | 204 Participants | 102 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 96 / 97 | 53 / 102 | 21 / 37 |
| serious Total, serious adverse events | 64 / 97 | 37 / 102 | 20 / 37 |
Outcome results
Percentage of Participants With Prostate Specific Antigen (PSA) Best Response
Percentage of participants with PSA best response of either PSA normalization (PN) or partial PSA response (PR) relative to the total number of participants evaluable for response. PN was defined as PSA =\< 0.2 nanogram/milliliter (ng/ml) on 2 successive evaluations at least 3 weeks apart and no imaging or clinical evidence of disease progression. PP was defined as \>= 50% decrease in PSA from baseline on 2 successive evaluations at least 3 weeks apart and no imaging or clinical evidence of disease progression.
Time frame: Baseline, Day 1 and Day 15 of each cycle, end of treatment (up to 28 days post last dose) and follow-up (monthly, up to 150 days post last dose)
Population: Response-evaluable population: All enrolled participants who had a baseline PSA reference value and received at least one dose of assigned treatment with the exception of those participants without symptomatic or objective progression (participants with PSA progression only) who withdraw consent prior to Cycle 3.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Percentage of Participants With Prostate Specific Antigen (PSA) Best Response | 51.7 Percentage of participants |
| Docetaxel+Prednisone | Percentage of Participants With Prostate Specific Antigen (PSA) Best Response | 60.2 Percentage of participants |
| Docetaxel+Prednisone+CP-751,871 Crossover | Percentage of Participants With Prostate Specific Antigen (PSA) Best Response | 28.1 Percentage of participants |
Area Under the Curve From Time Zero to End of Dosing Interval (AUC0-tau) for CP-751,871
Time frame: Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose)
Population: The summary table of this outcome measure was not provided based on lack of resources as the program was terminated.
Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUC0-t) for CP-751,871
Area under the plasma concentration versus time curve from time zero to time of last quantifiable concentration.
Time frame: Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose)
Population: The summary table of this outcome measure was not provided based on lack of resources as the program was terminated.
Human Anti-human Antibody (HAHA) at Baseline (Day 1 of Cycle 1)
Levels of HAHA in serum were detected at baseline.
Time frame: Baseline (Day 1 of Cycle 1)
Population: All participants who were enrolled in the study, received at least one assigned treatment and had available HAHA assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Human Anti-human Antibody (HAHA) at Baseline (Day 1 of Cycle 1) | 1130.3 mg/deciliter (dl) | Standard Deviation 406.49 |
| Docetaxel+Prednisone | Human Anti-human Antibody (HAHA) at Baseline (Day 1 of Cycle 1) | 1338.1 mg/deciliter (dl) | Standard Deviation 804.3 |
Human Anti-human Antibody (HAHA) at the Last Follow-up Visit
Levels of HAHA in serum were detected at the last follow-up visit.
Time frame: The last follow-up visit (150 days post last dose)
Population: All participants who were enrolled in the study, received at least one assigned treatment and had HAHA available assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Human Anti-human Antibody (HAHA) at the Last Follow-up Visit | 944.81 mg/dl | Standard Deviation 946.42 |
| Docetaxel+Prednisone | Human Anti-human Antibody (HAHA) at the Last Follow-up Visit | 819.00 mg/dl | Standard Deviation 487.94 |
| Docetaxel+Prednisone+CP-751,871 Crossover | Human Anti-human Antibody (HAHA) at the Last Follow-up Visit | 970.86 mg/dl | Standard Deviation 295.28 |
Maximum Observed Plasma Concentration (Cmax) for CP-751,871
Time frame: Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose)
Population: The summary table of this outcome measure was not provided based on lack of resources as the program was terminated.
Minimum Observed Plasma Trough Concentration (Cmin) for CP-751,871
Time frame: Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose)
Population: The summary table of this outcome measure was not provided based on lack of resources as the program was terminated.
Pain Measured by the Modified Brief Pain Inventory-Short Form (mBPI-sf Modified Pfizer)
The mBPI-sf was a self administered questionnaire developed to assess pain severity and pain interference with functional activities during a 24-hour period prior to evaluation. For the worst pain item of the mBPI-sf scale (11 point Likert scale; range: 0 \[no pain\] to 10 \[pain as bad as you can imagine\]), participants were asked to rate their pain by marking an X in one of the 10 boxes that best described their pain at its worst in the last 24 hours post surgery and at least 12 hours after discontinuation of the peripheral nerve block or neuraxial block.
Time frame: Baseline, Cycle 1 to Cycle 10 before drug administration and end of treatment (up to 28 days post last dose)
Population: The summary table was not provided based on 1) the negative primary finding of the study that CP-751,871 did not improve response in CP-751,871+Docetaxel + Prednisone and had significantly worse PFS than Docetaxel +Prednisone, which rendered the PRO summary irrelevant 2) lack of resources as the program was terminated.
Population PK Parameters of CP-751,871
Population pharmacokinetic analysis involved mixed effects modeling using nonlinear mixed effects modeling (NONMEM) software. The intent of this analysis was to establish a basic population pharmacokinetic model for CP-751,871 and to determine inter-individual and residual variability in population clearance, and volume of distribution of drug. Relationship of demographic variables (gender, age, body weight, height and ethnicity), concomitant medications and measures of altered hepatic and renal function were examined by fitting measured CP-751,871 concentrations
Time frame: Days 1, 8 and 15 of each cycle and last follow-up visit (150 days post last dose)
Progression Free Survival (PFS)
PFS was defined as the time from randomization to first event of disease progression. Disease progression events were defined as the following: PSA progression,objective disease progression as per RECIST, death, and discontinuation of treatment due to symptomatic deterioration. PSA progression was defined as the time-point of PSA progression on 2 successive evaluations taken 1 week apart after dosing in cycle 3.
Time frame: Baseline, Day 15 of each cycle and follow-up (monthly, up to 150 days post last dose)
Population: Full analysis set included all participants who were enrolled into the study and received at least one assigned treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Progression Free Survival (PFS) | 4.9 Months |
| Docetaxel+Prednisone | Progression Free Survival (PFS) | 7.7 Months |
| Docetaxel+Prednisone+CP-751,871 Crossover | Progression Free Survival (PFS) | 4.0 Months |
Quality of Life Measured by the Functional Assessment of Cancer Treatment-Prostate (FACT-P)
The FACT-P was a 39-item participant questionnaire which assesses physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), functional well-being (7 items), and additional prostate cancer specific concerns (12 items). All items were scored from 0 (not at all) to 4 (very much). The total FACT-P score ranged from 0-156, with higher scores representing a better QoL with fewer symptoms. A score of 156 represented the best outcome.
Time frame: Baseline, Cycle 1 to Cycle 10 before drug administration and end of treatment (up to 28 days post last dose)
Population: The summary table was not provided based on 1) the negative primary finding of the study that CP-751,871 did not improve response in CP-751,871+Docetaxel + Prednisone and had significantly worse PFS than Docetaxel +Prednisone, which rendered the patient reported outcome (PRO) summary irrelevant 2) lack of resources as the program was terminated.
Total Number of Circulation Tumor Cells (CTCs)
Blood samples were collected and processed to enumerate the number of total CTCs via Veridex CellSearch technology in which CTCs were identified based on cell surface positive epithelial cell adhesion molecule (EpCAM) and cytokeratin staining.
Time frame: Baseline, prior to dosing in odd numbered cycles (ie. Cycle 1, 3, 5, etc) and end of treatment (up to 28 days post last dose)
Population: Participants who were enrolled to the study were included in the analysis. n = number of participants with evaluable data at each timeframe.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Baseline (Cycle 1 Day 1) (n=46, 39) | 105.17 Number of CTCs/7.5 mL | Standard Deviation 259.6 |
| CP-751,871+Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Cycle 3 Day1 (n=28, 29) | 6.39 Number of CTCs/7.5 mL | Standard Deviation 11.39 |
| CP-751,871+Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Cycle 5 Day 1 (n=25, 23) | 15.20 Number of CTCs/7.5 mL | Standard Deviation 46.4 |
| Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Baseline (Cycle 1 Day 1) (n=46, 39) | 213.23 Number of CTCs/7.5 mL | Standard Deviation 555.82 |
| Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Cycle 3 Day1 (n=28, 29) | 12.21 Number of CTCs/7.5 mL | Standard Deviation 27.52 |
| Docetaxel+Prednisone | Total Number of Circulation Tumor Cells (CTCs) | Cycle 5 Day 1 (n=25, 23) | 17.78 Number of CTCs/7.5 mL | Standard Deviation 28.11 |
Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs
Blood samples were collected to enumerate the number of total IGF-1R positive CTCs via Veridex CellSearch technology in which CTCs were identified based on cell surface positive EpCAM and cytokeratin staining. A separate CellSave tube of cells was also collected and processed with cell surface staining of IGF-1R to enumerate surfaces of IGF-1R-positive CTCs.
Time frame: Baseline, prior to dosing in odd numbered cycles (ie. Cycle 1, 3, 5, etc) and end of treatment (up to 28 days post last dose)
Population: Participants who were enrolled to the study were included in the analysis. n = number of participants with evaluable data at each timeframe.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CP-751,871+Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Baseline (Cycle 1 Day 1) (n=22, 18) | 24.73 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 25.32 |
| CP-751,871+Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Cycle 3 Day1 (n=12, 15) | 2.33 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 4.48 |
| CP-751,871+Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Cycle 5 Day 1 (n=11, 10) | 2.00 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 4.49 |
| Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Baseline (Cycle 1 Day 1) (n=22, 18) | 54.94 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 55.52 |
| Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Cycle 3 Day1 (n=12, 15) | 4.93 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 7.74 |
| Docetaxel+Prednisone | Total Number of the Insulin Like Growth Factor Receptor Type 1 (IGF-1R) Positive CTCs | Cycle 5 Day 1 (n=11, 10) | 3.90 Number of IGF-1R positive CTCs/7.5 mL | Standard Deviation 6.03 |