Skip to content

XRP6258 Plus Prednisone Compared to Mitoxantrone Plus Prednisone in Hormone Refractory Metastatic Prostate Cancer

A Randomized, Open Label Multi-Center Study of XRP6258 at 25 mg/m^2 in Combination With Prednisone Every 3 Weeks Compared to Mitoxantrone in Combination With Prednisone For The Treatment of Hormone Refractory Metastatic Prostate Cancer Previously Treated With A Taxotere®-Containing Regimen

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00417079
Acronym
TROPIC
Enrollment
755
Registered
2006-12-29
Start date
2007-01-31
Completion date
2009-09-30
Last updated
2011-03-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Neoplasms, Prostatic Neoplasms

Keywords

Cancer, Prostate

Brief summary

This is a randomized, open-label, multi-center study comparing the safety and efficacy of XRP6258 plus prednisone to mitoxantrone plus prednisone in the treatment of hormone refractory metastatic prostate cancer previously treated with a Taxotere®-containing regimen. The primary objective is overall survival. Secondary objectives include progression free survival, overall response rate, prostate-specific antigen (PSA) response/progression, pain response/progression, overall safety, and pharmacokinetics. Patients will be treated until disease progression, death, unacceptable toxicity, or for a maximum of 10 cycles. Patients will have long-term follow-up for a maximum of up to 2 years.

Interventions

DRUGcabazitaxel (XRP6258) (RPR116258)

25 mg/m\^2 administered by intravenous (IV) route over 1 hour on day 1 of each 21-day cycle

DRUGmitoxantrone

12 mg/m\^2 administered by intravenous (IV) route over 15-30 minutes on day 1 of each 21-day cycle

DRUGprednisone

10 mg daily administered by oral route

Sponsors

Sanofi
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Histologically or cytologically confirmed adenocarcinoma of the prostate that is refractory to hormone therapy and previously treated with a Taxotere®-containing regimen. 2. Documented progression of disease (demonstrating at least one visceral or soft tissue metastatic lesion, including a new lesion). Patients with non-measurable disease must have documented rising prostate-specific antigen (PSA) levels or appearance of new lesion. 3. Surgical or hormone-induced castration 4. Life expectancy \> 2 months 5. Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2

Exclusion criteria

1. Previous treatment with mitoxantrone 2. Previous treatment with \<225 mg/m\^2 cumulative dose of Taxotere (or docetaxel) 3. Prior radiotherapy to ≥ 40% of bone marrow 4. Surgery, radiation, chemotherapy, or other anti-cancer therapy within 4 weeks prior to enrollment in the study 5. Other prior malignancy, except for adequately treated superficial basal cell skin cancer, or any other cancer from which the patient has been disease-free for less than 5 years 6. Known brain or leptomeningeal involvement 7. Other concurrent serious illness or medical conditions 8. Inadequate organ function evidenced by unacceptable laboratory results The investigator will evaluate whether there are other reasons why a patient may not participate.

Design outcomes

Primary

MeasureTime frameDescription
Overall SurvivalFrom the date of randomization up to 104 weeks (study cut-off)Overall survival was defined as the time interval from the date of randomization to the date of death due to any cause. In the absence of confirmation of death, the survival time was censored at the last date patient was known to be alive or at the cut-off date, whichever had come first.

Secondary

MeasureTime frameDescription
Overall Tumor ResponseFrom the date of randomization up to 104 weeks (study cut-off)Tumor Overall Response Rate (ORR) (only in patients with measurable disease): Objective responses (Complete Response and Partial Response) for measurable disease as assessed by investigators according to RECIST criteria. Complete Response (CR) is defined as: Disappearance of all target lesions. Partial Response (PR) is defined as: At least a 30% decrease in the sum of longest diameter (LD) of target lesions taking as reference baseline sum LD. Confirmation of objective responses will be performed by repeat tumor imaging (CT scans, MRI, bone scans) after the first documentation of response.
Time to Tumor ProgressionFrom the date of randomization up to 104 weeks (study cut-off)Time to tumor progression is defined as the number of months from randomization until evidence of progressive disease (RECIST)
Time to Prostatic Specific Antigen (PSA) Progressionat screening, day 1 of every treatment cycle, up to 104 weeks (study cut-off)In PSA non-responders, progression will be defined as a 25% increase over nadir and increase in the absolute value PSA level by at least 5 ng/ml and confirmed by a second value at least 4 weeks later. In PSA responders and in patients not evaluable for PSA response at baseline, progression will be defined as a ≥50% increase over nadir, provided that the increase is a minimum of 5 ng/ml and confirmed by a second value at least 1 week later.
Time to Progression Free Survival (PFS)From the date of randomization up to 104 weeks (study cut-off)Progression free survival was defined as a composite endpoint evaluated from the date of randomization to the date of tumor progression, PSA progression, pain progression, or death due to any cause, whichever occurred first
Time to Pain Progressionfrom baseline up to 104 weeks (study cut-off)Pain Progression is defined as an increase of ≥1 point in the median Personal Pain Intensity (PPI) from its nadir noted on 2 consecutive 3-week-apart visits or ≥25 % increase in the mean analgesic score compared with the baseline score & noted on 2 consecutive 3-week-apart visits or requirement for local palliative radiotherapy. Evaluation of the PPI & analgesic scores are based on the short-form McGill Pain Questionnaire which consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0=none (best) 1=mild 2=moderate 3=severe (worst) (TOTAL: 0=best 45=worst)
Pain Responsefrom baseline up to 104 weeks (study cut-off)Pain Response was defined as a two-point or greater reduction from baseline median Present Pain Intensity (PPI) score without an increased Analgesic Score (AS) or a decrease of ≥50% in the AS without an increase in the PPI score, maintained for at least 3 weeks.
PSA (Prostate-Specific Antigen) Responsefrom baseline up to 104 weeks (study cut-off)PSA response was defined as a ≥ 50% reduction in serum PSA, determined only for patients with a serum PSA ≥ 20ng/mL at baseline, confirmed by a repeat PSA ≥ 3 weeks later.

Countries

Argentina, Belgium, Brazil, Canada, Chile, Czechia, Denmark, Finland, France, Germany, Hungary, India, Italy, Mexico, Netherlands, Russia, Singapore, Slovakia, South Africa, South Korea, Spain, Sweden, Taiwan, Turkey (Türkiye), United Kingdom, United States

Participant flow

Recruitment details

Multicenter study: 146 actives sites from 26 countries in Europe, USA, South America and Asia Pacific region. Study initiation date: January 2nd, 2007; study completion date/study cut off date: September 25th, 2009.

Pre-assignment details

165 patients signed informed consent but were not randomized and considered as screen failure. Intention to Treat Population (ITT or randomized patients): 755 patients (377 mitoxantrone, 378 cabazitaxel). Safety population (treated patients): 742 patients (371 mitoxantrone, 371 cabazitaxel) (Patients not treated: 6 mitoxantrone, 7 cabazitaxel).

Participants by arm

ArmCount
Mitoxantrone + Prednisone
mitoxantrone 12 mg/m\^2 (Day 1) by intravenous (IV) every 3 weeks, and prednisone 10 mg orally given daily
377
Cabazitaxel + Prednisone
cabazitaxel 25 mg/m\^2 (Day 1) by intravenous (IV) every 3 weeks, and prednisone 10 mg orally given daily
378
Total755

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall Studyabnormal liver function tests01
Overall StudyAdverse Event3267
Overall StudyClinical deterioration10
Overall StudyDisease progression267180
Overall StudyInvestigator's decision14
Overall StudyLost to Follow-up20
Overall StudyNon-compliance to protocol01
Overall StudyNon-confirmed Disease progression11
Overall StudyNot treated67
Overall StudyPatient unable to come to the clinic01
Overall StudyScreened failure21
Overall StudyScreening error21
Overall StudyWithdrawal by Subject178
Overall StudyWithdrawal by subject's family01

Baseline characteristics

CharacteristicMitoxantrone + PrednisoneCabazitaxel + PrednisoneTotal
Age Continuous67.0 years68.0 years67 years
Eastern Cooperative Oncology Group (ECOG) Performance Status
0 - Fully Active
120 Participants141 Participants261 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
1 - Ambulatory, Restricted Activity
224 Participants209 Participants433 Participants
Eastern Cooperative Oncology Group (ECOG) Performance Status
2 - Ambulatory, No Work Activities
33 Participants28 Participants61 Participants
Extent of disease
Locoregional Recurrence
20 Participants14 Participants34 Participants
Extent of disease
Metastatic
356 Participants364 Participants720 Participants
Extent of disease
Missing
1 Participants0 Participants1 Participants
Measurable disease
Measurable disease
204 Participants201 Participants405 Participants
Measurable disease
Not Measurable disease
173 Participants177 Participants350 Participants
Prostatic Specific Antigen PSA127.5 ng/mL143.9 ng/mL135.00 ng/mL
Region of Enrollment
Argentina
7 participants3 participants10 participants
Region of Enrollment
Belgium
16 participants15 participants31 participants
Region of Enrollment
Brazil
7 participants4 participants11 participants
Region of Enrollment
Canada
16 participants16 participants32 participants
Region of Enrollment
Chile
9 participants12 participants21 participants
Region of Enrollment
Czech Republic
10 participants12 participants22 participants
Region of Enrollment
Denmark
19 participants26 participants45 participants
Region of Enrollment
Finland
4 participants1 participants5 participants
Region of Enrollment
France
44 participants46 participants90 participants
Region of Enrollment
Germany
6 participants11 participants17 participants
Region of Enrollment
Hungary
8 participants7 participants15 participants
Region of Enrollment
India
11 participants9 participants20 participants
Region of Enrollment
Italy
17 participants18 participants35 participants
Region of Enrollment
Korea, Republic of
8 participants7 participants15 participants
Region of Enrollment
Mexico
2 participants3 participants5 participants
Region of Enrollment
Netherlands
8 participants9 participants17 participants
Region of Enrollment
Russian Federation
6 participants4 participants10 participants
Region of Enrollment
Singapore
6 participants3 participants9 participants
Region of Enrollment
Slovakia
1 participants1 participants2 participants
Region of Enrollment
South Africa
7 participants9 participants16 participants
Region of Enrollment
Spain
10 participants9 participants19 participants
Region of Enrollment
Sweden
11 participants10 participants21 participants
Region of Enrollment
Taiwan
4 participants7 participants11 participants
Region of Enrollment
Turkey
17 participants19 participants36 participants
Region of Enrollment
United Kingdom
17 participants20 participants37 participants
Region of Enrollment
United States
106 participants97 participants203 participants
Sex/Gender, Customized
Male
377 participants378 participants755 participants
Tumor Location: number of sites involved
1
134 Participants146 Participants280 Participants
Tumor Location: number of sites involved
2
117 Participants112 Participants229 Participants
Tumor Location: number of sites involved
3
78 Participants73 Participants151 Participants
Tumor Location: number of sites involved
4 or more
43 Participants44 Participants87 Participants
Tumor Location: number of sites involved
Missing
5 Participants3 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
323 / 371350 / 371
serious
Total, serious adverse events
77 / 371145 / 371

Outcome results

Primary

Overall Survival

Overall survival was defined as the time interval from the date of randomization to the date of death due to any cause. In the absence of confirmation of death, the survival time was censored at the last date patient was known to be alive or at the cut-off date, whichever had come first.

Time frame: From the date of randomization up to 104 weeks (study cut-off)

Population: Analysis was performed on the intention To Treat (ITT) population. The ITT population is composed of all randomized patients (i.e. patients assigned to a treatment group by the randomization, regardless of whether patients received any study drug or received a different study drug from which they were randomized).

ArmMeasureValue (MEDIAN)
Mitoxantrone + PrednisoneOverall Survival12.7 Months
Cabazitaxel + PrednisoneOverall Survival15.1 Months
Comparison: The study required an estimated sample size of 720 patients (360 per arm) in order to detect a 25% reduction in the hazard ratio for death in the cabazitaxel group relative to the mitoxantrone group with 90% power. The final analysis was planned for when 511 deaths had occurred.p-value: <0.0001Log Rank
Secondary

Overall Tumor Response

Tumor Overall Response Rate (ORR) (only in patients with measurable disease): Objective responses (Complete Response and Partial Response) for measurable disease as assessed by investigators according to RECIST criteria. Complete Response (CR) is defined as: Disappearance of all target lesions. Partial Response (PR) is defined as: At least a 30% decrease in the sum of longest diameter (LD) of target lesions taking as reference baseline sum LD. Confirmation of objective responses will be performed by repeat tumor imaging (CT scans, MRI, bone scans) after the first documentation of response.

Time frame: From the date of randomization up to 104 weeks (study cut-off)

Population: Tumor response rate was evaluated only for patients, in the Intention-To-Treat (ITT) population, with measurable disease by Response Evaluation Criteria in Solid Tumor (RECIST).

ArmMeasureValue (NUMBER)
Mitoxantrone + PrednisoneOverall Tumor Response4.4 percentage of participants
Cabazitaxel + PrednisoneOverall Tumor Response14.4 percentage of participants
p-value: 0.0005Chi-squared
Secondary

Pain Response

Pain Response was defined as a two-point or greater reduction from baseline median Present Pain Intensity (PPI) score without an increased Analgesic Score (AS) or a decrease of ≥50% in the AS without an increase in the PPI score, maintained for at least 3 weeks.

Time frame: from baseline up to 104 weeks (study cut-off)

Population: Pain Response (applies only to patients, in the Intention-To-Treat (ITT) population, with median PPI ≥2 on McGill-Melzack scale and/or mean Analgesic Score ≥10 points at baseline)

ArmMeasureValue (NUMBER)
Mitoxantrone + PrednisonePain Response7.7 Percentage of participants
Cabazitaxel + PrednisonePain Response9.2 Percentage of participants
p-value: 0.6286Chi-squared
Secondary

PSA (Prostate-Specific Antigen) Response

PSA response was defined as a ≥ 50% reduction in serum PSA, determined only for patients with a serum PSA ≥ 20ng/mL at baseline, confirmed by a repeat PSA ≥ 3 weeks later.

Time frame: from baseline up to 104 weeks (study cut-off)

Population: Prostate Specific Antigen (PSA) response was evaluated only in patients, in the Intention-To-Treat population, with a baseline PSA \>20ng/mL.

ArmMeasureValue (NUMBER)
Mitoxantrone + PrednisonePSA (Prostate-Specific Antigen) Response17.8 Percentage of participants
Cabazitaxel + PrednisonePSA (Prostate-Specific Antigen) Response39.2 Percentage of participants
p-value: 0.0002Chi-squared
Secondary

Time to Pain Progression

Pain Progression is defined as an increase of ≥1 point in the median Personal Pain Intensity (PPI) from its nadir noted on 2 consecutive 3-week-apart visits or ≥25 % increase in the mean analgesic score compared with the baseline score & noted on 2 consecutive 3-week-apart visits or requirement for local palliative radiotherapy. Evaluation of the PPI & analgesic scores are based on the short-form McGill Pain Questionnaire which consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0=none (best) 1=mild 2=moderate 3=severe (worst) (TOTAL: 0=best 45=worst)

Time frame: from baseline up to 104 weeks (study cut-off)

Population: Analysis was performed on the intention To Treat (ITT) population. Data from 265 and 279 patients in the cabazitaxel and mitoxantrone groups, respectively, were censored as a results of \> 2 PPI and/or AS assessments being missed during the same week (unless a complete evaluation of ≥5 values showed pain progression).

ArmMeasureValue (MEDIAN)
Mitoxantrone + PrednisoneTime to Pain ProgressionNA Months
Cabazitaxel + PrednisoneTime to Pain Progression11.1 Months
p-value: 0.519295% CI: [0.69, 1.19]Log Rank
Secondary

Time to Progression Free Survival (PFS)

Progression free survival was defined as a composite endpoint evaluated from the date of randomization to the date of tumor progression, PSA progression, pain progression, or death due to any cause, whichever occurred first

Time frame: From the date of randomization up to 104 weeks (study cut-off)

Population: Analysis was performed on the intention To Treat (ITT) population. The ITT population is composed of all randomized patients (i.e. patients assigned to a treatment group by the randomization, regardless of whether patients received any study drug or received a different study drug from which they were randomized).

ArmMeasureValue (MEDIAN)
Mitoxantrone + PrednisoneTime to Progression Free Survival (PFS)1.4 Months
Cabazitaxel + PrednisoneTime to Progression Free Survival (PFS)2.8 Months
p-value: <0.0001Log Rank
Secondary

Time to Prostatic Specific Antigen (PSA) Progression

In PSA non-responders, progression will be defined as a 25% increase over nadir and increase in the absolute value PSA level by at least 5 ng/ml and confirmed by a second value at least 4 weeks later. In PSA responders and in patients not evaluable for PSA response at baseline, progression will be defined as a ≥50% increase over nadir, provided that the increase is a minimum of 5 ng/ml and confirmed by a second value at least 1 week later.

Time frame: at screening, day 1 of every treatment cycle, up to 104 weeks (study cut-off)

Population: Analysis was performed on the intention To Treat (ITT) population. The ITT population is composed of all randomized patients (i.e. patients assigned to a treatment group by the randomization, regardless of whether patients received any study drug or received a different study drug from which they were randomized).

ArmMeasureValue (MEDIAN)
Mitoxantrone + PrednisoneTime to Prostatic Specific Antigen (PSA) Progression3.1 Months
Cabazitaxel + PrednisoneTime to Prostatic Specific Antigen (PSA) Progression6.4 Months
p-value: 0.00195% CI: [0.63, 0.9]Log Rank
Secondary

Time to Tumor Progression

Time to tumor progression is defined as the number of months from randomization until evidence of progressive disease (RECIST)

Time frame: From the date of randomization up to 104 weeks (study cut-off)

Population: Analysis was performed on the intention To Treat (ITT) population. The ITT population is composed of all randomized patients (i.e. patients assigned to a treatment group by the randomization, regardless of whether patients received any study drug or received a different study drug from which they were randomized).

ArmMeasureValue (MEDIAN)
Mitoxantrone + PrednisoneTime to Tumor Progression5.4 Months
Cabazitaxel + PrednisoneTime to Tumor Progression8.8 Months
p-value: <0.000195% CI: [0.49, 0.76]Log Rank

Source: ClinicalTrials.gov · Data processed: Mar 30, 2026