Prostate Cancer, Prostatic Neoplasms
Conditions
Keywords
Prostatic Neoplasms, Prostate cancer, Abiraterone acetate, CB7630, Prednisone
Brief summary
The purpose of this study is to evaluate the efficacy and safety of abiraterone acetate in participants with advanced prostate cancer (a disease in which cells in the prostate gland become abnormal and start to grow uncontrollably, forming tumors).
Detailed description
This is an open-label (all people know the identity of the intervention), single-arm, multicenter (when more than one hospital or medical school team work on a medical research study) study to evaluate the anti-tumor activities and safety of abiraterone acetate in participants with prostate cancer who have failed androgen deprivation and docetaxel-based chemotherapy. Abiraterone acetate oral tablet will be administered as a total dose of 1000 milligram (mg) orally (by mouth) once daily after an overnight fast and prednisone/prednisolone will be administered as 5 mg oral tablet twice daily. Participants will be enrolled and treated up to 12 cycles (or longer, if they have not progressed and continue to benefit from treatment). The study will consist of 3 parts: Screening (14 days), Open-label Treatment; and follow-up (up to 60 months). Participants will be evaluated primarily for prostate specific antigen response according to Prostate Specific Antigen Working Group (PSAWG) criteria. Participants' safety will be monitored throughout the study.
Interventions
Abiraterone acetate oral tablets 250 milligram (mg) each will be administered at a total dose of 1000 mg until documented disease progression or unacceptable toxicity.
Prednisone/Prednisolone 5 mg tablet will be taken orally twice daily.
Sponsors
Study design
Eligibility
Inclusion criteria
* Histologically or cytologically confirmed adenocarcinoma (malignant epithelial tumor with a glandular organization)of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum), but not with neuroendocrine (specialized neurons that produce hormones, such as neuropeptides or biogenic amines) differentiation or of small cell histology * Prior chemotherapy (treatment of disease, usually cancer, by chemical agents) for prostate cancer with regimen(s) containing docetaxel * Documented prostate specific antigen (PSA) progression according to Prostate Specific Antigen Working Group (PSAWG) eligibility criteria with a PSA more than (\>) 5 nanogram per milliliter (ng/mL) or objective progression by Response Evaluation Criteria in Solid Tumors (RESIST) criteria * Ongoing androgen deprivation with serum testosterone less than (\<) 50 nanogram per deciliter (ng/dL) * Eastern Cooperative Oncology Group (ECOG) Performance Status of less than equal to (\<=) 2 (Karnofsky Performance Status \>= 50 percent)
Exclusion criteria
* Active or uncontrolled autoimmune disease (disorder in which a person's immune system attacks parts of his or her own body) that may require corticosteroid therapy * Serious or uncontrolled co-existent non-malignant disease, including active and uncontrolled infection * Uncontrolled hypertension (high blood pressure) * Hemoglobin \<=9.0 gram per deciliter (g/dL) without growth factor or transfusion support * Abnormal liver (large organ that helps in many body functions, including digestion, metabolism, and storage of substances) function
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Prostate Specific Antigen (PSA) Response | Day 1 of each cycle (of 28 days each) up to Cycle 12 | The PSA response was evaluated according to Prostate-Specific Antigen Working Group (PSAWG) criterion, which is, greater than or equal to 50 percent decrease in PSA from Baseline during the study, which would be subsequently confirmed by a measurement that is at least 4 or more weeks after initial documentation of PSA response. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Progression Free Survival (PFS) | Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months | The RAD-PFS is defined as the time from randomization to the earliest objective evidence of radiographic progression or death due to any cause. Progression is defined using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.0, as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions. |
| Overall Survival (OS) | Every 3 months until death or up to 60 months | Overall survival is defined as the interval from the date of the first dose of abiraterone acetate to the date of death. |
| Percentage of Participants With Objective Radiographic Response | Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months | Percentage of participants with radiographic objective response is defined as the percentage of participants with complete response (CR) or partial response (PR) as best overall response based on reconciled radiographic disease assessment according to RECIST Version 1.0. The CR is disappearance of all lesions. The PR is at least 30 percent decrease in sum of the longest diameter of target lesions or persistence of one or more non-target lesion(s) or/and maintenance of tumor marker level above the normal limits. |
| Prostate-Specific Antigen Based Progression-free Survival (PSA-PFS) | Baseline and Day 1 of each cycle until first documented disease progression or up to 60 months | The PSA-PFS is defined as time to first PSA failure (that is, two consecutive increases in PSA of 50 percent and greater than or equal to 5 nanogram per milliliter, as per Prostate-Specific Antigen Working Group \[PSAWG\] criterion) or death or the start of secondary anti-tumor therapy, whichever occurs first. If a PSA progression or death does not occur, subject will be censored at the last PSA evaluation. |
| Time to Radiographic Progression | Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months | Time to radiographic progression is defined as the time from first dose until the first radiographic progression date that was confirmed. |
| Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline and Day 1 of each cycle until first documented disease progression or up to 60 months | ECOG performance status score ranges from 0 to 5 where 0=fully active, perform all pre-disease activities without restriction. 1=restricted in physically strenuous activity but ambulatory, carry out work of a light or sedentary nature, 2=ambulatory, capable of self-care, unable to carry out any work activities, up and about more than (\>) 50 percent of waking hours, 3=capable of limited self-care, confined to bed or chair \>50 percent of waking hours, 4=completely disabled, not capable of any self-care, totally confined to bed or chair and 5=dead. |
| Percentage of Participants With Clinical Benefit | Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months | Clinical benefit was defined as an observation of at least 1 of the following: PSA response by PSAWG criteria; radiographic response by RECIST criteria; stable disease by RECIST criteria lasting 6 months; or improvement by at least 1 unit in ECOG performance status. |
| Time to PSA Progression | Day 8 of Cycle 1, thereafter Day 1 of each cycle up to end of study (60 months) | The time interval from first dose of abiraterone acetate to the date of PSA progression as defined by the Prostate-Specific Antigen Working Group (PSAWG) criteria. If a PSA progression does not occur, subject will be censored at the last PSA evaluation. |
Countries
United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Abiraterone Abiraterone acetate 1000 milligram (mg) (4 oral tablets of 250 mg each) was administered once daily along with 5 mg oral prednisolone or prednisone tablet administered twice daily for 28-days dosing cycle and was continued until disease progression or unacceptable toxicity. | 58 |
| Total | 58 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 5 |
| Overall Study | Initiation of new anti-cancer treatment | 2 |
| Overall Study | Other | 3 |
| Overall Study | Progressive Disease | 44 |
| Overall Study | Treatment ongoing at cutoff date | 2 |
Baseline characteristics
| Characteristic | Abiraterone |
|---|---|
| Age Continuous | 68.6 Years STANDARD_DEVIATION 9.78 |
| Region of Enrollment United Kingdom | 4 Participants |
| Region of Enrollment United States | 54 Participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 58 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 57 / 58 |
| serious Total, serious adverse events | 23 / 58 |
Outcome results
Percentage of Participants With Prostate Specific Antigen (PSA) Response
The PSA response was evaluated according to Prostate-Specific Antigen Working Group (PSAWG) criterion, which is, greater than or equal to 50 percent decrease in PSA from Baseline during the study, which would be subsequently confirmed by a measurement that is at least 4 or more weeks after initial documentation of PSA response.
Time frame: Day 1 of each cycle (of 28 days each) up to Cycle 12
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Abiraterone | Percentage of Participants With Prostate Specific Antigen (PSA) Response | 37.9 percentage of participants |
Overall Survival (OS)
Overall survival is defined as the interval from the date of the first dose of abiraterone acetate to the date of death.
Time frame: Every 3 months until death or up to 60 months
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abiraterone | Overall Survival (OS) | 492 days |
Percentage of Participants With Clinical Benefit
Clinical benefit was defined as an observation of at least 1 of the following: PSA response by PSAWG criteria; radiographic response by RECIST criteria; stable disease by RECIST criteria lasting 6 months; or improvement by at least 1 unit in ECOG performance status.
Time frame: Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abiraterone | Percentage of Participants With Clinical Benefit | Disease Stabilization | 12 percentage of participants |
| Abiraterone | Percentage of Participants With Clinical Benefit | Change in participant ECOG score | 16 percentage of participants |
Percentage of Participants With Objective Radiographic Response
Percentage of participants with radiographic objective response is defined as the percentage of participants with complete response (CR) or partial response (PR) as best overall response based on reconciled radiographic disease assessment according to RECIST Version 1.0. The CR is disappearance of all lesions. The PR is at least 30 percent decrease in sum of the longest diameter of target lesions or persistence of one or more non-target lesion(s) or/and maintenance of tumor marker level above the normal limits.
Time frame: Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months
Population: Per protocol population defined as participants who had received at least 1 dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment. N (number of participants analyzed) =participants who were evaluable for this measure.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abiraterone | Percentage of Participants With Objective Radiographic Response | Complete response (CR) | 0 percentage of participants |
| Abiraterone | Percentage of Participants With Objective Radiographic Response | Partial Response (PR) | 6.3 percentage of participants |
Prostate-Specific Antigen Based Progression-free Survival (PSA-PFS)
The PSA-PFS is defined as time to first PSA failure (that is, two consecutive increases in PSA of 50 percent and greater than or equal to 5 nanogram per milliliter, as per Prostate-Specific Antigen Working Group \[PSAWG\] criterion) or death or the start of secondary anti-tumor therapy, whichever occurs first. If a PSA progression or death does not occur, subject will be censored at the last PSA evaluation.
Time frame: Baseline and Day 1 of each cycle until first documented disease progression or up to 60 months
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abiraterone | Prostate-Specific Antigen Based Progression-free Survival (PSA-PFS) | 141 days |
Radiographic Progression Free Survival (PFS)
The RAD-PFS is defined as the time from randomization to the earliest objective evidence of radiographic progression or death due to any cause. Progression is defined using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.0, as at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions.
Time frame: Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abiraterone | Radiographic Progression Free Survival (PFS) | 126 days |
Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score
ECOG performance status score ranges from 0 to 5 where 0=fully active, perform all pre-disease activities without restriction. 1=restricted in physically strenuous activity but ambulatory, carry out work of a light or sedentary nature, 2=ambulatory, capable of self-care, unable to carry out any work activities, up and about more than (\>) 50 percent of waking hours, 3=capable of limited self-care, confined to bed or chair \>50 percent of waking hours, 4=completely disabled, not capable of any self-care, totally confined to bed or chair and 5=dead.
Time frame: Baseline and Day 1 of each cycle until first documented disease progression or up to 60 months
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment. 'N' (number of participants analyzed) = participants who were evaluable for this measure.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Best Post-dose:0 | 22 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Best Post-dose:1 | 2 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Best Post-dose:2 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Best Post-dose:3 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Best Post-dose:4 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Best Post-dose:0 | 14 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Best Post-dose:1 | 15 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Best Post-dose:2 | 2 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Best Post-dose:3 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Best Post-dose:4 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Best Post-dose:0 | 1 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Best Post-dose:1 | 1 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Best Post-dose:2 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Best Post-dose:3 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Best Post-dose:4 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Worst Post-dose:0 | 6 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Worst Post-dose:1 | 17 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Worst Post-dose:2 | 1 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Worst Post-dose:3 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:0; Worst Post-dose:4 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Worst Post-dose:0 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Worst Post-dose:1 | 24 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Worst Post-dose:2 | 6 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Worst Post-dose:3 | 1 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:1; Worst Post-dose:4 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Worst Post-dose:0 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Worst Post-dose:1 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Worst Post-dose:2 | 2 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Worst Post-dose:3 | 0 participants |
| Abiraterone | Shift From Baseline in Number of Participants With Eastern Cooperative Oncology Group (ECOG) Performance Status Score | Baseline:2; Worst Post-dose:4 | 0 participants |
Time to PSA Progression
The time interval from first dose of abiraterone acetate to the date of PSA progression as defined by the Prostate-Specific Antigen Working Group (PSAWG) criteria. If a PSA progression does not occur, subject will be censored at the last PSA evaluation.
Time frame: Day 8 of Cycle 1, thereafter Day 1 of each cycle up to end of study (60 months)
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abiraterone | Time to PSA Progression | 169 days |
Time to Radiographic Progression
Time to radiographic progression is defined as the time from first dose until the first radiographic progression date that was confirmed.
Time frame: Baseline, Day 1 of Cycle 4, 7 and 10, and thereafter every third cycle until first documented disease progression or up to 60 months
Population: Per protocol population defined as participants who had received at least one dose of abiraterone acetate and must had PSA evaluation/tumor assessment at Baseline and at least 1 post-baseline, and had received a minimum of 3 cycles of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abiraterone | Time to Radiographic Progression | 88 days |