Prostatic Neoplasms
Conditions
Keywords
Docetaxel-refractory mCRPC, Second-line treatment with sunitinib and prednisone
Brief summary
This study will compare the safety and efficacy of sunitinib in combination with prednisone versus placebo and prednisone in patients that have metastatic castration-resistant prostate cancer that has progressed after treatment with a docetaxel-containing chemotherapy regimen. This is a second-line study.
Interventions
5 mg BID, oral
37.5 mg/day, oral, administered on a continuous daily dosing regimen
37.5 mg/day, oral, administered on a continuous daily dosing regimen
Sponsors
Study design
Eligibility
Inclusion criteria
* Histologically or cytologically confirmed adenocarcinoma of the prostate. * Progressive, metastatic castration-resistant prostate cancer after failure of docetaxel chemotherapy (resistant or intolerant). * Progressive disease based on PSA progression, RECIST, or positive bone scan. * ECOG 0 or 1.
Exclusion criteria
* Prior treatment with sunitinib and/or more than 1 prior chemotherapy regimen in the metastatic disease setting. * Chemotherapy within 3 weeks. * Impending complications from bone metastases. * Ongoing urinary obstruction. * Cardiac dysfunction, QTc \>470 msec. * CNS involvement.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | Baseline up to 32 months | OS is the duration from randomization to death. For participants who were alive, overall survival was censored at the last contact. OS (in months) calculated as (date of death minus \[-\] date of randomization plus \[+\] 1) divided (/) 30.4. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percent of Participants With Objective Response (OR) | Baseline, every 8 weeks up to 123 weeks | OR defined as the percent (%) of participants with confirmed Complete Response (CR) (disappearance of all target lesions) or Partial Response (PR) (\>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions) according to Response Evaluation Criteria in Solid Tumors (RECIST), relative to the full analysis population. Confirmed responses were those that persist on repeat imagining study \>= 4 weeks after initial documentation of response. |
| Duration of Response (DR) | Baseline, every 8 weeks up to 123 weeks | Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cause. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cause - the date of the first CR or PR that was subsequently confirmed plus 1 divided by 7.02. DR calculated for the subgroup of participants with a confirmed objective tumor response |
| Progression-Free Survival (PFS) | Baseline, every 8 weeks up to 123 weeks | PFS is the period from randomization until disease progression or death on study. PFS is censored on the date of last tumor assessment documenting absence of progressive disease. PFS (weeks) calculated as (first event date - randomization date + 1)/7.02 |
| Change From Baseline in Functional Assessment of Cancer Therapy-Prostate (FACT-P) | Baseline, every 4 weeks up to 123 weeks | FACT-P is a validated, self-administered instrument used to assess health-related quality of life and prostate cancer-specific symptoms. Scores ranged from 0 (not at all) to 4 (very much). It is 27-item FACT-General and 12 items for the prostate cancer specific concerns. The 27 items in FACT-G are grouped into 4 domains: physical well-being, social/family well-being, emotional well-being and functional well-being. The 12 prostate cancer symptoms items focus on pain (3 items), urination problems (3 items), sexual functions (2 items), weight loss, appetite, overall comfort, and bowel movement. |
| Change From Baseline in Euro Quality of Life (EQ-5D)- Health State Profile Utility Score | Baseline, every 4 weeks up to 123 weeks | EQ-5D: participant rated questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state (confined to bed). Overall scores range from 0 to 1, with lower scores representing a higher level of dysfunction. |
| Change From Baseline in Pain Severity | Day 1 through Day 7 every 28 days (every cycle) up to 29 months | Pain severity recorded on a numerical scale ranging from 0 (no pain) to 10 (pain as bad as you can imagine). Higher scores indicated greater level of pain. The pain score for each cycle averaged for the 7 days. |
Countries
Australia, Belgium, Brazil, Canada, China, Czechia, Denmark, Finland, France, Germany, Israel, Italy, Peru, Poland, Portugal, Slovakia, South Korea, Spain, Sweden, Taiwan, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Sunitinib and Prednisone Sunitinib capsules administered orally as a continuous daily dose in a continuous regimen, expressed as 4-week cycles; starting dose of 37.5 milligrams (mg) with option to increase dose to 50 mg at Cycle 3. Prednisone administered continuously at 5 mg orally twice a day (BID) as either a tablet, solution or concentrated solution. | 584 |
| Placebo and Prednisone Matched placebo administered orally as a continuous daily dose expressed as 4-week cycles; with a starting dose of 37.5 milligrams (mg) with option to increase dose to 50 mg at Cycle 3 plus prednisone administered continuously at 5 mg orally BID as either a tablet, solution or concentrated solution. | 289 |
| Total | 873 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 159 | 21 |
| Overall Study | Death | 45 | 14 |
| Overall Study | Global deterioration of health status | 66 | 31 |
| Overall Study | Lost to Follow-up | 0 | 1 |
| Overall Study | Objective progression or relapse | 189 | 140 |
| Overall Study | Other | 14 | 10 |
| Overall Study | Protocol Violation | 3 | 1 |
| Overall Study | Randomized but not treated | 3 | 4 |
| Overall Study | Study terminated by sponsor | 57 | 43 |
| Overall Study | Withdrawal by Subject | 48 | 24 |
Baseline characteristics
| Characteristic | Sunitinib and Prednisone | Placebo and Prednisone | Total |
|---|---|---|---|
| Age, Customized 18 - 44 years | 3 participants | 0 participants | 3 participants |
| Age, Customized 45 - 64 years | 177 participants | 97 participants | 274 participants |
| Age, Customized greater than or equal to (>=) 65 years | 404 participants | 192 participants | 596 participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 584 Participants | 289 Participants | 873 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 573 / 581 | 256 / 285 |
| serious Total, serious adverse events | 275 / 581 | 86 / 285 |
Outcome results
Overall Survival (OS)
OS is the duration from randomization to death. For participants who were alive, overall survival was censored at the last contact. OS (in months) calculated as (date of death minus \[-\] date of randomization plus \[+\] 1) divided (/) 30.4.
Time frame: Baseline up to 32 months
Population: Full analysis (FA) population: all participants who were randomized, with study drug assignment designated according to initial randomization, regaradless of whether participant received study drug according to the randomization schedule.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib and Prednisone | Overall Survival (OS) | 13.1 months |
| Placebo and Prednisone | Overall Survival (OS) | 11.8 months |
Change From Baseline in Euro Quality of Life (EQ-5D)- Health State Profile Utility Score
EQ-5D: participant rated questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state (confined to bed). Overall scores range from 0 to 1, with lower scores representing a higher level of dysfunction.
Time frame: Baseline, every 4 weeks up to 123 weeks
Population: Data not summarized, study terminated early
Change From Baseline in Functional Assessment of Cancer Therapy-Prostate (FACT-P)
FACT-P is a validated, self-administered instrument used to assess health-related quality of life and prostate cancer-specific symptoms. Scores ranged from 0 (not at all) to 4 (very much). It is 27-item FACT-General and 12 items for the prostate cancer specific concerns. The 27 items in FACT-G are grouped into 4 domains: physical well-being, social/family well-being, emotional well-being and functional well-being. The 12 prostate cancer symptoms items focus on pain (3 items), urination problems (3 items), sexual functions (2 items), weight loss, appetite, overall comfort, and bowel movement.
Time frame: Baseline, every 4 weeks up to 123 weeks
Population: Data not summarized, study terminated early
Change From Baseline in Pain Severity
Pain severity recorded on a numerical scale ranging from 0 (no pain) to 10 (pain as bad as you can imagine). Higher scores indicated greater level of pain. The pain score for each cycle averaged for the 7 days.
Time frame: Day 1 through Day 7 every 28 days (every cycle) up to 29 months
Population: Data not summarized, study terminated early
Duration of Response (DR)
Time in weeks from the first documentation of objective tumor response to objective tumor progression or death due to any cause. Duration of tumor response was calculated as (the date of the first documentation of objective tumor progression or death due to cause - the date of the first CR or PR that was subsequently confirmed plus 1 divided by 7.02. DR calculated for the subgroup of participants with a confirmed objective tumor response
Time frame: Baseline, every 8 weeks up to 123 weeks
Population: Data not summarized, study terminated early
Percent of Participants With Objective Response (OR)
OR defined as the percent (%) of participants with confirmed Complete Response (CR) (disappearance of all target lesions) or Partial Response (PR) (\>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum longest dimensions) according to Response Evaluation Criteria in Solid Tumors (RECIST), relative to the full analysis population. Confirmed responses were those that persist on repeat imagining study \>= 4 weeks after initial documentation of response.
Time frame: Baseline, every 8 weeks up to 123 weeks
Population: FA Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Sunitinib and Prednisone | Percent of Participants With Objective Response (OR) | 6.1 percentage of participants |
| Placebo and Prednisone | Percent of Participants With Objective Response (OR) | 1.8 percentage of participants |
Progression-Free Survival (PFS)
PFS is the period from randomization until disease progression or death on study. PFS is censored on the date of last tumor assessment documenting absence of progressive disease. PFS (weeks) calculated as (first event date - randomization date + 1)/7.02
Time frame: Baseline, every 8 weeks up to 123 weeks
Population: FA Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib and Prednisone | Progression-Free Survival (PFS) | 24.1 weeks |
| Placebo and Prednisone | Progression-Free Survival (PFS) | 17.9 weeks |