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OGX-427 in Metastatic Castrate-Resistant Prostate Cancer With Prostate-Specific Antigen Progression While Receiving Abiraterone

The Pacific Clinical Trial: A Randomized Phase II Study Evaluating OGX-427 in Patients With Metastatic Castrate-Resistant Prostate Cancer (MCRPC)Who Have Prostate-Specific Antigen (PSA) Progression While Receiving Abiraterone: Hoosier Oncology Group GU12-159

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01681433
Enrollment
72
Registered
2012-09-10
Start date
2012-12-31
Completion date
2017-06-21
Last updated
2022-07-11

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

Conditions

Metastatic Castrate-Resistant Prostate Cancer, Prostate Cancer, PSA

Keywords

OGX-427, Abiraterone Acetate

Brief summary

This Phase II study has been designed to evaluate the anti-tumor effects of adding OGX-427 to continuing abiraterone acetate and prednisone treatment in men with metastatic castrate-resistant prostate cancer (MCRPC) who have prostate-specific antigen (PSA) progression

Detailed description

OUTLINE: This is a multi-center study. This is an open-label, randomized, Phase II clinical trial designed to evaluate the anti-tumor effects of OGX-427 and continuing abiraterone acetate and prednisone versus continuing abiraterone acetate and prednisone alone in men with MCRPC who have evidence of PSA progression but no evidence of symptomatic or radiographic progression that would require alternative therapy (e.g., needing radiation therapy for pain or significant progression of visceral metastases). Patients on the control arm will be allowed to cross-over to receive OGX-427 following documented disease progression. Patients will be randomized with equal probability to one of the following arms: EXPERIMENTAL ARM (Arm A): OGX-427 Starting within 7 days of randomization, three loading doses of 600 mg intravenously (IV) within Week 1 if possible (up to 10 days of initiating treatment), followed by weekly doses of 800 mg IV Continuation of standard therapy with abiraterone acetate 1000 mg by mouth (PO) daily and prednisone 10-20 mg PO daily CONTROL ARM (Arm B): Continuation of standard therapy with abiraterone acetate 1000 mg PO daily and prednisone 10-20 mg PO daily After documented disease progression, patients on Arm B may opt to receive OGX-427 treatment (according to the Arm A schedule) following a screening evaluation (i.e., all inclusion and exclusion criteria have been met) Both Arms: Evaluations at 4 week-intervals. Disease assessments required at the milestone Day 60 assessment (expected to occur after 8 weeks of treatment and prior to Day 1, Week 9) and at 16, 24, 32, 40, and 48 weeks (if applicable) or until documented disease progression. Patients who are withdrawn from the study for a reason other than documented disease progression or patient withdrawal of consent will be followed every 4 weeks in the Off-Treatment Follow-up Period until documented disease progression. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Life Expectancy: Not Specified Hematopoietic: * Absolute neutrophil count (ANC) ≥ 1.5 x 109 cells /L, platelet count ≥ 100 x 109 /L, and hemoglobin ≥ 9 g/dL without transfusion Hepatic: * Total bilirubin ≤ 1.1 x upper limit of normal (ULN) unless elevated secondary to conditions such as Gilbert's disease, in which case a direct bilirubin ≤ ULN is required * Serum glutamic pyruvic transaminase (SGPT), alanine transaminase (ALT) and alanine transaminase (SGOT) aspartate transaminase (AST) ≤ 3.0 x ULN Renal: * Creatinine ≤ 1.3 x ULN Cardiac: * Known left ventricular ejection fraction (LVEF) \<50% or New York Heart Association (NYHA) Functional Classification Class III or IV heart failure Other: * Castrate serum testosterone level (\< 50 ng/dL or \< 1.7 nmol/L) * Potassium within normal limits

Interventions

OGX-427 started within 7 days of randomization, three loading doses of 600 mg IV within Week 1 if possible (up to 10 days of initiating treatment), followed by weekly doses of 800 mg IV

DRUGAbiraterone Acetate

Standard therapy: Abiraterone Acetate 1000 mg PO daily

DRUGPrednisone

Standard therapy: Prednisone 10-20 mg PO daily

Sponsors

Hoosier Cancer Research Network
CollaboratorOTHER
Achieve Life Sciences
CollaboratorINDUSTRY
Costantine Albany
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

Subjects must meet ALL of the following criteria to be eligible for inclusion into the study. * Histological or cytological diagnosis of adenocarcinoma of the prostate * Metastatic disease on chest, abdominal, or pelvic computed tomography (CT) scan and/or bone scan * Currently receiving abiraterone acetate and prednisone and meeting the following criteria: * Any PSA decline within 12 weeks from initiation of abiraterone acetate * Currently tolerating abiraterone acetate (1000 mg oral daily) and prednisone (10-20 mg oral daily) * PSA progression, defined as an increase in PSA which is ≥25% above the nadir and an absolute value of ≥2 ng/mL, which is confirmed by a second value ≥2 weeks later. * No evidence of symptomatic or radiographic progression that would require alternative therapy (e.g., needing radiation therapy for pain or significant progression of visceral metastases or \>33% increase in daily opioid use within 2 weeks prior to randomization). * All patients who have not had a surgical orchiectomy must continue treatment with a luteinizing hormone-releasing hormone (LHRH) agonist or antagonist to maintain a castrate level of testosterone. * Patient must fulfill Prior Therapy criteria as follows: * Chemotherapy: no more than 1 prior chemotherapy regimen for castrate-resistant prostate cancer (CRPC) is permitted; a minimum of at least 28 days must have passed since the last dose of chemotherapy. * Hormone therapy: hormonal androgen ablation therapy prior to abiraterone is required. * Experimental therapy: prior non-cytotoxic experimental therapy is permitted provided a minimum of at least 14 days has passed since completing therapy. Prior treatment with enzalutamide (MDV3100) is allowed. * Radiation: prior external beam radiation is permitted provided a minimum of at least 14 days have passed since completing radiotherapy (exception for radiotherapy: at least 7 days since completing a single fraction of ≤800 cGy to a restricted field or limited-field radiotherapy to non-marrow bearing area such as an extremity or orbit) at the time of randomization * Must be willing to use effective contraception throughout study treatment and for 3 months after completion of study treatment if able to father a child. * Must be willing not to change (add or subtract) bone protecting therapy (bisphosphonates and/or denosumab) during the study unless changed for toxicity. * Written informed consent must be obtained prior to any protocol-specific procedures being performed.

Exclusion criteria

Subjects meeting ANY of the following

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free Survival60 daysTo ascertain whether Arm A has a greater proportion of patients observed to be alive without progression at Day 60 (±7 days) as compared to Arm B.

Secondary

MeasureTime frameDescription
PSA Response60 daysCompare arms to determine the proportion of patients who have a PSA response (≥ 30% decline) and any PSA decline post-randomization.

Other

MeasureTime frameDescription
Circulating Tumor Cell (CTC) CountsEvery 4 weeksCompare arms to determine circulating tumor cell (CTC) counts for patients at baseline and while on study
Objective Response60 daysCompare arms to determine the objective response of study patients, per RECIST 1.1
Phosphatase and Tensin Homolog (PTEN) Deletion StatusEvery 4 weeksCompare arms to determine PTEN deletion status in original pathology specimens correlated with clinical outcomes
Protein LevelsEvery 4 weeksCompare arms to determine levels of heat shock protein 27 (Hsp27), clusterin, and other relevant proteins of patients at baseline and during study
Time to Disease Progression60 daysCompare arms to determine the time to disease progression of study patients

Countries

Canada, United States

Participant flow

Participants by arm

ArmCount
Experimental: Arm A
OGX-427 + continuation of standard therapy with abiraterone acetate and prednisone OGX-427: OGX-427 started within 7 days of randomization, three loading doses of 600 mg IV within Week 1 if possible (up to 10 days of initiating treatment), followed by weekly doses of 800 mg IV Abiraterone Acetate: Standard therapy: Abiraterone Acetate 1000 mg PO daily Prednisone: Standard therapy: Prednisone 10-20 mg PO daily
36
Control Arm: Arm B
Continuation of standard therapy with abiraterone acetate and prednisone Abiraterone Acetate: Standard therapy: Abiraterone Acetate 1000 mg PO daily Prednisone: Standard therapy: Prednisone 10-20 mg PO daily
36
Total72

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event24
Overall StudyLack of Efficacy2323
Overall StudyLost to Follow-up01
Overall StudyProtocol Violation20
Overall StudyWithdrawal by Subject55

Baseline characteristics

CharacteristicTotalExperimental: Arm AControl Arm: Arm B
Age, Continuous72 years71 years72 years
ECOG Status
ECOG 0
32 participants16 participants16 participants
ECOG Status
ECOG 1
40 participants20 participants20 participants
Median PSA23 ug/L34.19 ug/L18.17 ug/L
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants0 Participants2 Participants
Race (NIH/OMB)
Black or African American
8 Participants5 Participants3 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants1 Participants3 Participants
Race (NIH/OMB)
White
58 Participants30 Participants28 Participants
Region of Enrollment
Canada
29 participants14 participants15 participants
Region of Enrollment
United States
43 participants22 participants21 participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants
Sex: Female, Male
Male
72 Participants36 Participants36 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
8 / 566 / 36
other
Total, other adverse events
51 / 5632 / 36
serious
Total, serious adverse events
12 / 566 / 36

Outcome results

Primary

Progression-Free Survival

To ascertain whether Arm A has a greater proportion of patients observed to be alive without progression at Day 60 (±7 days) as compared to Arm B.

Time frame: 60 days

ArmMeasureValue (NUMBER)
Experimental: Arm AProgression-Free Survival12 participants
Control Arm: Arm BProgression-Free Survival6 participants
Secondary

PSA Response

Compare arms to determine the proportion of patients who have a PSA response (≥ 30% decline) and any PSA decline post-randomization.

Time frame: 60 days

ArmMeasureGroupValue (NUMBER)
Experimental: Arm APSA ResponsePSA DECLINE >= 30%2 participants
Experimental: Arm APSA ResponsePSA DELCINE >=50 %2 participants
Experimental: Arm APSA ResponseANY DECLINE13 participants
Control Arm: Arm BPSA ResponsePSA DECLINE >= 30%2 participants
Control Arm: Arm BPSA ResponsePSA DELCINE >=50 %1 participants
Control Arm: Arm BPSA ResponseANY DECLINE11 participants
Other Pre-specified

Circulating Tumor Cell (CTC) Counts

Compare arms to determine circulating tumor cell (CTC) counts for patients at baseline and while on study

Time frame: Every 4 weeks

ArmMeasureGroupValue (NUMBER)
Experimental: Arm ACirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline >=5 to <58 participants
Experimental: Arm ACirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline <5 to <516 participants
Experimental: Arm ACirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline >=5 to >=57 participants
Experimental: Arm ACirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline<5 to >=51 participants
Control Arm: Arm BCirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline<5 to >=51 participants
Control Arm: Arm BCirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline >=5 to <54 participants
Control Arm: Arm BCirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline >=5 to >=510 participants
Control Arm: Arm BCirculating Tumor Cell (CTC) CountsBest CTC Change from Baseline <5 to <515 participants
Other Pre-specified

Objective Response

Compare arms to determine the objective response of study patients, per RECIST 1.1

Time frame: 60 days

ArmMeasureGroupValue (NUMBER)
Experimental: Arm AObjective ResponseProgressive Disease26 participants
Experimental: Arm AObjective ResponsePartial Response1 participants
Experimental: Arm AObjective ResponseStable Disease6 participants
Control Arm: Arm BObjective ResponseProgressive Disease25 participants
Control Arm: Arm BObjective ResponsePartial Response0 participants
Control Arm: Arm BObjective ResponseStable Disease5 participants
Other Pre-specified

Phosphatase and Tensin Homolog (PTEN) Deletion Status

Compare arms to determine PTEN deletion status in original pathology specimens correlated with clinical outcomes

Time frame: Every 4 weeks

Population: Data for this objective was not collected or analyzed

Other Pre-specified

Protein Levels

Compare arms to determine levels of heat shock protein 27 (Hsp27), clusterin, and other relevant proteins of patients at baseline and during study

Time frame: Every 4 weeks

Population: Data for this secondary objective was not collected or analyzed

Other Pre-specified

Time to Disease Progression

Compare arms to determine the time to disease progression of study patients

Time frame: 60 days

ArmMeasureValue (MEDIAN)
Experimental: Arm ATime to Disease Progression1.9055 months
Control Arm: Arm BTime to Disease Progression1.0842 months

Source: ClinicalTrials.gov · Data processed: Feb 27, 2026