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A Proof of Concept Study of Maintenance Therapy With Tasquinimod in Patients With Metastatic Castrate-resistant Prostate Cancer Who Are Not Progressing After a First Line Docetaxel Based Chemotherapy

A Randomised, Double-Blind, Placebo-Controlled Proof Of Concept Study Of Maintenance Therapy With Tasquinimod In Patients With Metastatic Castrate-Resistant Prostate Cancer Who Are Not Progressing After A First Line Docetaxel Based Chemotherapy

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01732549
Enrollment
144
Registered
2012-11-26
Start date
2013-01-31
Completion date
2015-05-31
Last updated
2019-11-22

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

Brief summary

The purpose of this study is to confirm that tasquinimod used as maintenance therapy is active and tolerable in patients with metastatic castrate-resistant prostate cancer not progressing after a first chemotherapy with docetaxel.

Interventions

A patient's dose will escalate from one level to the next, once tolerability of the current dose is established. If tolerability issues arise at 0.5 or 1 mg/day, patients will have their dose reduced to 0.25 or 0.5 mg/day, respectively.

DRUGPlacebo

Placebo capsules are identical to tasquinimod capsules in appearance and excipients but exclude the active compound (tasquinimod), to be taken orally once a day with water and food

Sponsors

Ipsen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

* Histologically documented prostate cancer with evidence of metastatic disease on radiological evaluation, with or without symptoms (defined according to the BPI scale, with use of analgesics or narcotics) * Has received a first line docetaxel based chemotherapy (as a monotherapy) every 3 weeks schedule of administration with corticosteroids for a minimum of 6 cycles with a cumulative dose ≥360 mg/m2. Any combination with investigational or non investigational agent is prohibited * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 * Docetaxel-related adverse effects must have been resolved to NCI-CTCAE v4.03 (Common Toxicity Criteria for Adverse Effects) Grade ≤1. Chemotherapy-induced alopecia and Grade 2 peripheral neuropathy are allowed * No progressive disease at the end of docetaxel treatment defined according to RECIST criteria, no new lesion(s) assessed by bone scan and no elevated prostate specific antigen (PSA) for the three last tests with PSA3≤PSA2≤PSA1. The time between each PSA test should be preferably at least 14 days, however, a minimum of 7 days is acceptable. Note: PSA value can be rounded to the nearest whole number if PSA\>10 ng/mL. If the PSA3 value is above the PSA2, a fourth PSA test will be performed. The PSA4 value should be below or equal to PSA2 * Last dose of docetaxel administered between 21 and 42 days before randomisation * Chemical or surgical castration verified by levels of serum testosterone ≤50 ng/dL (1.75 nmol/L)

Exclusion criteria

* Has concurrent use of other anticancer agents or treatments, with the following exceptions: ongoing treatment with luteinising hormone-releasing hormone agonists or antagonists, denosumab or bisphosphonate (e.g., zoledronic acid) is permitted if started ≥4 weeks prior to Screening. Ongoing treatment should be kept at a stable dose regimen * Has ongoing treatment with warfarin * Had prior radiation therapy since starting docetaxel. Exceptions may be made for palliative non-myelosuppressive radiation therapy administered more than 2 weeks prior to randomisation * Had prior strontium, samarium or radium therapy or prior treatment with tasquinimod, or any agents with antiangiogenic properties * Has ongoing treatment with corticosteroids at \>10 mg/day prednisolone equivalent * Has prostate cancer pain that warrants the initiation of radiotherapy or chemotherapy * Has known brain or epidural metastases. Patients with previous medullary cord compression without any neurological deficit could be included * Has a history of other malignancies, except adequately treated non-melanoma skin cancer or other solid tumours curatively treated, without evidence of disease for \>5 years

Design outcomes

Primary

MeasureTime frameDescription
Time to Radiological Progression Free Survival [PFS]Every 8 weeks until disease progression documentation (approximately up to 2.5 years)The time from the date of randomisation to the date of radiological progression or death due to any cause. Radiological progression was defined \- Using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for soft tissue lesions (Eisenhauer, EJC 2009), as at least a 20% relative and a 5 mm absolute increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters recorded on study (including Screening or the appearance of one or more new lesions) for target Lesions. Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions \- Using Prostate Cancer Clinical Working Group in March 2008 (PCWG2) criteria for bone lesions (Scher, JCO 2008). Progression was defined as appearance of 2 or more bone lesions.

Secondary

MeasureTime frameDescription
Time to Progression Free Survival [PFS] on Next-line Therapy (PFS 2)Every 3 months after study treatment stop (follow-up) until progression under the next line therapy (approximately up to 2.5 years)The time from the date of randomisation to the date of radiological progression free survival \[PFS\] on next-line therapy (PFS 2) or death due to any cause. Radiological progression was defined \- Using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for soft tissue lesions (Eisenhauer, EJC 2009), as at least a 20% relative and a 5 mm absolute increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters recorded on study (including Screening or the appearance of one or more new lesions) for target Lesions. Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions \- Using Prostate Cancer Clinical Working Group in March 2008 (PCWG2) criteria for bone lesions (Scher, JCO 2008). Progression was defined as appearance of 2 or more bone lesions.
Symptomatic PFS Based on Number of Subjects Who Had Symptomatic Progression or DeathEvery 8 weeks until symptomatic or radiological progression documentation (approximately up to 2.5 years)Symptomatic PFS is defined as the time from the date of randomisation to the date of symptomatic progression or death due to prostate cancer, whichever occurs first \[symptomatic progression as assessed by Brief Pain Inventory (BPI) and analgesic use\]. Symptomatic progression was defined by the occurrence of pain with documented disease, skeleton related adverse events. The median symptomatic PFS for placebo and tasquinimod groups was not reached. Tasquinimod: Patients censored = 48, Patients at risk (t=0) = 71 Placebo: Patients censored = 54, Patients at risk (t=0) = 73
Time to Further Anticancer Treatment for Prostate CancerEvery 3 months after study treatment stop until further anticancer therapy for prostate cancer (approximately up to 2.5 years)Time from randomisation to further treatment for prostate cancer
Overall Survival Based on Number of Subjects Who DiedEvery 3 months after study treatment stop until death (approximately up to 2.5 years)Overall survival is defined as the time from randomisation to death due to any cause. The number of participants who died is presented since the Median was not reached for this assessment. Tasquinimod: Patients censored = 63, Patients at risk (t=0) = 71 Placebo: Patients censored = 67, Patients at risk (t=0) = 73
Change From Baseline of EuroQol-5 Dimension QoL Instrument (EQ-5D) VAS ScoreBaseline and End-of-study Visit (approximately up to 2.5 years)Baseline is defined as last measurement collected prior to the first dose of study drug. End of Study visit (within 14 days of last dose of study treatment) The EQ-5D, a 5-item scale useful in health resource utilisation and cost comparisons between treatment groups designed for self-completion by patients consists of two pages \[EQ-5 descriptive system and EQ Visual Analogue Scale(VAS)\]. The EQ-5 descriptive system comprises five dimensions: mobility, self care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, severe problems. The EQ-VAS records the respondent's self-rated health on a vertical VAS. The respondents are asked to mark health status on the day of the interview on a 10cm vertical scale with end points of 0 to100. There are notes at the both ends of the scale that the bottom rate(0) corresponds to the worst health you can imagine, and the highest rate(100) corresponds to the best health you can imagine
Safety Profile of TasquinimodAt regular intervals during the study treatment period and every 3 months during the follow-up until death (approximately up to 2.5 years)Number of subjects reporting adverse events
Time to Deterioration in Functional Assessment of Cancer Therapy - Prostate (FACT-P)Up to End of Study visit (approximately up to 2.5 years)End of Study visit (within 14 days of last dose of study treatment) Impact of tasquinimod on health related quality of life (QoL) - Analysis of time to deterioration in FACT-P The FACT-P measurement system is a validated collection of health related quality of life (HRQOL) questionnaires used to assess HRQOL in men with prostate cancer. It is appropriate for use with patients with any form of cancer and extensions of it have been used and validated in other chronic illness condition. The FACT-P is a self-administered 39-item scale comprising five domains: physical well-being, social/family well-being, functional well-being, emotional well-being and additional concerns. The individual subscale scores range from 0 to a high between 24 and 48 and the total score ranges between 0 and 156, with higher scores representing better Quality of Life (QoL)

Countries

Belgium, Czechia, Denmark, France, Germany, Hungary, Italy, Lithuania, Poland, Spain, United Kingdom

Participant flow

Recruitment details

The study was performed as a multicentre study at 51 investigational sites (of which 44 randomised patients) in Belgium, Czech Republic, Denmark, France, Germany, Hungary, Italy, Lithuania, Poland, Spain and United Kingdom (UK)

Pre-assignment details

A total of 219 patients were screened and 144 patients were randomised.

Participants by arm

ArmCount
Tasquinimod
1 capsule daily, taken orally with water and food (0.25 mg initially then dose escalated to 0.5 mg and then to 1 mg per day) until disease progression. Tasquinimod: Patients received initially an oral dose of 0.25 mg/day of tasquinimod, starting on Day 1, for at least 2 weeks. Once tolerability of the 0.25 mg/day dose was established, patients received a dose increase to 0.5 mg/day for at least 2 weeks, and then increased to 1 mg/day of study treatment. Patients showing poor tolerability for the escalated doses of tasquinimod were allowed to continue study treatment at the highest individually tolerated dose
71
Placebo
1 capsule daily, taken orally with water and food until disease progression Placebo: Patients received Placebo capsules (identical to tasquinimod capsules) to be taken orally once a day with water and food
73
Total144

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event133
Overall StudyConsent withdrawn136
Overall StudyDisease progression3750
Overall StudyOther814

Baseline characteristics

CharacteristicTasquinimodPlaceboTotal
Age, Continuous69.6 years
STANDARD_DEVIATION 7.18
69.6 years
STANDARD_DEVIATION 5.57
69.6 years
STANDARD_DEVIATION 6.39
Age, Customized
18 to ≤ 65 years
18 participants17 participants35 participants
Age, Customized
66 to ≤ 75 years
40 participants45 participants85 participants
Age, Customized
> 75 years
13 participants11 participants24 participants
BMI27.67 kg/m^2
STANDARD_DEVIATION 3.543
28.01 kg/m^2
STANDARD_DEVIATION 4.399
27.84 kg/m^2
STANDARD_DEVIATION 3.987
ECOG Performance Status Score
0 (Normal Activity)
39 participants31 participants70 participants
ECOG Performance Status Score
1 (Restricted Activity)
32 participants38 participants70 participants
ECOG Performance Status Score
Missing
0 participants4 participants4 participants
Ethnicity
Hispanic or Latino
2 participants4 participants6 participants
Ethnicity
Missing
17 participants14 participants31 participants
Ethnicity
Not Hispanic or Latino
52 participants55 participants107 participants
Race/Ethnicity, Customized
Black/African American
0 participants1 participants1 participants
Race/Ethnicity, Customized
Caucasian/White
52 participants58 participants110 participants
Race/Ethnicity, Customized
Missing
18 participants14 participants32 participants
Race/Ethnicity, Customized
Multiple Race
1 participants0 participants1 participants
Region
Eastern Europe
18 participants16 participants34 participants
Region
Western Europe
53 participants57 participants110 participants
Region of Enrollment
Belgium
5 participants6 participants11 participants
Region of Enrollment
Czech Republic
5 participants1 participants6 participants
Region of Enrollment
Denmark
6 participants13 participants19 participants
Region of Enrollment
France
17 participants14 participants31 participants
Region of Enrollment
Germany
3 participants3 participants6 participants
Region of Enrollment
Hungary
2 participants2 participants4 participants
Region of Enrollment
Italy
9 participants5 participants14 participants
Region of Enrollment
Lithuania
7 participants10 participants17 participants
Region of Enrollment
Poland
4 participants3 participants7 participants
Region of Enrollment
Spain
5 participants10 participants15 participants
Region of Enrollment
United Kingdom
8 participants6 participants14 participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants
Sex: Female, Male
Male
71 Participants73 Participants144 Participants
Weight83.7 kg
STANDARD_DEVIATION 12.57
83.4 kg
STANDARD_DEVIATION 15.09
83.6 kg
STANDARD_DEVIATION 13.86

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
69 / 7166 / 70
serious
Total, serious adverse events
24 / 7116 / 70

Outcome results

Primary

Time to Radiological Progression Free Survival [PFS]

The time from the date of randomisation to the date of radiological progression or death due to any cause. Radiological progression was defined \- Using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for soft tissue lesions (Eisenhauer, EJC 2009), as at least a 20% relative and a 5 mm absolute increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters recorded on study (including Screening or the appearance of one or more new lesions) for target Lesions. Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions \- Using Prostate Cancer Clinical Working Group in March 2008 (PCWG2) criteria for bone lesions (Scher, JCO 2008). Progression was defined as appearance of 2 or more bone lesions.

Time frame: Every 8 weeks until disease progression documentation (approximately up to 2.5 years)

Population: Intention to treat (ITT) Population

ArmMeasureValue (MEDIAN)
TasquinimodTime to Radiological Progression Free Survival [PFS]31.7 weeks
PlaceboTime to Radiological Progression Free Survival [PFS]22.7 weeks
Comparison: Stratified\[a\]p-value: =0.0315Log Rank
Comparison: Unstratified\[b\]p-value: =0.0344Log Rank
Secondary

Change From Baseline of EuroQol-5 Dimension QoL Instrument (EQ-5D) VAS Score

Baseline is defined as last measurement collected prior to the first dose of study drug. End of Study visit (within 14 days of last dose of study treatment) The EQ-5D, a 5-item scale useful in health resource utilisation and cost comparisons between treatment groups designed for self-completion by patients consists of two pages \[EQ-5 descriptive system and EQ Visual Analogue Scale(VAS)\]. The EQ-5 descriptive system comprises five dimensions: mobility, self care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, severe problems. The EQ-VAS records the respondent's self-rated health on a vertical VAS. The respondents are asked to mark health status on the day of the interview on a 10cm vertical scale with end points of 0 to100. There are notes at the both ends of the scale that the bottom rate(0) corresponds to the worst health you can imagine, and the highest rate(100) corresponds to the best health you can imagine

Time frame: Baseline and End-of-study Visit (approximately up to 2.5 years)

Population: ITT population

ArmMeasureValue (MEDIAN)
TasquinimodChange From Baseline of EuroQol-5 Dimension QoL Instrument (EQ-5D) VAS Score-9.0 Score on scale
PlaceboChange From Baseline of EuroQol-5 Dimension QoL Instrument (EQ-5D) VAS Score-3.5 Score on scale
Secondary

Overall Survival Based on Number of Subjects Who Died

Overall survival is defined as the time from randomisation to death due to any cause. The number of participants who died is presented since the Median was not reached for this assessment. Tasquinimod: Patients censored = 63, Patients at risk (t=0) = 71 Placebo: Patients censored = 67, Patients at risk (t=0) = 73

Time frame: Every 3 months after study treatment stop until death (approximately up to 2.5 years)

Population: ITT Population

ArmMeasureValue (NUMBER)
TasquinimodOverall Survival Based on Number of Subjects Who Died8 participants
PlaceboOverall Survival Based on Number of Subjects Who Died6 participants
Comparison: Stratified\[a\]p-value: =0.443Log Rank
Secondary

Safety Profile of Tasquinimod

Number of subjects reporting adverse events

Time frame: At regular intervals during the study treatment period and every 3 months during the follow-up until death (approximately up to 2.5 years)

Population: Safety Population: All patients who received at least one dose of study treatment. Patients were allocated to the treatment they actually received

ArmMeasureGroupValue (NUMBER)
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 3]32 participants
TasquinimodSafety Profile of TasquinimodCausality of TEAEs [Not Drug Related]15 participants
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 3-5 (severe)]36 participants
TasquinimodSafety Profile of TasquinimodTEAEs Leading to Drug Withdrawal12 participants
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 2 (moderate)]28 participants
TasquinimodSafety Profile of TasquinimodTEAEs leading to Dose Reduction16 participants
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 4]3 participants
TasquinimodSafety Profile of TasquinimodTEAEs leading to Drug Interruption33 participants
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 1 (mild)]5 participants
TasquinimodSafety Profile of TasquinimodTEAEs Leading to Death1 participants
TasquinimodSafety Profile of TasquinimodIntensity of TEAEs [Grade 5]1 participants
TasquinimodSafety Profile of TasquinimodSerious Adverse Event (SAEs)24 participants
TasquinimodSafety Profile of TasquinimodCausality of TEAEs [Drug Related]54 participants
TasquinimodSafety Profile of TasquinimodDrug Related SAEs6 participants
TasquinimodSafety Profile of TasquinimodAny Treatment Emergent Adverse Event (TEAEs)69 participants
PlaceboSafety Profile of TasquinimodDrug Related SAEs2 participants
PlaceboSafety Profile of TasquinimodAny Treatment Emergent Adverse Event (TEAEs)66 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 3-5 (severe)]19 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 5]3 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 4]2 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 3]14 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 2 (moderate)]28 participants
PlaceboSafety Profile of TasquinimodIntensity of TEAEs [Grade 1 (mild)]19 participants
PlaceboSafety Profile of TasquinimodCausality of TEAEs [Drug Related]38 participants
PlaceboSafety Profile of TasquinimodCausality of TEAEs [Not Drug Related]28 participants
PlaceboSafety Profile of TasquinimodTEAEs Leading to Drug Withdrawal3 participants
PlaceboSafety Profile of TasquinimodTEAEs leading to Dose Reduction2 participants
PlaceboSafety Profile of TasquinimodTEAEs leading to Drug Interruption12 participants
PlaceboSafety Profile of TasquinimodTEAEs Leading to Death0 participants
PlaceboSafety Profile of TasquinimodSerious Adverse Event (SAEs)16 participants
Secondary

Symptomatic PFS Based on Number of Subjects Who Had Symptomatic Progression or Death

Symptomatic PFS is defined as the time from the date of randomisation to the date of symptomatic progression or death due to prostate cancer, whichever occurs first \[symptomatic progression as assessed by Brief Pain Inventory (BPI) and analgesic use\]. Symptomatic progression was defined by the occurrence of pain with documented disease, skeleton related adverse events. The median symptomatic PFS for placebo and tasquinimod groups was not reached. Tasquinimod: Patients censored = 48, Patients at risk (t=0) = 71 Placebo: Patients censored = 54, Patients at risk (t=0) = 73

Time frame: Every 8 weeks until symptomatic or radiological progression documentation (approximately up to 2.5 years)

Population: ITT Population

ArmMeasureValue (NUMBER)
TasquinimodSymptomatic PFS Based on Number of Subjects Who Had Symptomatic Progression or Death23 participants
PlaceboSymptomatic PFS Based on Number of Subjects Who Had Symptomatic Progression or Death19 participants
Comparison: Stratified\[a\]p-value: =0.5442Log Rank
Secondary

Time to Deterioration in Functional Assessment of Cancer Therapy - Prostate (FACT-P)

End of Study visit (within 14 days of last dose of study treatment) Impact of tasquinimod on health related quality of life (QoL) - Analysis of time to deterioration in FACT-P The FACT-P measurement system is a validated collection of health related quality of life (HRQOL) questionnaires used to assess HRQOL in men with prostate cancer. It is appropriate for use with patients with any form of cancer and extensions of it have been used and validated in other chronic illness condition. The FACT-P is a self-administered 39-item scale comprising five domains: physical well-being, social/family well-being, functional well-being, emotional well-being and additional concerns. The individual subscale scores range from 0 to a high between 24 and 48 and the total score ranges between 0 and 156, with higher scores representing better Quality of Life (QoL)

Time frame: Up to End of Study visit (approximately up to 2.5 years)

Population: ITT population

ArmMeasureValue (MEDIAN)
TasquinimodTime to Deterioration in Functional Assessment of Cancer Therapy - Prostate (FACT-P)8.1 weeks
PlaceboTime to Deterioration in Functional Assessment of Cancer Therapy - Prostate (FACT-P)15.7 weeks
Comparison: Stratified\[a\]p-value: =0.2491Log Rank
Secondary

Time to Further Anticancer Treatment for Prostate Cancer

Time from randomisation to further treatment for prostate cancer

Time frame: Every 3 months after study treatment stop until further anticancer therapy for prostate cancer (approximately up to 2.5 years)

Population: ITT population

ArmMeasureValue (MEDIAN)
TasquinimodTime to Further Anticancer Treatment for Prostate Cancer42.3 weeks
PlaceboTime to Further Anticancer Treatment for Prostate Cancer29.0 weeks
Comparison: Stratified\[a\]p-value: =0.112Log Rank
Secondary

Time to Progression Free Survival [PFS] on Next-line Therapy (PFS 2)

The time from the date of randomisation to the date of radiological progression free survival \[PFS\] on next-line therapy (PFS 2) or death due to any cause. Radiological progression was defined \- Using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) for soft tissue lesions (Eisenhauer, EJC 2009), as at least a 20% relative and a 5 mm absolute increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters recorded on study (including Screening or the appearance of one or more new lesions) for target Lesions. Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions \- Using Prostate Cancer Clinical Working Group in March 2008 (PCWG2) criteria for bone lesions (Scher, JCO 2008). Progression was defined as appearance of 2 or more bone lesions.

Time frame: Every 3 months after study treatment stop (follow-up) until progression under the next line therapy (approximately up to 2.5 years)

Population: ITT Population

ArmMeasureValue (MEDIAN)
TasquinimodTime to Progression Free Survival [PFS] on Next-line Therapy (PFS 2)19.3 weeks
PlaceboTime to Progression Free Survival [PFS] on Next-line Therapy (PFS 2)24.1 weeks
Comparison: Stratified\[a\]p-value: 0.5219Log Rank

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026