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TerminatedNCT01145508Updated Sep 19, 2017Results posted

Docetaxel and Prednisone With or Without Vaccine Therapy in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer

A Phase 2 interventional study of Docetaxel and Laboratory Biomarker Analysis in Hormone-Resistant Prostate Cancer, Prostate Adenocarcinoma and Recurrent Prostate Carcinoma, sponsored by National Cancer Institute (NCI). Terminated at 14 sites in United States. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-09-19.

Sponsored by National Cancer Institute (NCI) · Phase 2, Interventional, and Treatment

Why this study was terminated
Poor accrual
Phase
Phase 2
Study type
Interventional
Enrollment
10
Allocation
Randomized
Ages
18 Years and older
Sex
Male
01

Study summary

This randomized phase II trial studies how well docetaxel and prednisone with or without vaccine therapy works in treating patients with hormone-resistant prostate cancer that has spread to other parts of the body. Drugs used in chemotherapy, such as docetaxel and prednisone, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Vaccines made from an antigen may help the body build an effective immune response to kill tumor cells. It is not yet known whether docetaxel and prednisone are more effective with or without vaccine therapy in treating prostate cancer.

Read the detailed description

PRIMARY OBJECTIVES:

I. To evaluate the overall survival in patients treated with PSA-TRICOM (fowlpox-PSA-TRICOM vaccine and rilimogene-galvacirepvec) and docetaxel chemotherapy versus docetaxel chemotherapy only.

SECONDARY OBJECTIVES:

I. To evaluate the time to radiographic progression after beginning docetaxel chemotherapy in patients previously treated with PSA-TRICOM vaccine versus those not treated with this vaccine.

II. To compare objective responses (according to Response Evaluation Criteria in Solid Tumors [RECIST]) between the two treatment groups in those patients with measurable disease.

III. To evaluate prostate-specific antigen (PSA) response rates (decline >= 50%) in patients treated with PSA-TRICOM and docetaxel chemotherapy versus docetaxel chemotherapy only.

IV. To evaluate immune responses elicited in patients treated before and after docetaxel chemotherapy.

V. To evaluate the association between development of prostate antigen-specific immune responses and time to progression and overall survival.

VI. To evaluate the association of predicted survival (by Halabi nomogram) with actual survival in patients treated with PSA-TRICOM vaccine versus those not treated with this vaccine.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM A (vaccine and chemotherapy): Patients receive rilimogene-galvacirepvec subcutaneously (SC) on day 1 of course 1 and fowlpox-PSA-TRICOM vaccine SC on days 15, 29, 43, and 57 of course 1. Beginning on day 85 (day 1 of course 2), patients receive docetaxel intravenously (IV) over 1 hour on day 1 and prednisone orally (PO) twice daily (BID) on days 1-21. Treatment with docetaxel and prednisone repeats every 21 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

ARM B (chemotherapy): Patients receive docetaxel IV over 1 hour on day 1 and prednisone PO BID on days 1-21. Treatment repeats every 21 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.

02

Conditions studied

  • Hormone-Resistant Prostate Cancer
  • Prostate Adenocarcinoma
  • Recurrent Prostate Carcinoma
  • Stage IV Prostate Cancer

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03

In context

Prostatic Neoplasms

6,370 studies on the registry are indexed under Prostatic Neoplasms; 1,400 are open to participants now.

This study's enrollment of 10 is below the median of 58 across 4,822 interventional studies indexed under Prostatic Neoplasms.

Browse Prostatic Neoplasms studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,506 studies on the registry; 334 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 365 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Patient must have histologically confirmed diagnosis of prostate cancer (adenocarcinoma of the prostate)
  • Patient must have metastatic disease as evidenced by the presence of soft tissue and/or bone metastases on imaging studies (computed tomography [CT] of abdomen/pelvis, bone scintigraphy)
  • Patient must have castrate-resistant disease, defined as follows:

    • Patient must have received standard of care androgen deprivation treatment (ADT) before trial entry (surgical castration versus gonadotropin-releasing hormone [GnRH] analogue or antagonist treatment); subjects receiving GnRH analogue or antagonist must continue this treatment throughout the time on this study
    • Patient must have been treated previously with a nonsteroidal antiandrogen, with evidence of subsequent disease progression; subjects must be off use of anti-androgen for at least 4 weeks (for flutamide) or 6 weeks (for bicalutamide or nilutamide) prior to randomization; subjects who demonstrate an anti-androgen withdrawal response, defined as a >= 25% decline in PSA within 4-6 week of stopping a nonsteroidal antiandrogen are not eligible until the PSA rises above the nadir observed after antiandrogen withdrawal
    • Patient must have castration levels of testosterone (\< 50 ng/dL) within 4 weeks prior to randomization
  • Patient must have progressive disease while receiving ADT as defined by any one of the following as per the Prostate Cancer Clinical Trials Working Group 2 (PCWG2) criteria:

    • PSA: at least two consecutive rises in serum PSA, obtained at a minimum of 1-week intervals, and each value >= 2.0 ng/mL
    • Measurable disease: >= 50% increase in the sum of the cross products of all measurable lesions or the development of new measurable lesions by RECIST criteria version 1.1; the greatest diameter of a target lesion must be at least 1.0 cm by CT scan (1.5 cm in shortest axis for lymph nodes)
    • Non-measurable (bone) disease: the appearance of two or more new areas of uptake on bone scan consistent with metastatic disease compared to previous imaging during castration therapy; the increased uptake of pre-existing lesions on bone scan will not be taken to constitute progression, and ambiguous results must be confirmed by other imaging modalities (e.g. X-ray, CT or magnetic resonance imaging [MRI])
  • Patient must not have poor prognosis features suggested by the following required information:

    • Presence of visceral (non-lymph node, non-bone) metastases
    • Poor performance status (Eastern Cooperative Oncology Group [ECOG] performance status [PS] of 2 or greater)
    • Alkaline phosphatase (IU/L) > 2 x institutional upper limit of normal
    • Lactate dehydrogenase (LDH) (U/L) > 2 x institutional upper limit of normal
  • Patient must have an ECOG performance status of 0 or 1
  • White blood cell (WBC) count >= 2000/mm\^3
  • Absolute neutrophil count (ANC) >= 1500/mm\^3
  • Platelet count >= 100,000/mm\^3
  • Creatinine =\< 2.0 mg/dL
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT) =\< 1.5 x institutional upper limit of normal (ULN)
  • Total bilirubin \< institutional upper limit of normal (ULN)
  • Patient must have completed any prior treatments (apart from androgen deprivation as previously described) >= 4 weeks prior to randomization and have recovered (to \< grade 2) from any acute toxicities attributed to this prior treatment
  • Patient must agree to use an accepted and effective method of contraception prior to study entry and for the duration of study participation (or at least 4 months after the last vaccination in subjects receiving vaccine series); if patient impregnates a woman while participating in this study, he should inform his treating physician immediately
  • Patient must not be receiving any other investigational agents or be receiving concurrent anticancer therapy other than ADT
  • Patient must not have been treated with a prior anti-cancer vaccine (including sipuleucel-T, Provenge®)
  • Patient must not have received treatment with any of the following medications within 4 weeks of randomization or while on study:

    • Systemic corticosteroids (excluding prednisone and dexamethasone administered as part of study protocol); inhaled, intranasal or topical corticosteroids are acceptable; steroid eye drops are contraindicated however, for 2 weeks prior to vaccination and for at least 4 weeks after vaccinia vaccination
    • PC-SPES
    • Saw palmetto
    • Megestrol
    • Ketoconazole
    • 5-alpha-reductase inhibitors - patients already taking 5-alpha-reductase inhibitors prior to 28 days prior to randomization may stay on these agents throughout the course of therapy, but these should not be started while patients are on study
    • Diethyl stilbestrol
    • Any other hormonal agent or supplement with possible anti-cancer activity
  • Patient must not have been treated with external beam radiation therapy within 4 weeks of randomization
  • Patient must not have received prior radiation therapy to > 30% of bone marrow
  • Patient must not have had surgery within 4 weeks of randomization
  • Patient must not have received prior chemotherapy within 6 months of randomization; prior and/or concurrent treatment with bisphosphonates, however, is permitted
  • Patient must not have received prior chemotherapy for metastatic prostate cancer
  • Patient cannot have a known history of human immunodeficiency virus (HIV) 1 or 2, human T-lymphotropic virus (HTLV)-1, hepatitis B, or hepatitis C (or any other potentially immunosuppressive infection); eligible subjects must have negative serologic testing for HIV, hepatitis B surface antigen, and hepatitis C
  • Patient cannot have a history of autoimmune disease requiring active immunosuppressive therapy or have organ dysfunction >= grade 2 as a result of known autoimmune disease; eligible subjects must have antinuclear antibodies (ANA) titer \< 1:320
  • Patient must not have undergone splenectomy
  • Patient must not have other active malignancies other than non-melanoma skin cancers or carcinoma in situ of the bladder; subjects with a history of other cancers who have been adequately treated and have been recurrence-free for >= 3 years are eligible
  • Patient cannot have a known allergy to eggs
  • Patient cannot have a known intolerance or allergic reactions to docetaxel or compounds of similar chemical or biologic composition
  • Patient cannot have a known history of allergy or intolerable reaction to a previous vaccinia virus vaccination (e.g., smallpox)
  • Patient or close household contacts of patient (those who share housing or have close physical contact with the patient) cannot have close physical contact to persons with the following conditions within 3 weeks after potential vaccinia immunization:

    • A history of eczema, active eczema or other acute, chronic or exfoliative skin conditions, including Darier's disease (e.g. atopic dermatitis, burns, impetigo, varicella zoster, severe acne, or open wounds)
    • Pregnant or nursing women
    • Children under 3 years of age
    • Immunodeficient or immunosuppressed persons (e.g. HIV, or treated for other diseases with immunosuppressive agents)
    • Any other moderate or severe acute illness until the illness resolves Patients who would be unable to avoid these conditions for a 3-week period are not eligible; patients should also refer to the patient instruction sheet for vaccinia virus
  • Patient cannot have known brain metastases
  • Patient cannot have a known history of recent (within 6 months) stroke, myocardial infarction, unstable angina, New York Heart Association class II-IV congestive heart failure, or significant cardiomyopathy requiring treatment
  • Patient cannot take known strong inducers or inhibitors of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) within 2 weeks of beginning docetaxel through its discontinuation; substrates of CYP3A4 with a narrow therapeutic/toxicity window may be used with caution, with prior approval of the study chair or institution's principal investigator (PI)
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
10 participants (actual)

Study arms

  • Experimental
    Arm A (vaccine therapy and chemotherapy)

    Patients receive rilimogene-galvacirepvec SC on day 1 of course 1 and fowlpox-PSA-TRICOM vaccine SC on days 15, 29, 43, and 57 of course 1. Beginning on day 85 (day 1 of course 2), patients receive docetaxel IV over 1 hour on day 1 and prednisone PO BID on days 1-21. Treatment with docetaxel and prednisone repeats every 21 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Docetaxel · Other: Laboratory Biomarker Analysis · Drug: Prednisone · Biological: Recombinant Fowlpox-PSA(L155)/TRICOM Vaccine · Biological: Rilimogene Galvacirepvec

  • Active comparator
    Arm B (docetaxel, prednisone)

    Patients receive docetaxel IV over 1 hour on day 1 and prednisone PO BID on days 1-21. Treatment repeats every 21 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.

    Drug: Docetaxel · Other: Laboratory Biomarker Analysis · Drug: Prednisone

Interventions

  • DrugDocetaxel

    Given IV

    Also known as: Docecad, RP56976, Taxotere, Taxotere Injection Concentrate

  • OtherLaboratory Biomarker Analysis

    Correlative studies

  • DrugPrednisone

    Given PO

    Also known as: .delta.1-Cortisone, 1, 2-Dehydrocortisone, Adasone, Cortancyl, Dacortin, DeCortin, Decortisyl, Decorton, Delta 1-Cortisone, Delta-Dome, Deltacortene, Deltacortisone, Deltadehydrocortisone, Deltasone, Deltison, Deltra, Econosone, Lisacort, Meprosona-F, Metacortandracin, Meticorten, Ofisolona, Orasone, Panafcort, Panasol-S, Paracort, PRED, Predicor, Predicorten, Prednicen-M, Prednicort, Prednidib, Prednilonga, Predniment, Prednisonum, Prednitone, Promifen, Servisone, SK-Prednisone

  • BiologicalRecombinant Fowlpox-PSA(L155)/TRICOM Vaccine

    Given SC

    Also known as: PROSTVAC-F, rFowlpox-PSA(L155)/TRICOM Vaccine

  • BiologicalRilimogene Galvacirepvec

    Given SC

    Also known as: PROSTVAC, Prostvac-V, Recombinant Vaccinia-PSA(L155)-TRICOM Vaccine, Recombinant Vaccinia-PSA(L155)/TRICOM, Recombinant Vaccinia-PSA(L155)/TRICOM Vaccine, rVaccinia-Prostate-Specific Antigen/TRICOM Vaccine, rVaccinia-PSA(L155)-TRICOM Vaccine

06

What researchers measure

Primary outcomes

  1. Overall Survival

    Overall survival is defined as the time from randomization to death or the date of last known alive.

    Time frame: Assessed every 3 months for 2 years, and then every 6 months for 3 years

07

Results

Posted Jul 23, 2014

Participant flow

Participants were recruited from Eastern Cooperative Oncology Group (ECOG) member institutions between December 29, 2010 and March 26, 2012.

Participant flow — Overall Study
MilestoneArm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)
Started73
Treated62
Completed21
Not completed52
Withdrew: Adverse event10
Withdrew: Death10
Withdrew: Physician decision21
Withdrew: Never started treatment11

Outcome measures

PrimaryOverall Survival

Overall survival is defined as the time from randomization to death or the date of last known alive.

Time frame:
Assessed every 3 months for 2 years, and then every 6 months for 3 years
Reported as:
Median · Months
Overall Survival
MonthsArm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)
Overall Survival20.8 (3.4 to NA)NA (14.8 to NA)

Adverse events

Collected over Assessed every 3 weeks while on treatment and for 30 days after the end of treatment. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Arm A (Vaccine and Chemotherapy)—5/6 (83.3%)5/6 (83.3%)
Arm B (Chemotherapy)—2/2 (100%)2/2 (100%)
Most frequent serious events
Most frequent serious events
EventArm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)
Neutrophil count decreasedInvestigations4/62/2
Febrile neutropeniaBlood and lymphatic system disorders1/61/2
White blood cell decreasedInvestigations3/61/2
FatigueGeneral disorders1/60/2
SepsisInfections and infestations1/60/2
Lymphocyte count decreasedInvestigations1/60/2
DehydrationMetabolism and nutrition disorders1/60/2
SyncopeNervous system disorders1/60/2
Thromboembolic eventVascular disorders1/60/2
Most frequent other events
Showing 10 of 45
Most frequent other events
EventArm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)
FatigueGeneral disorders5/62/2
AlopeciaSkin and subcutaneous tissue disorders4/62/2
DysgeusiaNervous system disorders3/62/2
DiarrheaGastrointestinal disorders4/61/2
NauseaGastrointestinal disorders4/60/2
Peripheral sensory neuropathyNervous system disorders4/61/2
AnemiaBlood and lymphatic system disorders2/61/2
Edema limbsGeneral disorders3/61/2
Injection site reactionGeneral disorders1/61/2
Nail ridgingSkin and subcutaneous tissue disorders1/61/2

Baseline characteristics

All randomized patients are included in this analysis.

Age, Continuous
Age, Continuous(years)Arm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)Total
Median63 (56 to 72)65 (65 to 73)64 (56 to 73)
Sex: Female, Male
Sex: Female, Male(Participants)Arm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)Total
Female000
Male7310
Region of Enrollment
Region of Enrollment(participants)Arm A (Vaccine and Chemotherapy)Arm B (Chemotherapy)Total
United States7310
08

Study locations

14 sites
  • Mayo Clinic in Florida
    Jacksonville, Florida 32224-9980, United States
  • Hematology and Oncology Associates
    Chicago, Illinois 60611, United States
  • Northwestern University
    Chicago, Illinois 60611, United States
  • Hematology Oncology Associates of Illinois-Highland Park
    Highland Park, Illinois 60035, United States
  • Presence Saint Mary's Hospital
    Kankakee, Illinois 60901, United States
  • NorthShore Hematology Oncology-Libertyville
    Libertyville, Illinois 60048, United States
  • Illinois Cancer Specialists-Niles
    Niles, Illinois 60714, United States
  • Hematology Oncology Associates of Illinois - Skokie
    Skokie, Illinois 60076, United States
  • Ochsner Medical Center Jefferson
    New Orleans, Louisiana 70121, United States
  • Johns Hopkins University/Sidney Kimmel Cancer Center
    Baltimore, Maryland 21287, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Laura and Isaac Perlmutter Cancer Center at NYU Langone
    New York, New York 10016, United States
  • University of Wisconsin Hospital and Clinics
    Madison, Wisconsin 53792, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01145508
Lead sponsor
National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Jun 16, 2010
Start date
Aug 2010
Primary completion
Oct 2012
Completion
Oct 2015
Results posted
Jul 23, 2014
Last update
Sep 19, 2017

Study contacts

Douglas McNeel
principal investigator · ECOG-ACRIN Cancer Research Group

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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