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CompletedNCT01194271Updated Jun 6, 2024Results posted

Neoadjuvant Ipilimumab in Prostate Cancer

A Phase 2 interventional study of Leuprolide Acetate and Ipilimumab in Prostate Cancer, sponsored by M.D. Anderson Cancer Center. Completed at 1 site in United States. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-06-06.

Sponsored by M.D. Anderson Cancer Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
19
Allocation
Not applicable
Ages
18 Years and older
Sex
Male
01

Study summary

The goal of this clinical research study is to learn how ipilimumab in combination with Lupron (leuprolide acetate) affects the body's own defense (immune) system before having surgery to remove prostate cancer. The safety of the drug combination will also be studied.

Read the detailed description

The Study Drugs:

Ipilimumab is designed to cause an immune response in your body by blocking 2 specific molecules that usually block an immune response. This may help to kill cancer cells.

Leuprolide acetate is designed to lower the level of testosterone (a male hormone) in the blood. This may slow the growth of cancer cells.

Study Drug Administration:

If you are found to be eligible to take part in this study, you will receive a leuprolide acetate injection in your muscle. This is considered Week 0. One week later, you will begin treatment with ipilimumab. Ipilimumab will be given by vein over 90 minutes during Weeks 1 and 4 (about 21 days apart). During the infusion, your blood pressure will be measured every 30 minutes, and again an hour after you are finished receiving the drug.

Study Visits:

At Weeks 0, 1, 4 and 7, the following tests and procedures will be performed:

  • You will have a physical exam, including measurement of your vital signs and weight.
  • You will be asked about any drugs or treatments you may be receiving.
  • You will be asked about any side effects you may have experienced.
  • Your performance status will be recorded.
  • Blood (about 7-10 tablespoons) will be drawn for routine tests. This blood will also be tested to measure your protein, PSA and testosterone levels, to check the function of your thyroid and adrenal glands, and to test for an immune response.

Surgery:

About 4 weeks after your second treatment with ipilimumab, you will have surgery to remove your prostate gland. You will be asked to sign a separate consent form that describes the surgery and its risks. A sample of the leftover prostate gland tissue from surgery will be tested for an immune response. On that day, the following tests and procedures will be performed:

Between 14 and 24 weeks after your surgery, you will return to the clinic for your post-operative follow-up visit. The following tests and procedures will be performed:

  • You will have a physical exam, including measurement of your vital signs and weight.
  • Your performance status will be recorded.
  • You will be asked about any drugs or treatments you may be receiving.
  • You will be asked about any side effects you have experienced since your last visit.
  • Blood (about 7-10 tablespoons) will be drawn for routine tests. This blood will also be used to measure your protein, testosterone and PSA levels, to check the function of your thyroid and adrenal glands, and to test for an immune response.
  • You will have a bone scan, and either a CT or MRI scan of your chest, abdomen, and pelvis to check the status of the disease.

Length of Study:

You will only receive 2 treatments with ipilimumab on this study. You will be on study until 24 weeks after surgery. You will be taken off study if intolerable side effects occur, if the disease gets worse, or if the study doctor thinks it is in your best interest to be taken off study.

This is an investigational study. Ipilimumab is not FDA approved or commercially available. Ipilimumab is currently being used for research purposes only. Leuprolide acetate is FDA approved for management of metastatic prostate cancer but is not approved for use before definitive surgery. It is commercially available to treat prostate cancer.

Up to 20 patients will take part in this study. All will be enrolled at MD Anderson.

02

Conditions studied

  • Prostate Cancer

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Keywords

  • Hormone Ablation
  • Prostate adenocarcinoma
  • Radical prostatectomy
  • Leuprolide Acetate
  • Lupron Depot
  • Ipilimumab
  • BMS-734016
  • MDX010
03

In context

Prostatic Neoplasms

6,484 studies on the registry are indexed under Prostatic Neoplasms; 1,415 are open to participants now.

This study's enrollment of 19 is below the median of 58 across 4,908 interventional studies indexed under Prostatic Neoplasms.

Browse Prostatic Neoplasms studies →

Lead sponsor

M.D. Anderson Cancer Center is the lead sponsor of 3,044 studies on the registry; 578 are open to participants now.

Of its 608 completed or terminated interventional studies of FDA-regulated products, 407 (67%) 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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Willing and able to give written informed consent;
  2. Histologic Documentation: Histologic documentation of prostatic adenocarcinoma. Patients with small cell, neuroendocrine, or transitional cell carcinomas are not eligible. All eligible patients must have a known Gleason sum based on biopsy or TURP at the time of registration.
  3. Locally Resectable Disease: Patients must have disease (localized or locally advanced) which is deemed by the surgeon to be resectable. Lymph node metastasis or lymph nodes suspicious of harboring metastasis should be deemed surgically resectable by the surgeon.
  4. Determination of high-risk status: Patients must have either: 1) a Prostate biopsy Gleason sum >/= 8 OR 2) PSA >/= 20.
  5. Prior Treatment: No prior treatment for prostate cancer including prior surgery (excluding TURP), pelvic lymph node dissection, radiation therapy, or chemotherapy. Patients who have initiated leuprolide acetate within 1 week of signing consent will be eligible.
  6. Patients must be appropriate candidates for radical prostatectomy. Evidence of underlying cardiac disease should be evaluated prior to enrollment to ensure that patients are not at high risk of cardiac complications.
  7. ECOG performance status of 0 or 1;
  8. Required values for initial laboratory tests: a) WBC >/= 3000/uL; b) ANC >/= 1500/uL, c) Platelets >/= 100 x 10\^3/uL; d) Hemoglobin >/= 9 g/dL; e) Creatinine \</= 2.0 x ULN; f) AST \</= 2.5 x ULN; g) Bilirubin 0 - 1.0 mg/dL, except patients with Gilbert's Syndrome, who must have a total bilirubin less than 3.0 mg/mL;
  9. Men >/= 18 years of age
  10. Patients must agree to practice barrier birth control methods while on therapy, prior to surgery.

Exclusion criteria

Exclusion Criteria:

  1. Any other malignancy from which the patient has been disease-free for less than 5 years, with the exception of adequately treated and cured basal or squamous cell skin cancer.
  2. Autoimmune disease: Patients with a history of Inflammatory Bowel Disease (including Crohn's disease and ulcerative colitis) are excluded from this study as are patients with a history of autoimmune disease (e.g., rheumatoid arthritis, systemic progressive sclerosis [scleroderma], Systemic Lupus Erythematosus, autoimmune vasculitis [e.g., Wegener's Granulomatosis]).
  3. Known HIV or chronic hepatitis.
  4. Any underlying medical condition, which in the opinion of the Investigator, will make the administration of study drug hazardous or obscure the interpretation of adverse events, such as a condition associated with frequent diarrhea.
  5. Patients who have had a history of acute diverticulitis, intra-abdominal abscess, GI obstruction, abdominal carcinomatosis which are known risks factors for bowel perforation, should be excluded from the study.
  6. Any non-oncology vaccine therapy used for prevention of infectious diseases (for up to one month prior to or after any dose of ipilimumab.
  7. Concomitant therapy with any of the following: IL-2, interferon or other non-study immunotherapy regimens; cytotoxic chemotherapy; immunosuppressive agents; other investigation therapies; or chronic use of systemic corticosteroids (used in the management of cancer or non-cancer-related illnesses);
  8. Previous treatment with other investigational products within 30 days;
  9. Previous enrollment in another MDX-010 (BMS-734016) clinical trial or prior treatment with a CD137 agonist or CTLA-4 inhibitor or agonist
  10. Concurrent use of 5-alpha-reductase inhibitors (finasteride, dutasteride).
  11. Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious disease) illness must not be enrolled in this study.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
19 participants (actual)

Study arms

  • Experimental
    Neoadjuvant Ipilimumab

    Leuprolide Acetate 22.5 mg administered as a single intramuscular 3 month depot + Ipilimumab 10 mg/kg by vein administered as 2 single doses, 3 weeks apart after hormone therapy + Radical Prostatectomy Surgery to remove prostate gland approximately 4 weeks after the second dose of Ipilimumab.

    Drug: Leuprolide Acetate · Drug: Ipilimumab · Procedure: Radical Prostatectomy

Interventions

  • 22.5 mg administered as a single intramuscular 3 month depot.

    Also known as: Lupron Depot

  • 10 mg/kg by vein administered as 2 single doses, 3 weeks apart after hormone therapy.

    Also known as: BMS-734016, MDX010

  • ProcedureRadical Prostatectomy

    Surgery to remove prostate gland approximately 4 weeks after the second dose of Ipilimumab.

06

What researchers measure

Primary outcomes

  1. Immunologic Response: Number of Participants With Immune Response

    Immunological response assays were measured at several time points starting at baseline until the eighth week after starting the medicine for each participant. The immunological responses measured were Cluster of Differentiation 4 (CD4), Cluster of Differentiation 8 (CD8) and Inducible T-cell Costimulatory (ICOS) markers. T-cells with the CD4 marker help coordinate the immune system response to an invader. Killer T-cells have the CD8 marker and are responsible for killing the invader. ICOS is a molecule which stimulates the activity of the immune response of the killer T-Cells and memory T cells. Participants with at least a 2 fold increase in the presence of CD4, CD8, or ICOS markers from the participant's baseline measure were considered a responder for that marker.

    Time frame: Baseline to Week 8

07

Results

Posted Sep 3, 2020

Participant flow

Recruitment period: September 1, 2010 to June 5, 2013. All recruitment done at The University of Texas MD Anderson Cancer Center.

Participant flow — Overall Study
MilestoneNeoadjuvant Ipilimumab
Started19
Completed16
Not completed3
Withdrew: Withdrawal by subject1
Withdrew: Ineligible, screen failure1
Withdrew: Death1

Outcome measures

PrimaryImmunologic Response: Number of Participants With Immune Response

Immunological response assays were measured at several time points starting at baseline until the eighth week after starting the medicine for each participant. The immunological responses measured were Cluster of Differentiation 4 (CD4), Cluster of Differentiation 8 (CD8) and Inducible T-cell Costimulatory (ICOS) markers. T-cells with the CD4 marker help coordinate the immune system response to an invader. Killer T-cells have the CD8 marker and are responsible for killing the invader. ICOS is a molecule which stimulates the activity of the immune response of the killer T-Cells and memory T cells. Participants with at least a 2 fold increase in the presence of CD4, CD8, or ICOS markers from the participant's baseline measure were considered a responder for that marker.

Time frame:
Baseline to Week 8
Reported as:
Count of participants · Participants
Immunologic Response: Number of Participants With Immune Response
ParticipantsNeoadjuvant Ipilimumab
CD412
CD87
ICOS9

Adverse events

Collected over Adverse event collection from baseline until 30 days after the last dose of drug, approximately 14 weeks post surgery.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Neoadjuvant Ipilimumab1/17 (5.9%)2/17 (11.8%)17/17 (100%)
Most frequent serious events
Most frequent serious events
EventNeoadjuvant Ipilimumab
Bilateral pulmonary embolismRespiratory, thoracic and mediastinal disorders1/17
Cardiac arrestCardiac disorders1/17
Most frequent other events
Showing 10 of 13
Most frequent other events
EventNeoadjuvant Ipilimumab
RashSkin and subcutaneous tissue disorders9/17
Colitis/DiarrheaGastrointestinal disorders9/17
FatigueGeneral disorders8/17
TransaminitisInvestigations7/17
HeadacheGeneral disorders6/17
PancreatitisGastrointestinal disorders5/17
HypophysitisInvestigations5/17
DehydrationMetabolism and nutrition disorders2/17
Cardiac arrestCardiac disorders1/17
Acute respiratory distress syndrome (ARDS)Respiratory, thoracic and mediastinal disorders1/17

Baseline characteristics

Two participants are not included in the demographics, excluded from the study due to screening failure or withdraw prior to being assigned any treatment.

Age, Continuous
Age, Continuous(years)Neoadjuvant Ipilimumab
Mean57.9 (36 to 71)
Sex: Female, Male
Sex: Female, Male(Participants)Neoadjuvant Ipilimumab
Female0
Male17
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Neoadjuvant Ipilimumab
White14
Black3
Region of Enrollment
Region of Enrollment(Participants)Neoadjuvant Ipilimumab
United States17
PSA (Average) Tumor Clinical Stage
PSA (Average) Tumor Clinical Stage(Participants)Neoadjuvant Ipilimumab
T15
T24
T38
Gleason Score
Gleason Score(Participants)Neoadjuvant Ipilimumab
71
85
910
101
Lupron Ipilimumab Dose
Lupron Ipilimumab Dose(Participants)Neoadjuvant Ipilimumab
One dose1
Two doses16
Surgery
Surgery(Participants)Neoadjuvant Ipilimumab
Yes16
No1
08

Study locations

1 site
  • University of Texas MD Anderson Cancer Center
    Houston, Texas 77030, United States
09

References and documents

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 6, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01194271
Responsible party
Sponsor
First posted
Sep 2, 2010
Start date
Sep 2010
Primary completion
Oct 2015
Completion
Oct 2015
Results posted
Sep 3, 2020
Last update
Jun 6, 2024

Study contacts

Padmanee Sharma, MD, PHD
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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