Background:
Metastatic castrate-sensitive prostate cancer is cancer that has spread beyond the
prostate area. It can be controlled by lowering the amount of testosterone in the body.
This is called androgen deprivation therapy (ADT). The vaccine PROSTVAC might help the
immune system kill cancer cells. Researchers want to add PROSTVAC and docetaxel
chemotherapy to ADT. They think this may work better against prostate cancer than ADT
alone.
Objective:
To test if adding PROSTVAC and docetaxel to ADT works better against prostate cancer than
ADT alone.
Eligibility:
Men ages 18 years and over with metastatic castrate-sensitive prostate cancer
Design:
Participants will be screened with:
Physical exam
Medical history
Blood tests
Possible computed tomography (CT), magnetic resonance imaging (MRI), or bone scan:
Participants lie in a machine. The machine takes pictures of the body.
Electrocardiogram: Soft electrodes are stuck to the skin to record heart signals.
Participants will have 2 optional tumor biopsies during the study.
Participants will join 1 of 2 groups. Both groups will get:
ADT
Docetaxel by vein
Steroids by mouth or vein before each docetaxel infusion
PROSTVAC injection
Both groups first have ADT. One to 4 months after, they have:
Group A:
Docetaxel every 3 weeks for 6 cycles
PROSTVAC 3 weeks after the last infusion
Booster injections 2 weeks later and then every 3 weeks, for 6 boosters total
Group B:
PROSTVAC
Booster 2 weeks later
Docetaxel hours later
Docetaxel and the booster every 3 weeks for 6 cycles
Participants will have a visit 4-5 weeks after the last treatment. They will then have
visits every 12 weeks.
Participants will be followed for up to 15 years. This includes physical exams every year
for 5 years.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT02649855.
Background:
- A phase III trial demonstrated that combining docetaxel and androgen deprivation
therapy (ADT) significantly improved survival (57.6 vs 44.0 months (hazard ration
(HR)=0.56, (0.44-0.70), p <0.0001) for men with metastatic castration sensitive
prostate cancer (mCSPC).
- PROSTVAC (developed by the National Cancer Institute [NCI] and licensed to Bavarian
Nordic Immunotherapeutics, Mountain View, California (CA) is a therapeutic cancer
vaccine for prostate cancer.
- Preclinical and clinical studies support the potential synergy in the combination of
docetaxel and PROSTVAC. The potential to combine docetaxel with vaccine in mCSPC
could improve upon the survival advantage that has been previously seen.
Objectives:
Primary
-To determine if PROSTVAC combined with docetaxel is able to induce greater antigen
spreading (i.e. a broader immune response) with greater associated response score
compared to docetaxel alone after 19 weeks.
Key Eligibility Criteria:
- Must have castrate sensitive prostate cancer (rising PSA and testosterone over 100)
or is within 134 days of starting ADT (Arm A or B) or within 28 days of start ADT
(Arm C)
- Histopathological confirmation of prostate cancer
- Patients must have metastatic disease
- Patients must have a performance status of 0 to 2 according to the Eastern
Cooperative Oncology Group (ECOG) criteria
- Patients must have adequate bone marrow, hepatic, and renal function
Design
- This is a randomized trial of ADT followed by simultaneous docetaxel 75 mg/m(2)
every (q)3 weeks x 6 cycles + PROSTVAC q3 weeks x 6 cycles versus ADT followed by
sequential docetaxel 75 mg/m(2) q3 weeks x 6 cycles followed by PROSTVAC q3 weeks x
6 cycles in men with newly diagnosed mCSPC.
- Patients who have not started ADT or who have been on ADT 28 days or fewer will be
assigned to treatment with PROSTVAC for 4 - 6 injections followed by docetaxel 75
mg/m^2 q3 weeks x 6 cycles.
Lead OrganizationNational Cancer Institute
Principal InvestigatorRavi A. Madan