NCT02269982

Brief Summary

This study will develop a first-in-man CTC-based molecular taxonomy of CRPC in the context of novel AR-directed therapies, categorize different patterns of resistance in this disease setting, and describe their evolution over time and treatment.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started May 2015

Longer than P75 for all trials

Geographic Reach
1 country

5 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 9, 2014

Completed
12 days until next milestone

First Posted

Study publicly available on registry

October 21, 2014

Completed
7 months until next milestone

Study Start

First participant enrolled

May 14, 2015

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2017

Completed
1.7 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2019

Completed
Last Updated

June 10, 2019

Status Verified

June 1, 2019

Enrollment Period

2.3 years

First QC Date

October 9, 2014

Last Update Submit

June 7, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • Comparison of median progression free survival (PFS) to AR-v7 status

    2 years

Secondary Outcomes (7)

  • Determine the prevalence of defined categories of a molecular taxonomy of mCRPC using CTC biomarkers and correlate each to clinical benefit (PSA response, PFS)

    4 years

  • Compare levels of circulating epithelial to mesenchymal transition (EMT) and other epithelial plasticity (EP) biomarkers with mCRPC taxonomic categories and clinical outcomes (PSA decline rates, PFS)

    4 years

  • Determine molecular lesions in CTCs and ctDNA that consistently emerge during enzalutamide and taxane chemotherapy progression in men with mCRPC

    4 years

  • Correlate specific AR-v7 assays with clinical outcomes (PSA decline rates, PFS)

    4 years

  • Correlatate other AR-variants with clinical outcomes (PSA decline rates, PFS)

    4 years

  • +2 more secondary outcomes

Study Arms (1)

men with mCRPC prior to enzalutamide/abiraterone

Device: AR-v7 assays

Interventions

men with mCRPC prior to enzalutamide/abiraterone

Eligibility Criteria

Age18 Years+
Sexmale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

The study population includes men with progressive metastatic castration resistant prostate cancer (mCRPC).

You may qualify if:

  • Histologically confirmed diagnosis of adenocarcinoma of the prostate. Pure small cell or neuroendocrine tumors of the prostate are not permitted.
  • Clinical or radiographic evidence of metastatic disease.
  • Planned therapy with either enzalutamide and/or abiraterone acetate within the coming 6 weeks
  • Castrate levels of testosterone (\<50 ng/dl) at most recent assessment and/or documented ongoing Androgen Deprivation Therapy for at lease three months.
  • Evidence of disease progression on or following most recent therapy as evidenced by at least one of the following:
  • Radiographic evidence of disease progression as defined by one or more new bone scan lesions that is not consistent with flare/healing, or growth of soft tissue/visceral metastases to greater than one centimeter (cm) in longest diameter (2 cm shortest diameter for lymph nodes).
  • Clinical progression as defined by the treating physician (such as pain progression)
  • Consecutive PSA rises meeting PSA progression criteria as determined by PCWG2 criteria (increase that is \>25% and \>2 ng/mL above the nadir, and which is confirmed by a second value 3 or more weeks later)
  • At least two of the following high risk features during screening for rapid disease progression:
  • Anemia with a hemoglobin \<12.0 g/dl
  • Elevated alkaline phosphatase above the institution upper limit of normal
  • High lactate dehydrogenase (LDH) above the upper limit of normal
  • Prior therapy with enzalutamide, abiraterone acetate, or orteronel. Patients are not permitted if they are continuing on the same therapy or restarting a therapy that they have been exposed to in the past.
  • Presence of visceral metastasis on imaging
  • Presence of clinically significant pain requiring opioid analgesia
  • +5 more criteria

You may not qualify if:

  • History of intercurrent or past medical or psychiatric illness that would make participation in a blood drawing protocol difficult or not feasible at the discretion of the principal investigator or co-investigator(s).
  • Treatment with an anthracycline or mitoxantrone within 1 week of CTC collection
  • Prior docetaxel in the castration resistant metastatic setting. Patients treated with docetaxel for metastatic castration sensitive disease will be eligible.
  • Unwillingness to be followed longitudinally for serial CTC biomarker studies.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

University of Chicago

Chicago, Illinois, 60637, United States

Location

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

Baltimore, Maryland, 21287, United States

Location

Memorial Sloan Kettering Cancer Center

New York, New York, 10065, United States

Location

Weill Medical College of Cornell University

New York, New York, 10065, United States

Location

Duke University

Durham, North Carolina, 27710, United States

Location

Related Publications (3)

  • Scher HI, Armstrong AJ, Schonhoft JD, Gill A, Zhao JL, Barnett E, Carbone E, Lu J, Antonarakis ES, Luo J, Tagawa S, Dos Anjos CH, Yang Q, George D, Szmulewitz R, Danila DC, Wenstrup R, Gonen M, Halabi S. Development and validation of circulating tumour cell enumeration (Epic Sciences) as a prognostic biomarker in men with metastatic castration-resistant prostate cancer. Eur J Cancer. 2021 Jun;150:83-94. doi: 10.1016/j.ejca.2021.02.042. Epub 2021 Apr 21.

  • Gupta S, Halabi S, Kemeny G, Anand M, Giannakakou P, Nanus DM, George DJ, Gregory SG, Armstrong AJ. Circulating Tumor Cell Genomic Evolution and Hormone Therapy Outcomes in Men with Metastatic Castration-Resistant Prostate Cancer. Mol Cancer Res. 2021 Jun;19(6):1040-1050. doi: 10.1158/1541-7786.MCR-20-0975. Epub 2021 Mar 26.

  • Armstrong AJ, Halabi S, Luo J, Nanus DM, Giannakakou P, Szmulewitz RZ, Danila DC, Healy P, Anand M, Rothwell CJ, Rasmussen J, Thornburg B, Berry WR, Wilder RS, Lu C, Chen Y, Silberstein JL, Kemeny G, Galletti G, Somarelli JA, Gupta S, Gregory SG, Scher HI, Dittamore R, Tagawa ST, Antonarakis ES, George DJ. Prospective Multicenter Validation of Androgen Receptor Splice Variant 7 and Hormone Therapy Resistance in High-Risk Castration-Resistant Prostate Cancer: The PROPHECY Study. J Clin Oncol. 2019 May 1;37(13):1120-1129. doi: 10.1200/JCO.18.01731. Epub 2019 Mar 13.

Biospecimen

Retention: SAMPLES WITH DNA

All 120 subjects will have blood collected at 3 time points for CTC-based AR-v7 analysis. Biopsy samples will be collected from up to 20 consenting subjects who are already undergoing a standard of care metastatic biopsy or from a research only biopsy.

MeSH Terms

Conditions

Prostatic Neoplasms

Condition Hierarchy (Ancestors)

Genital Neoplasms, MaleUrogenital NeoplasmsNeoplasms by SiteNeoplasmsGenital Diseases, MaleGenital DiseasesUrogenital DiseasesProstatic DiseasesMale Urogenital Diseases

Study Officials

  • Andrew J Armstrong, MD

    Duke University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 9, 2014

First Posted

October 21, 2014

Study Start

May 14, 2015

Primary Completion

September 1, 2017

Study Completion

April 30, 2019

Last Updated

June 10, 2019

Record last verified: 2019-06

Locations