Prostate Cancer Metastatic Clinical Trial
Official title:
A Randomized, Open-label, Phase 2 Trial of Sipuleucel-T With Concurrent Versus Sequential Administration of Abiraterone Acetate Plus Prednisone in Men With Metastatic Castrate Resistant Prostate Cancer (mCRPC)
The purpose of this study was to evaluate the impact of concurrent versus sequential administration of abiraterone acetate plus prednisone on the ability to manufacture sipuleucel-T (by assessing sipuleucel-T product parameters), and to assess the safety and efficacy of sipuleucel-T with concurrent or sequential administration of abiraterone acetate plus prednisone in men with metastatic castrate resistant prostate cancer.
Subjects underwent screening procedures at the Screening Visit to ensure that they met the
inclusion and exclusion criteria outlined in the protocol. Subjects were evaluated for
eligibility criteria, and if eligible, were registered and randomized in a 1:1 into either
the Concurrent Arm or the Sequential Arm.
Subjects in both arms underwent a standard 1.5 to 2.0 blood volume leukapheresis, followed
approximately 3 days later by an intravenous (IV) infusion of sipuleucel-T. This process
occurred at approximately 2-week intervals. A course of sipuleucel-T treatment comprised
three infusions.
Following the first infusion, subjects were limited to a maximum of three total product
failures for all subsequent infusions, due specifically to insufficient total nucleated cell
(TNC) count and/or CD54 upregulation. These subjects received no further leukaphereses or
sipuleucel-T infusions, but did receive abiraterone acetate plus prednisone per the schedule
of the arm to which they were randomized. All subjects received a total of 26 weeks of
abiraterone acetate plus prednisone therapy.
All immune monitoring (IM) endpoints were collected from all subjects who received at least
one infusion. Cellular and serological immune responses were assessed for subjects in both
arms. In both arms, IM blood samples were collected at baseline (screening);
pre-leukapheresis 2 and 3; post-infusion 1, 2, and 3; and weeks 6, 10, 14, and 26, with the
timing of IM visits based on the onset of treatment (Day 0). Day 0 was the day of the first
infusion. Post-infusion blood draws occurred at 3 hours (allowable window 1-24 hours) after
each infusion. If a subject received only one or two infusions, immune samples were still
drawn at the scheduled time points based on the first infusion (Day 0). If the subject was
not scheduled to undergo further leukapheresis, no other pre-leukapheresis procedures were
conducted.
During the active follow-up phase, subjects were followed from registration through the
Post-Treatment Visit (30-37 days post-last study treatment), or until disease progression,
unacceptable toxicity, or death, whichever occurred first.
During the long-term follow-up (LTFU) phase, subjects were followed from the Post-Treatment
Visit for up to 3 years from the date of registration/randomization. During the LTFU phase,
only new treatment-related serious adverse event (SAE)s, cerebrovascular event (CVE)s
(regardless of causality), the first anti-cancer therapy and first chemotherapy, and survival
status were collected via a quarterly telephone call.
Overall survival was measured as the time from randomization until death over a 3-year
period.
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