SPARC: Immediate Prostatectomy vs. Cabozantinib Followed by Prostatectomy in Men With High-Risk Prostate Cancer

Sponsor
Duke University (Other)
Overall Status
Terminated
CT.gov ID
NCT03964337
Collaborator
Exelixis (Industry)
3
1
2
14.6
0.2

Study Details

Study Description

Brief Summary

This is a prospective, randomized, open-label, phase II trial of cabozantinib in subjects with untreated, high risk prostate cancer undergoing radical prostatectomy. This multicenter study will enroll 30 subjects. Duke is the lead site for this trial. There will be a second site selected TBD.

Patients will be assigned (first 9 subjects only) or randomized 2:1 to either: (1) cabozantinib 40 mg by mouth daily for 4 weeks, followed by a 2 week drug washout period before prostatectomy (n = 20), or (2) immediate prostatectomy within 12 weeks of registration (n = 10). The first 9 subjects (6 subjects assigned to cabozantinib treatment, 3 subjects assigned to immediate prostatectomy) will constitute the Safety Lead-In Cohort, which will be only accrued at Duke. After six subjects have received cabozantinib and completed the 57-85 day safety visit without triggering a stopping rule, subjects may be accrued at the ex-Duke site.

The primary goal is to compare pathologic apoptotic indices (cleaved caspase-3) in prostatectomy specimens from patients who undergo immediate prostatectomy (controls) versus those who receive with cabozantinib followed by prostatectomy. The secondary objective is to conduct immune phenotypic profiling on the peripheral blood and tumor microenvironment in prostatectomy specimens from both groups. A statistical analysis will be used to compare the apoptotic indices between the two groups.

Condition or Disease Intervention/Treatment Phase
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
3 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Other
Official Title:
A Phase II, Open-Label Randomized Study of Immediate Prostatectomy vs. Cabozantinib Followed by Prostatectomy in Men With High-Risk Prostate Cancer (SPARC)
Actual Study Start Date :
Mar 17, 2020
Actual Primary Completion Date :
Jun 4, 2021
Actual Study Completion Date :
Jun 4, 2021

Arms and Interventions

Arm Intervention/Treatment
Experimental: Cabozantinib Followed by Prostatectomy (Arm A)

Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy.

Drug: Cabozantinib
Cabozantinib 40 mg by mouth daily for 4 weeks.
Other Names:
  • Cabometyx
  • Procedure: Radical Prostatectomy
    Radical prostatectomy as part of routine medical care.

    Active Comparator: Immediate Prostatectomy (Arm B)

    Control group will receive an immediate prostatectomy.

    Procedure: Radical Prostatectomy
    Radical prostatectomy as part of routine medical care.

    Outcome Measures

    Primary Outcome Measures

    1. Apoptotic Index in Prostatectomy Specimens From Patients Who Undergo Immediate Prostatectomy (Arm B) Versus Those Treated With Cabozantinib Followed by Prostatectomy (Arm A) [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Apoptotic index as measured by cleaved caspase-3 levels in tumor tissue

    Secondary Outcome Measures

    1. Immune Phenotyping of Myeloid-derived Suppressor Cells (MDSCs) [Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1]

      Percentage of MDSCs in peripheral blood and tumor tissue

    2. Immune Phenotyping of Neutrophils [Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1]

      Percentage of neutrophils in peripheral blood and tumor tissue

    3. Immune Phenotyping of M1 Macrophages [Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1]

      Percentage of M1 macrophages in peripheral blood and tumor tissue

    4. Immune Phenotyping of M2 Macrophages [Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1]

      Percentage of M2 macrophages in peripheral blood and tumor tissue

    5. Immunohistochemical (IHC) Analysis of CD8+ [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of CD8+ positive cells in tumor tissue

    6. Immunohistochemical (IHC) Analysis of Programmed Death Ligand-1 (PD-L1) [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of PD-L1 positive cells in tumor tissue

    7. Immunohistochemical (IHC) Analysis of Cytotoxic T-lymphocyte-associated Protein 4 (CTLA-4) [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of CTLA-4 positive cells in tumor tissue

    8. Immunohistochemical (IHC) Analysis of Interleukin-1 Receptor Antagonist (IL-1RA) [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of IL-1RA positive cells in tumor tissue

    9. Description of the Neutrophil Chemotactic Factor CXCL12 [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of neutrophil chemotactic factor CXCL12 positive cells in tumor tissue

    10. Description of the Neutrophil Chemotactic Factor HMGB1 [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of neutrophil chemotactic factor HMGB1 positive cells in tumor tissue

    11. Description of the MDSC-promoting Cytokine CCL5 [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of MDSC-promoting cytokine CCL5 positive cells in tumor tissue

    12. Description of the MDSC-promoting Cytokine CCL12 [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of MDSC-promoting cytokine CCL12 positive cells in tumor tissue

    13. Description of the MDSC-promoting Cytokine CD40 [At prostatectomy (Arm A: Day 43, Arm B: Day 1)]

      Percentage of MDSC-promoting cytokine CD40 cells in tumor tissue

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    Male
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Male, age ≥ 18 years old.

    2. ECOG performance status of 0 or 1

    3. Histologic evidence of adenocarcinoma of the prostate who are deemed candidates for curative radical prostatectomy.

    4. Planned robotic or laparoscopic prostatectomy technique.

    5. Low risk for conversion to open prostatectomy, in the opinion of the treating surgeon.

    6. Intermediate-high or high risk, clinically localized disease by the following criteria:

    • Prostate cancer in at least 2 cores with a Gleason score ≥ 7 (4+3 or 3+4) in at least 1 of those cores.

    • No definite evidence of metastasis, in the opinion of the investigator.

    1. Adequate organ function as defined by the following criteria within 14 days prior to first dose of study treatment:
    • Aspartate transaminase (AST) and alanine transaminase (ALT) ≤3 x local laboratory upper limit of normal (ULN)

    • Total serum bilirubin ≤1.5 x ULN, (for subjects with Gilbert's disease ≤ 3 x ULN)

    • Absolute neutrophil count (ANC) ≥1500/L without granulocyte colony-stimulating factor support.

    • White blood cell count ≥ 2500/mm3

    • Serum albumin ≥ 2.8 g/dl

    • Platelets ≥100,000/mm3

    • Hemoglobin ≥9.0 g/dL

    • Serum calcium ≤12.0 mg/dL

    • Serum creatinine ≤ 2.0 x ULN or calculated creatinine clearance ≥ 30mL/min.

    • Urine protein/creatinine ratio (UPCR) ≤ 1 mg/mg (≤ 113.2 mg/mmol).

    1. Written Authorization for Use and Release of Health and Research Study Information (HIPAA authorization per institutional requirements)

    2. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial.

    3. Willing/able to adhere to the prohibitions and restrictions specified in this protocol.

    4. Agrees to use a condom (even men with vasectomies) and another effective method of birth control if subject is having sex with a woman who is pregnant or a woman of childbearing potential while on study drug and for 4 months following the last dose of study drug.

    Exclusion Criteria:
    1. Prior treatment for prostate cancer.

    2. Major surgery or radiation therapy within 4 weeks of Day 1 on study.

    3. Planned radiation therapy until at least 4 weeks after prostatectomy.

    4. NCI CTCAE v4.0 grade 3 hemorrhage within 4 weeks of Day 1 on study.

    5. Prothrombin time (PT)/INR or partial thromboplastin time (PTT) test ≥ 1.3 x the laboratory ULN within 14 days before Day 1 on study (Arm A subjects only) or within 14 days of the completion of screening (Arm B subjects only).

    6. Concomitant anticoagulation with oral anticoagulants (e.g., warfarin, direct thrombin and Factor Xa inhibitors) or platelet inhibitors (eg, clopidogrel). However, low-dose aspirin for cardio protection is allowed (per local applicable guidelines).

    7. History of or known metastatic prostate cancer.

    8. QTcf interval > 500 msec on baseline EKG.

    9. The subject has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:

    1. Cardiovascular disorders:

    2. Symptomatic congestive heart failure (CHF) New York Heart Association Class 3 or 4, unstable angina pectoris, ongoing cardiac dysrhythmias of NCI CTCAE grade ≥2. coronary/peripheral artery bypass graft (CABG), within 6 months prior to screening.

    1. Stroke (including transient ischemic attack [TIA]), cerebrovascular accident (CVA), myocardial infarction (MI), or other ischemic event, or thromboembolic event (eg, deep venous thrombosis, pulmonary embolism (PE)) within 6 months prior to screening.
    1. Gastrointestinal (GI) disorders including those associated with a high risk of perforation or fistula formation:

    2. Evidence of tumor invading the GI tract, active peptic ulcer disease, inflammatory bowel disease (eg, Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis, acute pancreatitis, acute obstruction of the pancreatic duct or common bile duct, or gastric outlet obstruction.

    1. Abdominal fistula, GI perforation, bowel obstruction, or intra-abdominal abscess within 6 months before first dose.

    Note: Complete healing of an intra-abdominal abscess must be confirmed before first dose.

    1. Clinically significant hematuria, hematemesis, or hemoptysis of > 0.5 teaspoon (2.5 ml) of red blood, or other history of significant bleeding (eg, pulmonary hemorrhage) within 12 weeks before first dose.

    2. Serious non-healing wound/ulcer/bone fracture. e. Other clinically significant disorders that would preclude safe study participation.

    1. Hypertension that cannot be controlled by medications (>140/90 mm Hg despite optimal medical therapy).

    2. Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication.

    3. Concurrent treatment on another clinical trial. Supportive care trials or non-treatment trials, e.g. QOL, are allowed.

    4. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study.

    5. Inability to swallow tablets.

    6. Diagnosis of another malignancy within 2 years before first dose of study treatment, except for superficial skin cancers, or localized, low grade tumors deemed cured and not treated with systemic therapy.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Duke University Medical Center Durham North Carolina United States 27710

    Sponsors and Collaborators

    • Duke University
    • Exelixis

    Investigators

    • Principal Investigator: Michael Harrison, MD, Duke Cancer Institute

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Duke University
    ClinicalTrials.gov Identifier:
    NCT03964337
    Other Study ID Numbers:
    • Pro00101042
    First Posted:
    May 28, 2019
    Last Update Posted:
    Jun 29, 2022
    Last Verified:
    Jun 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail Study accrual was discontinued prior to enrolling any participants in the control arm (Immediate Prostatectomy, Arm B).
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Period Title: Overall Study
    STARTED 3 0
    COMPLETED 3 0
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B) Total
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Total of all reporting groups
    Overall Participants 3 0 3
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    62.47
    (8.40)
    62.47
    (8.40)
    Sex: Female, Male (Count of Participants)
    Female
    0
    0%
    0
    NaN
    Male
    3
    100%
    3
    Infinity
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    0
    0%
    0
    NaN
    Not Hispanic or Latino
    3
    100%
    3
    Infinity
    Unknown or Not Reported
    0
    0%
    0
    NaN
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    NaN
    Asian
    0
    0%
    0
    NaN
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    NaN
    Black or African American
    0
    0%
    0
    NaN
    White
    3
    100%
    3
    Infinity
    More than one race
    0
    0%
    0
    NaN
    Unknown or Not Reported
    0
    0%
    0
    NaN
    Region of Enrollment (Count of Participants)
    United States
    3
    100%
    3
    Infinity

    Outcome Measures

    1. Primary Outcome
    Title Apoptotic Index in Prostatectomy Specimens From Patients Who Undergo Immediate Prostatectomy (Arm B) Versus Those Treated With Cabozantinib Followed by Prostatectomy (Arm A)
    Description Apoptotic index as measured by cleaved caspase-3 levels in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    2. Secondary Outcome
    Title Immune Phenotyping of Myeloid-derived Suppressor Cells (MDSCs)
    Description Percentage of MDSCs in peripheral blood and tumor tissue
    Time Frame Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    3. Secondary Outcome
    Title Immune Phenotyping of Neutrophils
    Description Percentage of neutrophils in peripheral blood and tumor tissue
    Time Frame Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    4. Secondary Outcome
    Title Immune Phenotyping of M1 Macrophages
    Description Percentage of M1 macrophages in peripheral blood and tumor tissue
    Time Frame Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    5. Secondary Outcome
    Title Immune Phenotyping of M2 Macrophages
    Description Percentage of M2 macrophages in peripheral blood and tumor tissue
    Time Frame Arm A: Screening, Day 29, Day 43, Day 57-85; Arm B: Screening, Day 1

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    6. Secondary Outcome
    Title Immunohistochemical (IHC) Analysis of CD8+
    Description Percentage of CD8+ positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    7. Secondary Outcome
    Title Immunohistochemical (IHC) Analysis of Programmed Death Ligand-1 (PD-L1)
    Description Percentage of PD-L1 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    8. Secondary Outcome
    Title Immunohistochemical (IHC) Analysis of Cytotoxic T-lymphocyte-associated Protein 4 (CTLA-4)
    Description Percentage of CTLA-4 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    9. Secondary Outcome
    Title Immunohistochemical (IHC) Analysis of Interleukin-1 Receptor Antagonist (IL-1RA)
    Description Percentage of IL-1RA positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    10. Secondary Outcome
    Title Description of the Neutrophil Chemotactic Factor CXCL12
    Description Percentage of neutrophil chemotactic factor CXCL12 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    11. Secondary Outcome
    Title Description of the Neutrophil Chemotactic Factor HMGB1
    Description Percentage of neutrophil chemotactic factor HMGB1 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    12. Secondary Outcome
    Title Description of the MDSC-promoting Cytokine CCL5
    Description Percentage of MDSC-promoting cytokine CCL5 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    13. Secondary Outcome
    Title Description of the MDSC-promoting Cytokine CCL12
    Description Percentage of MDSC-promoting cytokine CCL12 positive cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0
    14. Secondary Outcome
    Title Description of the MDSC-promoting Cytokine CD40
    Description Percentage of MDSC-promoting cytokine CD40 cells in tumor tissue
    Time Frame At prostatectomy (Arm A: Day 43, Arm B: Day 1)

    Outcome Measure Data

    Analysis Population Description
    Data not collected.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    Measure Participants 0 0

    Adverse Events

    Time Frame Per the protocol, AEs are collected from the first dose of study drug (Day 0) through 30 days after the decision to discontinue study treatment (Day 57).
    Adverse Event Reporting Description Study accrual was discontinued prior to enrolling any participants in the control arm (Immediate Prostatectomy, Arm B). AEs were predominantly collected at protocol required study visits. The study coordinator would ask the subject about their health and any side effects they experienced. The investigator would perform a physical exam. Blood was collected for safety labs.
    Arm/Group Title Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Arm/Group Description Experimental group will received cabozantinib for 4 weeks, followed by a 2 week drug washout before a prostatectomy. Cabozantinib: Cabozantinib 40 mg by mouth daily for 4 weeks. Radical Prostatectomy: Radical prostatectomy as part of routine medical care. Control group will receive an immediate prostatectomy. Radical Prostatectomy: Radical prostatectomy as part of routine medical care.
    All Cause Mortality
    Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/3 (0%) 0/0 (NaN)
    Serious Adverse Events
    Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/3 (0%) 0/0 (NaN)
    Other (Not Including Serious) Adverse Events
    Cabozantinib Followed by Prostatectomy (Arm A) Immediate Prostatectomy (Arm B)
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 3/3 (100%) 0/0 (NaN)
    Blood and lymphatic system disorders
    Anemia 1/3 (33.3%) 0/0 (NaN)
    Gastrointestinal disorders
    Abdominal pain 2/3 (66.7%) 0/0 (NaN)
    Constipation 3/3 (100%) 0/0 (NaN)
    Diarrhea 1/3 (33.3%) 0/0 (NaN)
    Nausea 1/3 (33.3%) 0/0 (NaN)
    General disorders
    Fatigue 2/3 (66.7%) 0/0 (NaN)
    Pain 1/3 (33.3%) 0/0 (NaN)
    Hepatobiliary disorders
    Hepatobiliary disorders - Other 1/3 (33.3%) 0/0 (NaN)
    Investigations
    Alanine aminotransferase increased 1/3 (33.3%) 0/0 (NaN)
    Aspartate aminotransferase increased 1/3 (33.3%) 0/0 (NaN)
    Investigations - Other 1/3 (33.3%) 0/0 (NaN)
    Neutrophil count decreased 1/3 (33.3%) 0/0 (NaN)
    Platelet count decreased 1/3 (33.3%) 0/0 (NaN)
    Renal and urinary disorders
    Bladder spasm 1/3 (33.3%) 0/0 (NaN)
    Urinary incontinence 2/3 (66.7%) 0/0 (NaN)
    Reproductive system and breast disorders
    Erectile dysfunction 1/3 (33.3%) 0/0 (NaN)
    Skin and subcutaneous tissue disorders
    Dry skin 1/3 (33.3%) 0/0 (NaN)
    Hair color changes 1/3 (33.3%) 0/0 (NaN)
    Skin and subcutaneous tissue disorders - Other 2/3 (66.7%) 0/0 (NaN)
    Surgical and medical procedures
    Surgical and medical procedures - Other 1/3 (33.3%) 0/0 (NaN)
    Vascular disorders
    Hypertension 1/3 (33.3%) 0/0 (NaN)
    Hypotension 1/3 (33.3%) 0/0 (NaN)

    Limitations/Caveats

    Study accrual was discontinued prior to enrolling any participants in the control arm (Immediate Prostatectomy, Arm B).

    More Information

    Certain Agreements

    All Principal Investigators ARE employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Michael Harrison, M.D.
    Organization Duke University
    Phone 919-668-8108
    Email michael.harrison@duke.edu
    Responsible Party:
    Duke University
    ClinicalTrials.gov Identifier:
    NCT03964337
    Other Study ID Numbers:
    • Pro00101042
    First Posted:
    May 28, 2019
    Last Update Posted:
    Jun 29, 2022
    Last Verified:
    Jun 1, 2022