Study of Ipatasertib or Apitolisib With Abiraterone Acetate Versus Abiraterone Acetate in Participants With Castration-Resistant Prostate Cancer Previously Treated With Docetaxel Chemotherapy
Study Details
Study Description
Brief Summary
This multicenter, international, Phase Ib/II trial consists of three stages: a Phase Ib, open-label stage in which the recommended Phase II dose was determined for ipataseritib administrated in combination with abiraterone and of apitolisib administrated in combination with abiraterone (this phase is no longer active), a Phase II, 3-arm, double-blind, randomized comparison of ipatasertib with abiraterone and prednisone/prednisolone versus placebo with abiraterone and prednisone/prednisolone and a safety single-arm, open-label cohort of ipatasertib 400 mg daily alone or in combination with prednisone/prednisolone or prednisone/prednisolone plus abiraterone.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Phase 1/Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Phase Ib: Ipatasertib 400 mg + abiraterone Participants will receive ipatasertib 400 mg once daily, abiraterone 1000 mg once daily, and prednisone/prednisolone 5 mg twice daily (bid) continuously in 28-day treatment cycles until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Ipatasertib
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Experimental: Phase Ib: Apitolisib 30 mg + abiraterone Participants will receive apitolisib 30 mg once daily, abiraterone 1000 mg once daily, and prednisone/prednisolone 5 mg twice daily (bid) continuously in 28-day treatment cycles until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Apitolisib
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Experimental: Phase II: Ipatasertib 400 mg + abiraterone Participants will receive Ipatasertib 400 mg once daily, abiraterone 1000 mg once daily, and prednisone/prednisolone 5 mg bid continuously in 28-day treatment cycles until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Ipatasertib
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Experimental: Phase II: Ipatasertib 200 mg + abiraterone Participants will receive Ipatasertib 200 mg once daily, abiraterone 1000 mg once daily, and prednisone/prednisolone 5 mg bid continuously in 28-day treatment cycles until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Ipatasertib
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Placebo Comparator: Phase II: Placebo + abiraterone Participants will receive placebo (for Ipatasertib) once daily, abiraterone 1000 mg once daily, and prednisone/prednisolone 5 mg bid continuously in 28-day treatment cycles until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Placebo
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Experimental: Safety Cohort: Ipataseritib 400 mg + Abiraterone + Prednisone Participants will receive Ipataseritib 400 mg once daily in the AM for Cycle 1 day 1-18. On Day 19, Ipataseritib 400 mg will be switched to PM dosing for the remainder of the Cycle 1. Prednisone 5 mg starts in the PM of Cycle 1 day 8 and taken BID thereafter for the remainder of the study treatment Abiraterone 1000mg once a day starts on Cycle1 day 12 in the AM and should be taken at the same time as Ipataseritib. Starting from cycle 1 day 19, Ipataseritib and Abiraterone are dosed in PM at should be taken together at the same time each day until cycle 2 day 1. Starting from Cycle 2 Day 1, Participants may choose to take Ipatasertib and Abiraterone in either the AM or PM; however, they should be taken together at approximately the same time each day. Participants will receive the study treatment until disease progression or intolerable toxicity. |
Drug: Abiraterone
Orally once daily
Drug: Ipatasertib
Orally once daily
Drug: Prednisone
Orally bid
Drug: Prednisolone
Orally bid
|
Outcome Measures
Primary Outcome Measures
- Phase Ib: Percentage of Participants With Dose Limiting Toxicity (DLTs) [Days 1 to 28 of Cycle 1 (Cycle length = 28 days)]
- Phase Ib: Percentage of Participants with Adverse Events (AEs) [Baseline up until 30 days following the last administration of study treatment or until initiation of another anti-cancer therapy, whichever occurs first (up to 3.6 years overall)]
- Phase Ib: Recommended Phase II Dose (RP2D) of Ipatasertib [Days 1 to 28 of Cycle 1 (Cycle length = 28 days)]
- Phase II: Radiographic Progression Free Survival (rPFS) - Intent-To-Treat (ITT) Population [Screening up to radiographic progression or death, whichever occurs first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter, and at treatment completion [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: rPFS in Participants With Institute of Cancer Research (ICR) Phosphatase and Tensin Homolog (PTEN) Loss [Screening up to radiographic progression or death, whichever occurs first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter, and at treatment completion [up to 3.6 years overall]) (cycle length = 28 days)]
Secondary Outcome Measures
- Phase Ib: Maximum Plasma Concentration (Cmax) of Ipatasertib When Co-Administered With Abiraterone [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Time to Cmax (tmax) of Ipatasertib When Co-Administered With Abiraterone [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Area Under The Concentration-Time Curve From Time 0 to 24 Hours (AUC0-24) of Ipatasertib When Co-Administered With Abiraterone [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Total Body Clearance (CL/F) of Ipatasertib When Co-Administered With Abiraterone [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Accumulation Ratio of Ipatasertib When Co-Administered With Abiraterone [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Cmax of G-037720 (Metabolite of Ipatasertib) [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: tmax of G-037720 (Metabolite of Ipatasertib) [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: AUC0-24 of G-037720 (Metabolite of Ipatasertib) [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Day 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Accumulation Ratio of G-037720 (Metabolite of Ipatasertib) [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Cmax of Apitolisib When Co-Administered With Abiraterone [Pre-dose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length = 28 days)]
- Phase Ib: tmax of Apitolisib When Co-Administered With Abiraterone [Pre-dose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length = 28 days)]
- Phase Ib: AUC0-24 of Apitolisib When Co-Administered With Abiraterone [Pre-dose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length = 28 days)]
- Phase Ib: Cmax of Abiraterone When Co-Administered With Ipatasertib or Apitolisib [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: tmax of Abiraterone When Co-Administered With Ipatasertib or Apitolisib [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: AUC0-24 of Abiraterone When Co-Administered With Ipatasertib or Apitolisib [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Plasma Half-Life of Abiraterone When Co-Administered With Ipatasertib or Apitolisib [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase Ib: Accumulation Ratio of Abiraterone When Co-Administered With Ipatasertib or Apitolisib [Predose (0 hour), 1, 2, 4, 6, 24 hours post dose on Days 1, 15 of Cycle 1 (cycle length=28 days)]
- Phase II: Overall Survival in the ITT Population [Screening up to death (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 8.9 years overall]) (cycle length = 28 days)]
- Phase II: Overall Survival in Participants With ICR PTEN Loss [Screening up to death (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 8.9 years overall]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With PSA Progression in the ITT Population [Baseline up to 30 days after last dose (assessed at baseline, Day 1 of every cycle [starting from Cycle 2] till 30 days after last dose [up to overall 3.6 years]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With PSA Progression in Participants With ICR PTEN Loss [Baseline up to 30 days after last dose (assessed at baseline, Day 1 of every cycle [starting from Cycle 2] till 30 days after last dose [up to overall 3.6 years]) (cycle length = 28 days)]
- Phase II: Time to PSA Progression in the ITT Population [Screening up to PSA progression (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Time to PSA Progression in Participants With ICR PTEN Loss [Screening up to PSA progression (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With PSA Response in the ITT Population [Baseline up to 30 days after last dose (assessed at baseline, Day 1 of every cycle [starting from Cycle 2] till 30 days after last dose [up to overall 3.6 years]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With PSA Response in Participants With ICR PTEN Loss [Baseline up to 30 days after last dose (assessed at baseline, Day 1 of every cycle [starting from Cycle 2] till 30 days after last dose [up to overall 3.6 years]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With Objective Response in the ITT Population [Screening up to radiographic progression or death, whichever occurred first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With Objective Response in Participants With ICR PTEN Loss [Screening up to radiographic progression or death, whichever occurred first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Duration of Tumor Response in the ITT Population [Screening up to radiographic progression or death, whichever occurred first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Duration of Tumor Response in Participants with ICR PTEN Loss [Screening up to radiographic progression or death, whichever occurred first (assessed at screening, after Cycles 3, 5, 7, 9, every three cycles [12 weeks] thereafter up to end of treatment [up to 3.6 years overall]) (cycle length = 28 days)]
- Phase II: Percentage of Participants With Circulating Tumor Cells (CTC) Reduction Response in the ITT Population [Baseline, on Day 1 of Cycle 2, on Day 1 of Cycle 3, and at the treatment completion visit (up to overall 3.6 years) (cycle length=28 days)]
- Phase II: Percentage of Participants With CTC Reduction Response in Participants With ICR PTEN Loss [Baseline, on Day 1 of Cycle 2, on Day 1 of Cycle 3, and at the treatment completion visit (up to overall 3.6 years) (cycle length=28 days)]
- Phase II: Percentage of Participants With CTC Conversion in the ITT Population [Baseline, on Day 1 of Cycle 2, on Day 1 of Cycle 3, and at the treatment completion visit (up to overall 3.6 years) (cycle length=28 days)]
- Phase II: Percentage of Participants With CTC Conversion in Participants With ICR PTEN Loss [Baseline, on Day 1 of Cycle 2, on Day 1 of Cycle 3, and at the treatment completion visit (up to overall 3.6 years) (cycle length=28 days)]
- Phase II: Percentage of Participants With Pain Progression in the ITT Population [Screening, Day 1 of each cycle (cycle length=28 days) up to treatment completion (up to 3.6 years)]
- Phase II: Percentage of Participants With Pain Progression in Participants With ICR PTEN Loss [Screening, Day 1 of each cycle (cycle length=28 days) up to treatment completion (up to 3.6 years)]
- Phase II: Time to Pain Progression in the ITT Population [Screening, Day 1 of each cycle (cycle length=28 days) up to treatment completion (up to 3.6 years)]
- Phase II: Time to Pain Progression in Participants With ICR PTEN Loss [Screening, Day 1 of each cycle (cycle length=28 days) up to treatment completion (up to 3.6 years)]
- Phase II: Percentage of Participants With Adverse Events (AEs) [Baseline up until 30 days following the last administration of study treatment or until initiation of another anti-cancer therapy, whichever occurs first (up to 8.9 years)]
- Phase II: Ipatasertib Plasma Concentrations When Co-Administered With Abiraterone [Phase II: Cycle 1, Day 1: 1, 4 hours postdose; Cycle 1, Day 15: predose, 2, 4 hours postdose; Cycle 2, Day 1: predose, 1-4 hours postdose (cycle length = 28 days)]
- Phase II: G-037720 (Metabolite of Ipatasertib) Plasma Concentrations [Phase II: Cycle 1, Day 1: 1, 4 hours postdose; Cycle 1, Day 15: predose, 2, 4 hours postdose; Cycle 2, Day 1: predose, 1-4 hours postdose (cycle length=28 days)]
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Histologically confirmed metastatic or advanced prostate adenocarcinoma that has been previously treated with docetaxel-based therapy and has progressed during treatment of at least one hormonal therapy(prior docetaxel is not required for the safety cohort)
-
Two rising PSA levels greater than or equal to (>/=) 2 ng/mL measured >/= 1 week apart or radiographic evidence of disease progression in soft tissue or bone
-
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at screening
-
Adequate hematologic and organ function
-
Documented willingness to use an effective means of contraception
-
Safety cohort only: agreement to use CGM for first cycle of treatment
Exclusion Criteria:
-
History of Type I or Type II diabetes mellitus requiring insulin; safety cohort: patients who are receiving any pharmacologic treatment for diabetes are not eligible
-
New York Heart Association Class III or IV heart failure or Left ventricular ejection fraction < 50% or ventricular arrhythmia requiring medication
-
Significant atherosclerotic disease, as evidenced by: unstable angina, history of myocardial infarction within 6 months prior to Day 1, or cerebrovascular accident within 6 months prior to Day 1
-
Active autoimmune disease that is not controlled by nonsteroidal anti-inflammatory drugs or active inflammatory disease which requires immunosuppressive therapy
-
Clinically significant history of liver disease
-
History of adrenal insufficiency or hyperaldosteronism
-
Phase II only: Previous therapy for prostate cancer with 17 alpha-hydroxylase/C17,20-lyase inhibitors, including abiraterone
-
Phase II only: Previous treatment for prostate cancer with Protein kinase B phosphatidylinositol 3 kinase and/or mammalian target of rapamycin inhibitors
-
Need for chronic corticosteroid therapy of >/= 20 mg of prednisone per day or an equivalent dose of other anti inflammatory corticosteroids or immunosuppressant
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | HonorHealth Research Institute - Bisgrove | Scottsdale | Arizona | United States | 85258 |
2 | Pacific Hematology Oncology Associates | San Francisco | California | United States | 94115 |
3 | Florida Cancer Specialists - Fort Myers (New Hampshire Ct) | Fort Myers | Florida | United States | 33901-8101 |
4 | Florida Cancer Specialists; Sarasota | Sarasota | Florida | United States | 34232 |
5 | Kaiser Permanente Medical Ctr | Honolulu | Hawaii | United States | 96819 |
6 | Johns Hopkins Univ; Bunting Blaustein Cancer Center | Baltimore | Maryland | United States | 21231 |
7 | Karmanos Cancer Institute | Detroit | Michigan | United States | 48201 |
8 | Urology Cancer Center & GU Research Network | Omaha | Nebraska | United States | 68130 |
9 | New York Cancer and Blood Specialists - Setauket Medical Oncology | East Setauket | New York | United States | 11733 |
10 | Weill Cornell Medical College | New York | New York | United States | 10065 |
11 | Carolina Urologic Research Center | Myrtle Beach | South Carolina | United States | 29572 |
12 | Sarah Cannon Cancer Center - Tennessee Oncology, Pllc | Nashville | Tennessee | United States | 37203 |
13 | Masarykuv onkologicky ustav | Brno | Czechia | 656 53 | |
14 | Fakultni nemocnice Hradec Kralove; I. interni klinika,Oddeleni invazivni kardiologie | Hradec Kralove | Czechia | 50012 | |
15 | Urocentrum Praha s.r.o. | Praha 2 | Czechia | 120 00 | |
16 | Vseobecna fakultni nemocnice v Praze | Praha 2 | Czechia | 128 08 | |
17 | Fakultni Thomayerova Nemocnice; Revmatologicke Oddeleni | Praha | Czechia | 140 59 | |
18 | ICO Paul Papin; Oncologie Medicale. | Angers | France | 49055 | |
19 | Centre Léon Bérard - Centre régional de lutte contre le cancer Rhône-Alpes | Lyon | France | 69008 | |
20 | Hia Du Val De Grace | Paris | France | 75230 | |
21 | Institut Curie; Oncologie Medicale | Paris | France | 75231 | |
22 | GH Paris Saint Joseph; Hopital De Jour Oncologie | Paris | France | 75674 | |
23 | Hopital d'Instruction des Armees de Begin | Saint-Mande | France | 94160 | |
24 | Institut Gustave Roussy; Departement Oncologie Medicale | Villejuif | France | 94805 | |
25 | Alexandras Hospital; Dept. of Clin. Therapeutics, Athens Uni School of Medicine | Athens | Greece | 115 28 | |
26 | Univ General Hosp Heraklion; Medical Oncology | Heraklion | Greece | 711 10 | |
27 | University Hospital of Patras Medical Oncology | Patras | Greece | 265 04 | |
28 | Metropolitan Hospital; 2Nd Oncology Clinic | Piraeus | Greece | 185 47 | |
29 | University Hospital of Larissa; Oncology | Λαρισα | Greece | 413 35 | |
30 | IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia Medica | Meldola | Emilia-Romagna | Italy | 47014 |
31 | Azienda Ospedaliera Istituti Ospitalieri | Cremona | Lombardia | Italy | 26100 |
32 | Irccs Ospedale San Raffaele;Oncologia Medica | Milano | Lombardia | Italy | 20132 |
33 | Irccs Istituto Nazionale Dei Tumori (Int);S.C. Medicina Oncologica 2 | Milano | Lombardia | Italy | 20133 |
34 | Ospedale S. Donato; Divisione Di Reumatologia | Arezzo | Toscana | Italy | 52100 |
35 | Het Nederlands Kanker Inst | Amsterdam | Netherlands | 1066 EC | |
36 | Vu Medisch Centrum; Afdeling Longziekten | Amsterdam | Netherlands | 1081 HV | |
37 | MC Haaglanden; Oncologie | Den Haag | Netherlands | 2512 VA | |
38 | UMC St Radboud | Nijmegen | Netherlands | 6525 GA | |
39 | Sint Franciscus Gasthuis; Inwendige Geneeskunde | Rotterdam | Netherlands | 3045 PM | |
40 | Sf. Constantin Hospital; Oncology | Brasov | Romania | 500019 | |
41 | Prof. Dr. Th. Burghele Clin Urology Hosp | Bucharest | Romania | 050659 | |
42 | Prof. Dr. I. Chiricuta Institute of Oncology | Cluj Napoca | Romania | 400015 | |
43 | ONCOMED - Medical Centre | Timisoara | Romania | 300239 | |
44 | Municipal Hosp Turdal; Oncology | Turda | Romania | 401103 | |
45 | Hospital General Universitario de Elche; Servicio de Oncologia | Elche | Alicante | Spain | 03203 |
46 | Hospital Universitari Germans Trias i Pujol; Servicio de Oncologia | Badalona | Barcelona | Spain | 08916 |
47 | Corporacio Sanitaria Parc Tauli; Servicio de Oncologia | Sabadell | Barcelona | Spain | 8208 |
48 | Clinica Universitaria de Navarra | Pamplona | Navarra | Spain | 31008 |
49 | Hospital Univ Vall d'Hebron; Servicio de Oncologia | Barcelona | Spain | 08035 | |
50 | Hospital General Universitario Gregorio Marañon | Madrid | Spain | 28007 | |
51 | Hospital Universitario 12 de Octubre; Servicio de Oncologia | Madrid | Spain | 28041 | |
52 | Hospital Madrid Norte Sanchinarro | Madrid | Spain | 28050 | |
53 | Hospital Clinico Universitario Virgen de la Victoria | Malaga | Spain | 29010 | |
54 | Queen Elizabeth Hospital; Centre for Clinical Haematology | Birmingham | United Kingdom | B15 2TH | |
55 | Gartnavel General Hospital | Glasgow | United Kingdom | G12 0XH | |
56 | St. James University Hospital; Pharmacy Department | Leeds | United Kingdom | LS9 7TF | |
57 | The Clatterbridge Cancer Centre NHS Foundation Trust | Liverpool | United Kingdom | L7 8YA | |
58 | Sarah Cannon Research Institute | London | United Kingdom | W1G 6AD | |
59 | The Royal Marsden Hospital | Sutton | United Kingdom | SM2 5PT |
Sponsors and Collaborators
- Genentech, Inc.
Investigators
- Study Director: Clinical Trials, Genentech, Inc.
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- GO27983
- 2011-004126-10