A Proof of Concept Study of Maintenance Therapy With Tasquinimod in Patients With Metastatic Castrate-resistant Prostate Cancer Who Are Not Progressing After a First Line Docetaxel Based Chemotherapy
Condition: Metastatic Castrate Resistant Prostate Cancer
MeSH terms: Prostatic Neoplasms
Intervention: Tasquinimod; Placebo
Intervention description: A patient's dose will escalate from one level to the next, once tolerability of the current dose is established. If tolerability issues arise at 0.5 or 1 mg/day, patients will have their dose reduced to 0.25 or 0.5 mg/day, respectively.; Placebo capsules are identical to tasquinimod capsules in appearance and excipients but exclude the active compound (tasquinimod), to be taken orally once a day with water and food
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 144.0
Sex: Male
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      The purpose of this study is to confirm that tasquinimod used as maintenance therapy is
      active and tolerable in patients with metastatic castrate-resistant prostate cancer not
      progressing after a first chemotherapy with docetaxel.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Histologically documented prostate cancer with evidence of metastatic disease on
             radiological evaluation, with or without symptoms (defined according to the BPI scale,
             with use of analgesics or narcotics)

          -  Has received a first line docetaxel based chemotherapy (as a monotherapy) every 3
             weeks schedule of administration with corticosteroids for a minimum of 6 cycles with a
             cumulative dose ≥360 mg/m2. Any combination with investigational or non
             investigational agent is prohibited

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

          -  Docetaxel-related adverse effects must have been resolved to NCI-CTCAE v4.03 (Common
             Toxicity Criteria for Adverse Effects) Grade ≤1. Chemotherapy-induced alopecia and
             Grade 2 peripheral neuropathy are allowed

          -  No progressive disease at the end of docetaxel treatment defined according to RECIST
             criteria, no new lesion(s) assessed by bone scan and no elevated prostate specific
             antigen (PSA) for the three last tests with PSA3≤PSA2≤PSA1. The time between each PSA
             test should be preferably at least 14 days, however, a minimum of 7 days is
             acceptable.

        Note: PSA value can be rounded to the nearest whole number if PSA>10 ng/mL. If the PSA3
        value is above the PSA2, a fourth PSA test will be performed. The PSA4 value should be
        below or equal to PSA2

          -  Last dose of docetaxel administered between 21 and 42 days before randomisation

          -  Chemical or surgical castration verified by levels of serum testosterone ≤50 ng/dL
             (1.75 nmol/L)

        Exclusion Criteria:

          -  Has concurrent use of other anticancer agents or treatments, with the following
             exceptions: ongoing treatment with luteinising hormone-releasing hormone agonists or
             antagonists, denosumab or bisphosphonate (e.g., zoledronic acid) is permitted if
             started ≥4 weeks prior to Screening. Ongoing treatment should be kept at a stable dose
             regimen

          -  Has ongoing treatment with warfarin

          -  Had prior radiation therapy since starting docetaxel. Exceptions may be made for
             palliative non-myelosuppressive radiation therapy administered more than 2 weeks prior
             to randomisation

          -  Had prior strontium, samarium or radium therapy or prior treatment with tasquinimod,
             or any agents with antiangiogenic properties

          -  Has ongoing treatment with corticosteroids at >10 mg/day prednisolone equivalent

          -  Has prostate cancer pain that warrants the initiation of radiotherapy or chemotherapy

          -  Has known brain or epidural metastases. Patients with previous medullary cord
             compression without any neurological deficit could be included

          -  Has a history of other malignancies, except adequately treated non-melanoma skin
             cancer or other solid tumours curatively treated, without evidence of disease for >5
             years