Prostate Cancer Intensive, Non-Cross Reactive Therapy (PRINT) for Castration Resistant Prostate Cancer (CRPC)
Condition: Prostate Cancer
MeSH terms: Prostatic Neoplasms
Intervention: Abiraterone acetate; Prednisone; Radium-223 dichloride; cabazitaxel; Carboplatin; Enzalutamide
Intervention description: Abiraterone acetate 1000 mg PO daily; 5 mg PO twice a day; 50 kBq/kg IV monthly; 25 mg/m2 IV every 3 weeks; Carboplatin AUC 4 IV every 3 weeks; 160 mg PO daily
Intervention MeSH terms: Prednisone; Carboplatin; Abiraterone Acetate; Radium Ra 223 dichloride
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 40.0
Sex: Male
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Castration resistant; Prostate cancer; Metastatic; First-line; Treatment naive; Rapidly cycling; Non-cross resistant

Summary:

      The purpose of this study is to determine the clinical benefits of using a rapidly cycling,
      non-cross reactive regimen of FDA-approved prostate cancer therapeutic agents in the
      management of castration resistant prostate cancer. The hypothesis is that the identification
      of optimal combinations and sequencing of therapies can help prevent or delay the development
      of therapeutic drug resistance, and can be safely tolerated.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Histologically or cytologically confirmed adenocarcinoma of the prostate

          -  Metastatic castrate resistant prostate cancer, defined by progressive disease based on
             either rising PSA, new bone metastases, or progression of measurable disease on
             standard imaging, according to PCWG2 guidelines, despite androgen deprivation therapy

          -  Ongoing androgen deprivation therapy with a GnRH analogue, GnRH antagonist, or
             bilateral orchiectomy

          -  ECOG performance status 0-1

          -  Serum testosterone level < 50 ng/dL

          -  Absolute neutrophil count > 1,500/μL, platelet count > 100,000/μL, and hemoglobin > 9
             g/dL

          -  Creatinine < 2 mg/dL

          -  Total bilirubin < 1 times the upper limit of normal, alanine aminotransferase (ALT) or
             aspartate aminotransferase (AST) ≤ 1.5 times the upper limit of normal

        Exclusion Criteria:

          -  History of uncontrolled seizure disorder

          -  Clinically significant cardiovascular disease including:

               1. Myocardial infarction or uncontrolled angina within 6 months

               2. Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or
                  patients with history of congestive heart failure NYHA class 3 or 4 in the past

               3. Uncontrolled hypertension as indicated by a resting systolic blood pressure > 170
                  mmHg or diastolic blood pressure > 105 mmHg at the screening visit

          -  Have used or plan to use from 30 days prior to enrollment through the end of the study
             medication known to lower the seizure threshold or prolong the QT interval

          -  Major surgery within 4 weeks of enrollment

          -  Radiation therapy within 4 weeks of enrollment

          -  Prior use of abiraterone acetate, enzalutamide, docetaxel, cabazitaxel, carboplatin,
             or radium-223 for the treatment of castration-resistant disease

          -  Prior docetaxel use in the hormone-sensitive disease setting is allowed, but must be
             completed ≥ 4 weeks prior to enrollment

          -  Prior sipuleucel-T use is allowed, but must be completed ≥ 4 weeks prior to enrollment

          -  Concurrent use of zoledronic acid or denosumab is allowed on study