Tecemotide (L-BLP25) in Prostate Cancer

Study Overview
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Brief Summary
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This study examines tecemotide (L-BLP25) in combination with standard treatment for prostate cancer.

Official Title
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A Randomized Phase II Study of Tecemotide in Combination With Standard Androgen Deprivation Therapy and Radiation Therapy for Untreated, Intermediate and High Risk Prostate Cancer Patients

Conditions
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Prostate Cancer

Intervention / Treatment
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* Radiation: Radiation therapy
* Drug: Goserelin
* Drug: Cyclophosphamide
* Drug: Tecemotide (L-BLP25)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histopathologic documentation of prostate cancer confirmed at the institution of study enrollment prior to starting this study Newly diagnosed or previously untreated prostate cancer with intermediate or high risk features as defined in the protocol No evidence of metastatic disease on computed tomography (CT) / magnetic resonance imaging (MRI) or bone scans No systemic steroid use within 2 weeks prior to initiation of experimental therapy. Limited doses of systemic steroids to prevent intravenous contrast, allergic reaction or anaphylaxis (in subjects who have known contrast allergies) are allowed Eastern Co-operative Oncology Group (ECOG) performance status of 0-1 Human leukocyte antigen (HLA)-A2 or A3 positive for immunologic monitoring Hematological and biochemical eligibility parameters as defined in the protocol No other active malignancies within the past 3 years (with the exception of non-melanoma skin cancers or carcinoma in situ of the bladder) Willing to travel to the study center(s) for follow-up visits Age greater than or equal to 18 years old Able to understand and sign informed consent Must agree to use effective birth control (such as a condom) or abstinence during and for a period of 4 months after the last administration of immunotherapy Exclusion Criteria: No evidence of being immunocompromised by human immunodeficiency virus, a medical condition requiring systemic steroids, a medical condition requiring immunosuppressive therapy, splenectomy Active Hepatitis B or Hepatitis C Subjects should have no autoimmune diseases that have required treatment as specified in the protocol History of immunodeficiency diseases, hereditary or congenital immunodeficiencies Serious intercurrent medical illness A clinically significant cardiac disease Subjects who have received any prior therapy for prostate cancer Subjects who have known brain metastasis, or with a history of seizures, encephalitis, or multiple sclerosis Subjects receiving any other investigational agents Contraindication to biopsy such as bleeding disorders, ratio of prothrombin time to partial thromboplastin time (PT/PTT) >=1.5 times the upper limit of normal, artificial heart valve Contraindication to MRI such as subjects weighing >136 kilograms, allergy to magnetic resonance (MR) contrast agent, subjects with pacemakers, cerebral aneurysm clips, shrapnel injury or implantable electronic devices Contraindication to radiation therapy such as pre-existing and active prostatitis or proctitis, inflammatory bowel disease or known genetic sensitivity to ionizing radiation, or history of prior radiation to the pelvis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard therapy<br>Radiation therapy in combination with androgen deprivation therapy (ADT). | Radiation: Radiation therapy<br>* Radiation therapy will be administered at a daily dose of 180 centigrays (cGy) 5 days a week for approximately 6 to 8 weeks.<br>Drug: Goserelin<br>* ADT (Goserelin) will be administered at a dose of 10.8 milligrams (mg) subcutaneously every 3 months for 24 months for the high risk group and for 6 months in the intermediate risk group, starting 2-3 months prior to radiation therapy.<br>|
| Experimental: Standard therapy plus tecemotide (L-BLP25)<br>Standard therapy (radiation therapy in combination with ADT) plus tecemotide (L-BLP25). | Radiation: Radiation therapy<br>* Radiation therapy will be administered at a daily dose of 180 centigrays (cGy) 5 days a week for approximately 6 to 8 weeks.<br>Drug: Goserelin<br>* ADT (Goserelin) will be administered at a dose of 10.8 milligrams (mg) subcutaneously every 3 months for 24 months for the high risk group and for 6 months in the intermediate risk group, starting 2-3 months prior to radiation therapy.<br>Drug: Cyclophosphamide<br>* Cyclophosphamide will be administered at a single dose of 300 milligrams per square meter (mg/m^2) to a maximum of 600 mg, as an intravenous injection 3 days prior to the first administration of tecemotide (L-BLP25).<br>Drug: Tecemotide (L-BLP25)<br>* Tecemotide (L-BLP25) will be administered at a dose of 918 microgram (mcg) as subcutaneous injection every 2 weeks for 5 doses followed by every 6 weeks for an additional 4 doses, starting 2-3 months prior to radiation therapy and on the same day that ADT began.<br>* Other names: Epipepimut-S;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Subjects With Change From Baseline in the Mucinous Glycoprotein 1 (MUC1) Specific Systemic T-Cells Immune Response at Day 60 (Pre-Radiation) | MUC1-specific systemic immune response was measured by intracellular cytokine antigen specific staining following a period of in vitro stimulation (IVS) with overlapping 15-mer peptide pools encoding the tumor-associated antigen (TAA) MUC-1. Baseline was defined as the measurement taken prior to the first dose of study medication (Day 1). | Baseline and Day 60 (Pre-Radiation) | 
| Number of Subjects With Change From Baseline in the Mucinous Glycoprotein 1 (MUC1) Specific Systemic T-Cells Immune Response at Day 190 (Post-radiation) | MUC1-specific systemic immune response was measured by intracellular cytokine antigen specific staining following a period of in vitro stimulation (IVS) with overlapping 15-mer peptide pools encoding the tumor-associated antigen (TAA) MUC-1. Baseline was defined as the measurement taken prior to the first dose of study medication (Day 1). | Baseline and Day 190 (Post-radiation) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Subjects With Progression/Recurrence Status Based on Prostate-specific Antigen (PSA) Levels | Progression/recurrence status was reported based on Prostate-specific Antigen (PSA) Levels. Recurrence of PSA after completion of therapy represents disease progression and was determined using the American Society for Therapeutic Radiology and Oncology (ASTRO) Phoenix criteria. These criteria define biochemical recurrence after radiation therapy as a PSA level equal to the lowest (nadir) PSA level achieved after therapy plus 2 nanogram per milliliter. | From randomization up to 24 months | 
| Number of Subjects With a Doubling in Number of T-cells in Tumor Biopsy From Baseline at Pre-radiotherapy (Pre-RT) and Post-radiotherapy (Post-RT) | Doubling in number of T-cells was assessed by immunologic responses (in the tumor microenvironment) in subjects consenting to undergo study biopsies. Baseline was defined as the measurement taken within 8 weeks of prior to the first dose of study medication (Day 1). | Baseline, Week 6-12 (Pre-RT), Week 40 (Post-RT) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tecemotide, Prostate Cancer, Goserelin, Cyclophosphamide, Radiotherapy