Abiraterone Post Ketoconazole for Prostate Cancer

Study Overview
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Brief Summary
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This is a phase II, open label, single center study to evaluate the efficacy of abiraterone acetate (CB7630) administered to patients with castrate resistant prostate cancer who have experienced disease progression on ketoconazole. It is hypothesized that abiraterone will be active in patients who have experienced disease progression on ketoconazole

Official Title
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A Phase II Study of Abiraterone Acetate in Patients With Castration Resistant Prostate Cancer (CRPC) and Prior Therapy With Ketoconazole

Conditions
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Prostate Cancer

Intervention / Treatment
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* Drug: Abiraterone acetate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Histologically confirmed adenocarcinoma of the prostate Prior therapy with ketoconazole for castration resistant prostate cancer. Patients should demonstrate evidence of progression (see below definitions) on ketoconazole or evidence of grades 3/4 toxicities on ketoconazole. Ketoconazole must have been administered for >28 days At least 27 days must elapse since last ketoconazole dose and first dose of abiraterone acetate No prior therapy with chemotherapy for metastatic prostate cancer Metastatic disease based on a positive bone scan or objective imaging on CT scan Ongoing gonadal androgen deprivation therapy with LHRH analogues or orchiectomy. Patients, who have not had an orchiectomy, must be maintained on effective LHRH analogue therapy for the duration of the trial Testosterone < 50 ng/dL Progressive disease after androgen deprivation: PSA evidence for progressive prostate cancer consists of a PSA level of at least 2 ng/ml which has risen on at least 2 successive occasions, at least 2 weeks apart Patients who are receiving an antiandrogen as part of primary androgen ablation must demonstrate disease progression following discontinuation of antiandrogen ECOG Performance Status 0-1 Age >18 years and able to comply with protocol requirements Serum Creatinine ≤1.5 x ULN Serum potassium >3.5mmol/L Bilirubin ≤1.5x ULN AST and ALT ≤2.5 x ULN Life expectancy of >12 weeks Exclusion Criteria: Therapy with other hormonal therapy, including any dose of megestrol acetate (Megace), finasteride (Proscar), dutasteride (Avodart) any herbal product known to decrease PSA levels (e.g., Saw Palmetto and PC-SPES), or any systemic corticosteroid within 4 weeks prior to first dose of study drug Therapy with supplements or complementary medicines/botanicals within 4 weeks of first dose of study drug, except for any combination of the following; conventional multivitamin supplements, Selenium, Lycopene and Soy supplements Prior radiation therapy completed < 4 weeks prior to enrollment Prior chemotherapy for castration resistant prostate cancer. Patients who have received chemotherapy for early stage prostate cancer (e.g. as part of a neoadjuvant or adjuvant trial) or for other malignancies are eligible provided that >1 year has passed since the administration of the last chemotherapy dose. Hemoglobin ≤9.0 g/dL Any currently active second malignancy, other than non-melanoma skin cancer Patients are not considered to have a currently active malignancy, if they have completed therapy and are considered by their physician to be at least less than 30% risk of relapse over next 3 months Blood pressure that is not controlled despite >2 oral agents (SBP >160 and DBP >90 on three or more readings within the screening period) Serum K+ <3.5 mmoL/L on more than one reading within the screening period NYHA Class II, NYHA Class III or IV Congestive Heart Failure Myocardial infarction within the 6 months prior to the first dose of study drug Serious intercurrent infections or nonmalignant medical illnesses that are uncontrolled Concurrent therapy with drugs that are metabolized as substrates of CYP1A2, CYP2D6, or CYP2C19 and are considered by the investigators to pose a risk for drug to drug interactions

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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Abiraterone acetate<br> | Drug: Abiraterone acetate<br>* Abiraterone acetate 1000 mg by mouth per day<br>* Other names: CB7630;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Preliminary Evidence of Efficacy of Abiraterone Acetate | number of patients with ≥ 30% PSA decline after 12 weeks of abiraterone treatment | 12 weeks from beginning of abiraterone treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time To Progression (TTP) |  | beginning of treatment until disease progression according to Prostate Cancer Working Group 2 (PCWG2) criteria | 
| Proportion of Patients With PSA Decline of > 50% |  | 12 weeks from beginning of therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Abiraterone acetate