Phase 2
N=10
Ipilimumab in Combination With Androgen Suppression Therapy in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer
Adenocarcinoma of the Prostate · Hormone-resistant Prostate Cancer · Recurrent Prostate Cancer · Stage IV Prostate Cancer
Bottom Line
View on ClinicalTrials.gov: NCT01498978 ↗Enrolled (actual)
10
Serious AEs
10.0%
Results posted
May 2018
Primary outcome: Primary: Percentage of Patients Who Achieve an Undetectable PSA (=< 0.2 ng/ml) — 0.0 percentage of patients
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- ipilimumab (Biological); laboratory biomarker analysis (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- Male
- Sponsor
- OHSU Knight Cancer Institute
- Primary completion
- Feb 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Patients Who Achieve an Undetectable PSA (=< 0.2 ng/ml) |
0.0 | — |
| SECONDARY Time to PSA Progression |
525 | — |
| SECONDARY Time to Progression by Any Measure |
118 | — |
| SECONDARY Time to Death From Any Cause |
1825 | — |
| SECONDARY Number of Patients With IRAEs |
6 | 0.754 |
| SECONDARY Correlation Between IRAE and PSA Progression. |
5; 1; 1; 3 | 0.190 |
| SECONDARY Correlation of IRAEs With Ratio of T Regulatory Cells to T Effector Cells |
— | — |
| SECONDARY Correlation Between IRAEs and Immune Response |
— | — |
| SECONDARY Correlation Between IRAE and Radiographic Progression. |
1; 2; 5; 2 | 0.500 |
| SECONDARY Correlation Between IRAE and Any Progression. |
5; 3; 1; 1 | 1.000 |
| SECONDARY Correlation Between IRAE and Overall Survival. |
2; 3; 4; 1 | 0.524 |
Summary
This phase II trial studies how well ipilimumab works when given together with androgen suppression therapy in treating patients with hormone-resistant prostate cancer that has spread to other parts of the body. Monoclonal antibodies, such as ipilimumab, can block tumor growth in different ways. Some block the ability of tumors to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Androgen can cause the growth of prostate cancer. Androgen deprivation therapy may stop the adrenal glands from making androgen. Giving ipilimumab together with androgen suppression therapy may kill more tumor cells.
Eligibility Criteria
Inclusion Criteria
- Willing and able to give written informed consent
- Histologic diagnosis of adenocarcinoma of the prostate
- A PSA of > 0.2 ng/ml after 6-18 months of androgen suppression therapy, which may consist of luteinizing hormone-releasing hormone (LHRH) agonist or antagonist alone or the combination of an LHRH agonist or antagonist plus an antiandrogen, such as bicalutamide; androgen suppression therapy will continue without interruption
- Radiographic evidence of regional or distant metastasis at the time of study enrollment or at the time of diagnosis
- White blood cell (WBC) >= 2000/uL
- Absolute neutrophil count (ANC) >= 1000/uL
- Platelets >= 50 x 10^3/uL
- Hemoglobin >= 8 g/dL
- Creatinine = = 6 months; this must be documented
- Patients who are sexually active with a partner who could become pregnant are to use an effective form of barrier contraception, such as condoms or a partner using oral contraceptive pills; persons of reproductive potential must agree to use an adequate method of contraception throughout treatment and for at least 8 weeks after ipilimumab is stopped
- If a patient enters the trial on androgen suppression therapy (AST) that consists of both an LHRH agonist and an oral antiandrogen, both agents should be continued throughout the study; if an antiandrogen is stopped prior to study entry, it should be stopped 4 weeks before for nilutamide and flutamide and 6 weeks before for bicalutamide to ensure that a withdrawal phenomenon does not interfere with interpretation of efficacy results
Exclusion Criteria
- Radiation to any area of the body < 28 days prior to randomization
- Any other active malignancy with the exception of adequately treated basal or squamous cell skin cancer or superficial bladder cancer
- Autoimmune disease: patients with a history of inflammatory bowel disease are excluded from this study, as are patients with a history of symptomatic disease (eg, rheumatoid arthritis, systemic progressive sclerosis [scleroderma], systemic lupus erythematosus, autoimmune vasculitis [eg, Wegener's granulomatosis]); motor neuropathy considered of autoimmune origin (e.g. myasthenia gravis, Guillain-Barre syndrome); those with immune-mediated skin toxicity (i.e. toxic epidermal necrolysis, Stevens-Johnson syndrome) will also be excluded
- Any underlying medical or psychiatric condition, which in the opinion of the investigator will make the administration of ipilimumab hazardous or obscure the interpretation of adverse events (AEs), such as a condition associated with frequent diarrhea
- Any non-oncology vaccine therapy used for prevention of infectious diseases (for up to 1 month before or after any dose of ipilimumab)
- A history of prior treatment with ipilimumab or prior cluster of differentiation (CD)137 agonist or cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor or agonist
- Concomitant therapy with any of the following: interleukin (IL)-2, interferon, or other non-study immunotherapy regimens; cytotoxic chemotherapy; immunosuppressive agents (over the counter [OTC]/herbal/prescribed); immunostimulant agents, other than the study agent; other investigational therapies; or chronic use of systemic corticosteroids (greater than prednisone 10 mg orally per day, or its equivalent)
- Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (i.e., infectious) illness
Data sourced from ClinicalTrials.gov (NCT01498978). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.