E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced prostate cancer. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10029096 |
E.1.2 | Term | Neoplasm prostate |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Using an individual dose-ranging approach, to estimate the PSA response rate of adding dasatinib to ongoing androgen deprivation with Luteinizing Hormone Releasing Hormone LHRH treatment or surgical castration |
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E.2.2 | Secondary objectives of the trial |
To describe tumor response, bone scan response, duration of Prostate Specific Antigen PSA response, and time to disease progression. To assess safety and tolerability of dasatinib in combination with an LHRH agonist as a function of dose, and identify a well-tolerated dose range in this setting. To assess changes in markers of bone loss during dasatinib treatment To evaluate an individual dose-ranging design in this setting and obtain pharmacokinetic data. To describe disease related symptoms using the NCCN/FACT Prostate Symptom Index FPSI . |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
Signed written informed consent according to institutional guidelines Target population Men 18 years of age Histologically or cytologically proven advanced prostate carcinoma Metastatic disease documented by transaxial imaging or radionuclide bone scan. Progressive disease based on PSA with a minimum of 3 consecutive rising levels, with an interval of 1 week between each determination. The last determination must have a minimal value of 5 ng/mL and be determined within two weeks prior to registration. Castrate levels of serum testosterone 61500; 61472;30 ng/dL determined within two weeks prior to starting treatment. No prior chemotherapy, adjuvant, or neo-adjuvant chemotherapy in the prostate cancer setting. Patients who have received an anti-androgen as part of their prior hormonal therapy must have shown progression of disease off of the anti-androgen prior to enrollment. The first of the three consecutive PSA measurements confirming progression should be dated at least 6 weeks after bicalutamide withdrawal and 4 weeks for other antiandrogens. At least 6 weeks must have elapsed for isotope therapy 12 weeks for Strontium-89 or immunotherapy , prior to beginning protocol therapy. At least 4 weeks must have elapsed from major surgery. Toxicities related to prior therapy must either have returned to 61472; CTC Grade 1, baseline or deemed irreversible. Adequate organ function as defined by the following laboratory tests Hepatic enzymes AST, ALT , Total bilirubin all CTC Grade 0-1 Serum Calcium 61619; the lower limit of normal Serum Potassium, Magnesium, and Phosphate all CTC Grade 0-1 Creatinine CTC Grade 0-2 Hemoglobin, Neutrophil count, Platelets, PT, PTT all CTC Grade 0-1 ECOG performance status 0-2 Appendix 1 . Life expectancy at least 3 months. Patient must be available for follow-up. |
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E.4 | Principal exclusion criteria |
Sex and Reproductive Status 1 Women Target Disease Exceptions 2 Symptomatic CNS metastases Medical History and Concurrent Diseases 3 Medical condition which could significantly increase the risk of toxicity, including a Clinically-significant coagulation or platelet function disorder subjects who have never experienced surgical or dental bleeding challenge should also be tested for clinically significant von Willebrand s disease. b Infection requiring intravenous antibiotics c Ongoing or recent gastrointestinal bleeding d Clinically-significant cardiovascular disease, including myocardial infarction or ventricular tachyarrhythmia within 6 months, prolonged QTc 450 msec. Fridericia correction , Ejection Fraction EF 40 or major conduction abnormality unless a cardiac pacemaker is present e Requirement for prohibited concomitant therapy for details, see section 6.4.1 . 4 Any prior or ongoing anti-neoplastic medical therapy or immunotherapy for prostate cancer other than primary androgen deprivation agents and anti-androgens e.g., cytotoxic chemotherapy, mitoxantrone, estramustine, or docetaxel; adrenal androgen production inhibitors aminoglutethamide or ketoconazole; glucocorticoids in cytotoxic doses and schedules; vaccine therapy. 5 Any other concurrent malignancy other than in situ carcinoma of skin. History of malignancy other than prostate cancer that has been in complete remission 5 years is acceptable. 6 Inability to take or absorb oral medication for any reason 7 Inability to understand the potential risks and provide informed consent Prohibited Therapies and/or Medications 8 Bisphosphonate use may not commence within 3 weeks of study entry. Subjects with current bisphosphonate use fulfilling study entry criteria may continue bisphosphates during study. 9 See section 6.4.1 for specific details a potent CYP3A4 inhibitors b QTc prolonging agents strongly associated with Torsades de Pointes arrhythmia c non-reversible platelet inhibiting agents Other Exclusion Criteria 10 Prisoners or subjects who are compulsorily detained involuntarily incarcerated for treatment of either a psychiatric or physical e.g., infectious disease illness must not be enrolled into this study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the PSA response rate. A two-sided 95 exact confidence interval for the PSA response rate will be constructed using the Atkinson-Brown method. In addition to the total population, results will be presented for the patients characterized as post-anti-androgen withdrawal therapy separately from patients who have not received anti-androgens. The PSA response rate will also be computed separately for the response evaluable subjects. The study will utilize a modified Gehan two-stage design. In the first stage 29 response-evaluable subjects will be used. If no responses are observed, the study will be closed to accrual with the conclusion that the true response rate is unlikely to be greater than or equal to 10 . Otherwise, if there is at least 1 response, 21 additional subjects will be enrolled. With this design there is a less than 5 chance of stopping after the first stage if the true response rate is 10 or greater. With a total accrual of 50 response-evaluable subjects the maximum width of the 95 confidence interval will be 27 when the expected response rate is in the expected 10-30 range for the entire sample of 50 subjects. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |