E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Castrate Resistant Prostate Cancer/Hormone-Refractory Prostate Cancer patients with bone metastasis |
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E.1.1.1 | Medical condition in easily understood language |
Prostate cancer which has spread to the bone |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036916 |
E.1.2 | Term | Prostate cancer stage D |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 |
Provide radium-223 chloride to patients diagnosed with CRPC/HRPC with bone metastasis
To assess acute and long-term safety of radium-223 chloride |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Has provided written informed consent. Subjects must be able to understand and be willing to sign the written informed consent form (ICF). A signed ICF must be appropriately obtained prior to the conduct of the any trial- specific procedure.
• Age ≥ 18 years
• Histologically or cytologically confirmed prostate cancer
• Patients diagnosed with progressive bone predominant metastatic CRPC/HRPC with at least two skeletal metastases on bone scan with no lung, liver, and/or brain metastasis (lymph node only metastasis is allowed)
• Progressive disease is defined either by:
o The appearance of new bone lesions. If progression is based on new lesion(s) on bone scan only without an increase in PSA, PSA values from 3 assessments within the last 6 months must be provided; OR
o In the absence of a new bone lesions by 2 consecutive increases in serum PSA over previous reference value, which should not be more than 6 months before screening, each measured at least 1 week apart with the last PSA ≥5 ng/mL
• Life expectancy ≥ 6 months
• ECOG PS 0-2
• Adequate hematological, liver and renal function
o Absolute neutrophil count (ANC) ≥ 1.5 x109/L
o Platelet count ≥ 100 x109/L
o Hemoglobin ≥10.0 g/dL (100 g/L; 6.2 mmol/L)
o Total bilirubin level ≤ 1.5 x institutional upper limit of normal (ULN)
o Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN
o Creatinine ≤ 1.5 x ULN
o Albumin > 25 g/L
• Willing and able to comply with the protocol, including follow-up visits and examinations
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E.4 | Principal exclusion criteria |
• Treatment with an investigational drug within previous 4 weeks, or planned during the treatment period or follow-up
• Eligible for first course of docetaxel, i.e., patients who are fit enough, willing, and who are located where treatment with docetaxel is available
• Treatment with cytotoxic chemotherapy within previous 4 weeks, or failure to recover from AEs due to cytotoxic chemotherapy administered more than 4 weeks previous (however, ongoing neuropathy is permitted)
• Received previous radiotherapy to approximately > 25% of bone marrow, including hemibody radiation
• Received systemic therapy with radionuclides (e.g., strontium-89, samarium-153, rhenium-186, or rhenium-188, or radium-223 chloride) for the treatment of bony metastases
• Other malignancy treated within the last 3 years (except non-melanoma skin cancer or low-grade superficial bladder cancer)
• Visceral metastases as assessed by abdominal or pelvic computed tomography (CT) or other imaging modality
• Presence of brain metastases
• Lymphadenopathy exceeding 6 cm in short-axis diameter
• Any size pelvic lymphadenopathy if it is thought to be a contributor to concurrent hydronephrosis.
• Imminent or history of spinal cord compression based on clinical findings and/or magnetic resonance imaging (MRI)
• Any other serious illness or medical condition, such as but not limited to:
o Any infection ≥ NCI-CTCAE v.4.03 Grade 2
o Cardiac failure New York Heart Association (NYHA) III or IV
o Crohn’s disease or ulcerative colitis
o Bone marrow dysplasia
• Fecal incontinence
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E.5 End points |
E.5.1 | Primary end point(s) |
Acute (during treatment and up to 30 days last treatment) and Long-Term Safety (30 days last treatment and on-ward) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
During treatment and follow-up |
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E.5.2 | Secondary end point(s) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Upon obtaining signed informed consent, obtain baseline safety data.
During the treatment period, patients will be evaluated
at each visit, prior to receiving Ra-223 Cl.
During the follow-up period, patients will be evaluated every 6 months for long-term safety. |
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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 | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.6.13.1 | Other scope of the trial description |
Quality of Life will be evaluated by BPI-SF (this is not primary outcome/variable) |
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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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | Yes |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
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 |
Belgium |
Canada |
Czech Republic |
Denmark |
Finland |
France |
Germany |
Ireland |
Israel |
Italy |
Netherlands |
Norway |
Poland |
Slovakia |
Spain |
Sweden |
Switzerland |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | No |
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
|
For each participating European Union (EU) country, the end of the study according to the
EU Clinical Trial Directive will be reached when the last visit of the last patient for all centers
in the respective country has occurred.
Sites/Countries will be closed to enrolment as marketing approval of radium-223 chloride is obtained for that country. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |