Phase II, Randomized Study of Patients With Rising PSA at High-Risk of Progression After Primary Therapy to Assess the Clinical and Molecular Efficacy of the Enzastaurin - Bicalutamide Combination to Suppress the Androgen Receptor Without Testosterone Ablation
OBJECTIVES:
Primary
- To compare the two regimens on the proportion of patients with undetectable
prostate-specific antigen (PSA) level (< 0.2 ng/mL) at 44 weeks.
Secondary
- To assess the proportion of patients with PSA decline > 85% at 44 weeks on the
combination therapy arm compared to that of bicalutamide monotherapy arm.
- To assess the distribution of best PSA response in each study arm.
- To assess the time to PSA progression and the time to PSA nadir in each arm of the
study.
- To assess the duration of PSA response in each arm of the study.
- To characterize the PSA slope before, during, and after treatment.
- To evaluate the safety and tolerability of enzastaurin hydrochloride in this patient
population.
- To determine whether Gleason score or prior hormonal therapy has any effect on PSA
response to treatment.
OUTLINE: This is a multicenter study. Patients are stratified according to Gleason score (≤
6 vs 7 vs 8-10) and prior hormonal therapy (yes vs no). Patients are randomized to 1 of 2
treatment arms.
- Arm A:
- Weeks 1-12: Patients are observed without treatment. Patients with a
prostate-specific antigen (PSA) rise of > 50% above baseline or nadir (whichever
is lowest) and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2
weeks later, may be started on bicalutamide before the end of week 12 at the
discretion of the treating physician.
- Weeks 13-44: Patients with a rise PSA ≥ 50% above baseline or nadir, and a PSA
rise of at least 5 ng/mL confirmed by a repeat PSA at least 2 weeks later, are
removed from study. Patients receive oral bicalutamide once daily. Patients
achieving a PSA decline ≥ 50% in the absence of toxicity may continue to receive
bicalutamide up to 72 weeks.
- Arm B:
- Weeks 1-12: Patients receive oral enzastaurin hydrochloride twice daily. Patients
with a PSA rise of > 50% above baseline or nadir, and a rise of at least 5 ng/mL,
confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide
before the end of week 12 at the discretion of the treating physician.
- Weeks 13-44: Patients with a PSA rise of ≥ 50% above baseline or nadir, and a rise
of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, are removed
from study. Patients receive oral enzastaurin twice daily and oral bicalutamide
once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may
continue on this combination therapy up to 72 weeks.
After completion of study treatment, patients are followed every 3 months for 5 years, and
then every 6 months for up to 10 years.
Interventional
Allocation: Randomized, Primary Purpose: Treatment
Comparison of proportion of patients with undetectable prostate-specific antigen PSA level (< 0.2 ng/mL) at 44 weeks
No
Anna C. Ferrari, MD
Study Chair
New York University School of Medicine
Unspecified
CDR0000596077
NCT00685633
December 2008
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