Phase II Study of Apalutamide With Carotuximab in Metastatic, Castration-Resistant Prostate Cancer
Summary
This is an open-label, multi-site study of apalutamide with carotuximab in patients who have progressed on androgen receptor signaling inhibitor (ARSI) therapy. This study will begin with a safety assessment in the first 10 subjects (part 1: Safety Lead-in). If the combination is deemed safe, the trial will proceed to the Phase II stage. The purpose of this study is to compare progression free survival (PFS) between patients receiving apalutamide and apalutamide + carotuximab using Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3. The secondary objectives are to describe adverse events related to the intervention, overall response rate (ORR), proportion of patients resistant to apalutamide that benefit from the addition of carotuximab, and to determine the ORR, radiographic PFS, and biochemical PFS in the overall population.
Arms & interventions
- DrugApalutamide
Standard of care Apalutamide 240 mg administered orally and daily on Days 1-28 of every 28 day cycle
- DrugCarotuximab
Carotuximab administered intravenously at the following doses: Cycle 1 Day 1: 3 mg/kg Cycle 1 Day 4: 7 mg/kg Cycle 1 Day 8: 10 mg/kg Cycle 1 Day 15: 10 mg/kg Cycle 1 Day 22: 10 mg/kg Cycle 2 Day 1: 15 mg/kg Cycle 2 Day 15: 15 mg/kg Cycle 3+ Day 1: 15 mg/kg After completion of cycle 2, dosing of carotuximab will continue at a q4 week schedule using the 15 mg/kg dose.
Outcome measures
Primary
Progression free survival (rPFS) between patients receiving apalutamide and apalutamide + carotuximab
From the start of study treatment until documented progression, per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3, or death due to any cause.
Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
Secondary
Incidence of Adverse events (grade 3 or higher) related to carotuximab and apalutamide
Time frame: From start of study treatment through 4 weeks on treatment
Overall radiographic response rate (ORR) of the combination of apalutamide + carotuximab
Time frame: From the start of combination study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
Proportion of patients resistant to apalutamide benefit from the addition of carotuximab
Time frame: From the start of combination therapy study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
Overall radiographic response rate (ORR) in the overall population
Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
To determine the radiographic progression free survival (rPFS) in the overall population
Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
To determine the biochemical PFS (by PCWG3) in the overall population
Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.
Eligibility criteria
Study locations (3)
City of Hope
Duarte, California, 91010
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Huntsman Cancer Institute and Hospital
Salt Lake City, Utah, 84112