Trial Outcomes & Findings for Genomic Guided Therapy With Dasatinib or Nilutamide in Metastatic Castration-Resistant Prostate Cancer (NCT NCT00918385)

NCT ID: NCT00918385

Last Updated: 2014-10-29

Results Overview

PFS is the interval from start of monotherapy until first disease progression or death, whichever occurred first.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

57 participants

Primary outcome timeframe

During monotherapy ( at least 12 weeks)

Results posted on

2014-10-29

Participant Flow

Accrual open from January 2009 to July 2011 in these institutions: Dana Farber Cancer Institute, Duke Cancer Institute, MD Anderson Cancer Center, Oregon Health \& Science Univ, U of CA at San Francisco, U of Washington.

64 consented, 7 screen failures. Of the 57 who began enrollment, 2 not assigned to treatment (withdrew consent, clinically unstable), 22 QC technical failures (received dasatinib off study) and 33 assigned per protocol (15 high AR, 18 low AR), 2 progressed before treatment. 14 high AR and 17 low AR began treatment and are included in the analysis.

Participant milestones

Participant milestones
Measure
Arm 1=High AR Nilutamide
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Monotherapy
STARTED
14
17
Monotherapy
COMPLETED
12
11
Monotherapy
NOT COMPLETED
2
6
Combination Nilutamide and Dasatinib
STARTED
12
11
Combination Nilutamide and Dasatinib
COMPLETED
6
3
Combination Nilutamide and Dasatinib
NOT COMPLETED
6
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm 1=High AR Nilutamide
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Monotherapy
Adverse Event
1
6
Monotherapy
Complicating illness
1
0
Combination Nilutamide and Dasatinib
Adverse Event
1
1
Combination Nilutamide and Dasatinib
Withdrawal by Subject
2
7
Combination Nilutamide and Dasatinib
Complicating illness
1
0

Baseline Characteristics

Genomic Guided Therapy With Dasatinib or Nilutamide in Metastatic Castration-Resistant Prostate Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1=High AR Nilutamide
n=14 Participants
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
n=17 Participants
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Total
n=31 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
n=5 Participants
4 Participants
n=7 Participants
10 Participants
n=5 Participants
Age, Categorical
>=65 years
8 Participants
n=5 Participants
13 Participants
n=7 Participants
21 Participants
n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Male
14 Participants
n=5 Participants
17 Participants
n=7 Participants
31 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
White
13 Participants
n=5 Participants
15 Participants
n=7 Participants
28 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
14 participants
n=5 Participants
17 participants
n=7 Participants
31 participants
n=5 Participants

PRIMARY outcome

Timeframe: During monotherapy ( at least 12 weeks)

PFS is the interval from start of monotherapy until first disease progression or death, whichever occurred first.

Outcome measures

Outcome measures
Measure
Arm 1=High AR Nilutamide
n=14 Participants
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
n=17 Participants
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Progression Free Survival (PFS)
2.8 months
Interval 2.7 to 4.4
2.6 months
Interval 1.1 to 3.0

SECONDARY outcome

Timeframe: During monotherapy (at least 12 weeks)

Population: 14 subjects began treatment; 13 with response documentation are included in the calculation; 1 subject was omitted because response documentation was not provided.

Tumor response was based on Response Criteria in Solid Tumors (RECIST). Complete response (CR) is defined as disappearance of all target and non-target lesions and normalization of tumor marker level. Partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Outcome measures

Outcome measures
Measure
Arm 1=High AR Nilutamide
n=13 Participants
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Overall Response Rate of Men With High AR Activity
0 percentage of patients with CR,PR
Interval 0.0 to 23.0

SECONDARY outcome

Timeframe: During dasatinib monotherapy ( at least 12 weeks)

Population: Of the 17 subjects treated, 15 had response documentation and are included in the calculation. Two were omitted (1 because response documentation was not provided; 1 ended treatment after 2 weeks for toxicity prior to repeat scans).

Tumor response is based on Response Evaluation Criteria in Solid Tumors (RECIST). Complete response (CR) is defined as disappearance of all target and non-target lesions and normalization of tumor marker level. Partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Outcome measures

Outcome measures
Measure
Arm 1=High AR Nilutamide
n=15 Participants
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Overall Response Rate of Men With Low AR Activity
0 percentage of patients with CR,PR
Interval 0.0 to 21.0

Adverse Events

Arm 1=High AR Nilutamide

Serious events: 14 serious events
Other events: 3 other events
Deaths: 0 deaths

Arm 2= Low AR Dasatinib

Serious events: 16 serious events
Other events: 1 other events
Deaths: 0 deaths

Combination Nilutamide and Dasatinib

Serious events: 14 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Arm 1=High AR Nilutamide
n=14 participants at risk
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
n=17 participants at risk
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Combination Nilutamide and Dasatinib
n=23 participants at risk
Blood and lymphatic system disorders
Anemia
78.6%
11/14
64.7%
11/17
56.5%
13/23
Blood and lymphatic system disorders
Lymph node pain
7.1%
1/14
0.00%
0/17
0.00%
0/23
Ear and labyrinth disorders
Ear and labyrinth disorders - Other
0.00%
0/14
5.9%
1/17
0.00%
0/23
Ear and labyrinth disorders
Ear pain
7.1%
1/14
0.00%
0/17
0.00%
0/23
Eye disorders
Blurred vision
7.1%
1/14
0.00%
0/17
0.00%
0/23
Eye disorders
Dry eye
0.00%
0/14
5.9%
1/17
4.3%
1/23
Eye disorders
Eye disorders - Other
64.3%
9/14
0.00%
0/17
21.7%
5/23
Eye disorders
Eye pain
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Abdominal pain
14.3%
2/14
11.8%
2/17
4.3%
1/23
Gastrointestinal disorders
Anal hemorrhage
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Constipation
28.6%
4/14
35.3%
6/17
30.4%
7/23
Gastrointestinal disorders
Diarrhea
28.6%
4/14
23.5%
4/17
17.4%
4/23
Gastrointestinal disorders
Dyspepsia
7.1%
1/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Dysphagia
7.1%
1/14
0.00%
0/17
0.00%
0/23
Gastrointestinal disorders
Fecal incontinence
14.3%
2/14
0.00%
0/17
0.00%
0/23
Gastrointestinal disorders
Flatulence
0.00%
0/14
11.8%
2/17
4.3%
1/23
Gastrointestinal disorders
Gastritis
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Gastrointestinal disorders - Other
7.1%
1/14
5.9%
1/17
4.3%
1/23
Gastrointestinal disorders
Hemorrhoids
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Mucositis oral
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Nausea
71.4%
10/14
35.3%
6/17
30.4%
7/23
Gastrointestinal disorders
Rectal pain
0.00%
0/14
5.9%
1/17
0.00%
0/23
Gastrointestinal disorders
Vomiting
28.6%
4/14
17.6%
3/17
8.7%
2/23
General disorders
Edema limbs
28.6%
4/14
23.5%
4/17
4.3%
1/23
General disorders
Edema trunk
7.1%
1/14
5.9%
1/17
0.00%
0/23
General disorders
Fatigue
28.6%
4/14
64.7%
11/17
43.5%
10/23
General disorders
Fever
7.1%
1/14
5.9%
1/17
0.00%
0/23
General disorders
Flu like symptoms
7.1%
1/14
0.00%
0/17
4.3%
1/23
General disorders
Pain
42.9%
6/14
23.5%
4/17
8.7%
2/23
Infections and infestations
Gum infection
7.1%
1/14
0.00%
0/17
0.00%
0/23
Infections and infestations
Infections and infestations - Other
7.1%
1/14
0.00%
0/17
0.00%
0/23
Infections and infestations
Sinusitis
7.1%
1/14
0.00%
0/17
0.00%
0/23
Infections and infestations
Tooth infection
7.1%
1/14
0.00%
0/17
0.00%
0/23
Infections and infestations
Urinary tract infection
7.1%
1/14
0.00%
0/17
0.00%
0/23
Injury, poisoning and procedural complications
Fracture
0.00%
0/14
5.9%
1/17
0.00%
0/23
Investigations
Aspartate aminotransferase increased
7.1%
1/14
0.00%
0/17
4.3%
1/23
Investigations
Creatinine increased
7.1%
1/14
0.00%
0/17
0.00%
0/23
Investigations
Neutrophil count decreased
0.00%
0/14
23.5%
4/17
0.00%
0/23
Investigations
Platelet count decreased
7.1%
1/14
17.6%
3/17
8.7%
2/23
Investigations
Weight loss
0.00%
0/14
5.9%
1/17
13.0%
3/23
Investigations
White blood cell decreased
7.1%
1/14
0.00%
0/17
0.00%
0/23
Metabolism and nutrition disorders
Anorexia
21.4%
3/14
41.2%
7/17
26.1%
6/23
Metabolism and nutrition disorders
Dehydration
7.1%
1/14
5.9%
1/17
0.00%
0/23
Metabolism and nutrition disorders
Hyperglycemia
7.1%
1/14
5.9%
1/17
4.3%
1/23
Metabolism and nutrition disorders
Hypoalbuminemia
7.1%
1/14
0.00%
0/17
0.00%
0/23
Metabolism and nutrition disorders
Hypocalcemia
7.1%
1/14
0.00%
0/17
0.00%
0/23
Metabolism and nutrition disorders
Hypokalemia
14.3%
2/14
0.00%
0/17
4.3%
1/23
Metabolism and nutrition disorders
Hyponatremia
7.1%
1/14
0.00%
0/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Arthralgia
7.1%
1/14
0.00%
0/17
4.3%
1/23
Musculoskeletal and connective tissue disorders
Back pain
7.1%
1/14
17.6%
3/17
17.4%
4/23
Musculoskeletal and connective tissue disorders
Bone pain
21.4%
3/14
11.8%
2/17
8.7%
2/23
Musculoskeletal and connective tissue disorders
Buttock pain
7.1%
1/14
5.9%
1/17
4.3%
1/23
Musculoskeletal and connective tissue disorders
Chest wall pain
7.1%
1/14
5.9%
1/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Generalized muscle weakness
0.00%
0/14
5.9%
1/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Musculoskeletal and connective tissue disorder - Other
0.00%
0/14
5.9%
1/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Myalgia
7.1%
1/14
5.9%
1/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Neck pain
7.1%
1/14
0.00%
0/17
0.00%
0/23
Musculoskeletal and connective tissue disorders
Pain in extremity
42.9%
6/14
29.4%
5/17
17.4%
4/23
Nervous system disorders
Ataxia
0.00%
0/14
5.9%
1/17
0.00%
0/23
Nervous system disorders
Cognitive disturbance
7.1%
1/14
0.00%
0/17
0.00%
0/23
Nervous system disorders
Dizziness
21.4%
3/14
11.8%
2/17
8.7%
2/23
Nervous system disorders
Dysgeusia
0.00%
0/14
0.00%
0/17
21.7%
5/23
Nervous system disorders
Headache
0.00%
0/14
0.00%
0/17
8.7%
2/23
Nervous system disorders
Memory impairment
0.00%
0/14
5.9%
1/17
0.00%
0/23
Nervous system disorders
Peripheral motor neuropathy
0.00%
0/14
5.9%
1/17
0.00%
0/23
Nervous system disorders
Peripheral sensory neuropathy
14.3%
2/14
17.6%
3/17
13.0%
3/23
Nervous system disorders
Sinus pain
0.00%
0/14
5.9%
1/17
0.00%
0/23
Psychiatric disorders
Agitation
7.1%
1/14
0.00%
0/17
0.00%
0/23
Psychiatric disorders
Anxiety
7.1%
1/14
0.00%
0/17
8.7%
2/23
Psychiatric disorders
Depression
14.3%
2/14
5.9%
1/17
0.00%
0/23
Psychiatric disorders
Insomnia
7.1%
1/14
11.8%
2/17
8.7%
2/23
Renal and urinary disorders
Hematuria
7.1%
1/14
11.8%
2/17
4.3%
1/23
Renal and urinary disorders
Renal and urinary disorders - Other
14.3%
2/14
5.9%
1/17
4.3%
1/23
Renal and urinary disorders
Urinary frequency
7.1%
1/14
5.9%
1/17
8.7%
2/23
Renal and urinary disorders
Urinary incontinence
14.3%
2/14
0.00%
0/17
0.00%
0/23
Renal and urinary disorders
Urinary retention
14.3%
2/14
0.00%
0/17
0.00%
0/23
Renal and urinary disorders
Urinary tract obstruction
7.1%
1/14
0.00%
0/17
0.00%
0/23
Renal and urinary disorders
Urine discoloration
0.00%
0/14
5.9%
1/17
0.00%
0/23
Reproductive system and breast disorders
Gynecomastia
0.00%
0/14
5.9%
1/17
0.00%
0/23
Reproductive system and breast disorders
Pelvic pain
14.3%
2/14
11.8%
2/17
13.0%
3/23
Reproductive system and breast disorders
Scrotal pain
7.1%
1/14
0.00%
0/17
0.00%
0/23
Reproductive system and breast disorders
Testicular pain
0.00%
0/14
5.9%
1/17
0.00%
0/23
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
7.1%
1/14
0.00%
0/17
0.00%
0/23
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/14
5.9%
1/17
8.7%
2/23
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.00%
0/14
17.6%
3/17
13.0%
3/23
Respiratory, thoracic and mediastinal disorders
Epistaxis
0.00%
0/14
5.9%
1/17
0.00%
0/23
Respiratory, thoracic and mediastinal disorders
Hiccups
7.1%
1/14
0.00%
0/17
8.7%
2/23
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.00%
0/14
11.8%
2/17
0.00%
0/23
Respiratory, thoracic and mediastinal disorders
Respiratory, thoracic and mediastinal disorders - Other
14.3%
2/14
5.9%
1/17
17.4%
4/23
Respiratory, thoracic and mediastinal disorders
Sinus disorder
0.00%
0/14
5.9%
1/17
0.00%
0/23
Respiratory, thoracic and mediastinal disorders
Voice alteration
0.00%
0/14
5.9%
1/17
0.00%
0/23
Skin and subcutaneous tissue disorders
Dry skin
0.00%
0/14
11.8%
2/17
4.3%
1/23
Skin and subcutaneous tissue disorders
Purpura
0.00%
0/14
5.9%
1/17
0.00%
0/23
Skin and subcutaneous tissue disorders
Rash maculo-papular
21.4%
3/14
5.9%
1/17
0.00%
0/23
Vascular disorders
Hot flashes
28.6%
4/14
5.9%
1/17
4.3%
1/23
Vascular disorders
Hypertension
0.00%
0/14
5.9%
1/17
0.00%
0/23
Eye disorders
Extraocular muscle paresis
0.00%
0/14
0.00%
0/17
4.3%
1/23
Gastrointestinal disorders
Dry mouth
0.00%
0/14
0.00%
0/17
4.3%
1/23
Gastrointestinal disorders
Lower gastrointestinal hemorrhage
0.00%
0/14
0.00%
0/17
4.3%
1/23
General disorders
Non-cardiac chest pain
0.00%
0/14
0.00%
0/17
4.3%
1/23
Infections and infestations
Rhinitis infective
0.00%
0/14
0.00%
0/17
4.3%
1/23
Investigations
Electrocardiogram QT corrected interval prolonged
0.00%
0/14
0.00%
0/17
8.7%
2/23
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain
0.00%
0/14
0.00%
0/17
4.3%
1/23

Other adverse events

Other adverse events
Measure
Arm 1=High AR Nilutamide
n=14 participants at risk
High Androgen Receptor (AR) activity of \>= 0.50 Nilutamide: Nilutamide 150mg orally each day for 28 days per cycle. After first progression, Nilutamide 150mg orally each day in combination with Dasatinib 100mg orally each day for 28 days per cycle.
Arm 2= Low AR Dasatinib
n=17 participants at risk
Low Androgen Receptor (AR) activity of \< 0.50 Dasatinib: Dasatinib 100mg orally daily x 28 days per cycle. After first progression, Dasatinib 100mg orally each day in combination with Nilutamide 150mg orally each day for 28 days per cycle.
Combination Nilutamide and Dasatinib
n=23 participants at risk
Blood and lymphatic system disorders
Anemia
7.1%
1/14
5.9%
1/17
0.00%
0/23
Nervous system disorders
Dizziness
7.1%
1/14
0.00%
0/17
0.00%
0/23
Renal and urinary disorders
Obstruction, GU:Ureter
7.1%
1/14
0.00%
0/17
0.00%
0/23
Eye disorders
Eye disorders - Other
0.00%
0/14
0.00%
0/17
4.3%
1/23

Additional Information

Dr. Daniel George

Duke University

Phone: (919) 668 4615

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place