A randomized phase II study comparing cabazitaxel/prednisone to cabazitaxel alone in docetaxel-pretreated men with metastatic castration resistant prostate cancer (mCRPC): The CABACARE trial.

Authors

null

Carlo Buonerba

Federico II University, Naples, Italy

Carlo Buonerba , Francesco Grillone , Sabrina Rossetti , Lorenzo Livi , Mario Scartozzi , Pierosandro Tagliaferri , Dario Bruzzese , Luca Scafuri , Vittorio Riccio , Ferdinando Costabile , Davide Bosso , Simona Iaccarino , Gaetano Facchini , Simone Carrano , Michela Izzo , Michele Caraglia , Sabino De Placido , Giuseppe di Lorenzo

Organizations

Federico II University, Naples, Italy, UNiversity of Catanzaro, Catanzaro, Italy, Istituto Nazionale Tumori Fondazione G. Pascale - IRCCS, Naples, Italy, University of Florence, Florence, Italy, Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy, Section of Medical Oncology, University of Catanzaro School of Medicine, Catanzaro, Italy, University of Naples, Naples, Italy, University of Naples Federico II, Naples, Italy, FEDERICO II, San Giorgio a Cremano, Napoli, AE, Italy, Universita Studi Napoli Fed II, oncology, Napoli, Italy, University Federico II of Naples, Naples, Italy, Universita Studi Napoli Fed II, Napoli, Italy, University Federico II, Portici, Italy, Medical Oncology, University of Naples Federico II, Naples, Italy, Department of Biochemistry, Biophisics and General Pathology, University of Campania "L.Vanvitelli", Caserta, Italy

Research Funding

Pharmaceutical/Biotech Company

Background: In the TROPIC trial, cabazitaxel (CAB) plus daily prednisone (PDN) was associated with a significant advantage in OS and PFS in docetaxel (DOC)-pretreated patients (Pts). Whether daily PDN may significantly contribute to CAB efficacy or improve its safety profile is unknown. In the CHARTEED trial, DOC was administered without daily PDN with no concerns about the lack of efficacy or greater toxicity. Safety data about CAB without PDN are scarce. Corticosteroids present multiple biological effects, which may potentially be either positive, such as those mediated by adrenal androgen and cytokine suppression, or detrimental, such as those associated with the activation of the glucocorticoid receptor (GR) and of the androgen receptor (AR). Furthermore, PDN is a CYP3A4 inducer and can potentially negatively affect CAB clearance. Finally, AR-V7 positivity in circulating tumor cells and retinoblastoma (RB) loss/inactivation have been identified as potential mechanisms of resistance to hormonal and chemotherapy treatments in prostate cancer. For this reason, we also aim to evaluate if CAB activity is related to such biomarkers. Methods: CABACARE (EudraCT 2016-005251-25) is a randomized, phase II, open label, multi-center study comparing CAB at 25 mg/m2 q21 plus daily PDN (10 mg) vs CAB at 25 mg/m2 q21 alone in mCRPC pts progressed during or after DOC treatment. The study is designed to test non inferiority in terms of PFS, according PCWG-2, of CAB alone vs CAB plus PDN assuming that the two arms are equally effective (non-inferiority HR = 1.4). Main secondary objectives are: safety, QoL, pain assessment, overall response rate (ORR), PSA response, time to PSA progression, Time to radiological progression; OS; time to skeletal related events . The influence of AR-V7 and RB status measured in circulating epithelial cells at baseline on CAB activity will also be evaluated. A total of 35 Italian centers have started / will start recruiting pts in the CABACARE trial. Of the 220 pts required by the trial design, 43 pts have been enrolled since 30th Nov , 2017 until 2nd Oct, 2018 in 10 different Italian Institutions. Clinical trial information: 2016-005251-25.

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Abstract Details

Meeting

2019 Genitourinary Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Clinical Trial Registration Number

2016-005251-25

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr TPS345)

DOI

10.1200/JCO.2019.37.7_suppl.TPS345

Abstract #

TPS345

Poster Bd #

N21

Abstract Disclosures