Carolina Urologic Research Center, Myrtle Beach, SC
Neal D. Shore , Jose W. Avitia , James L. Bailen , Luke T. Nordquist , William Richardson , Cody J. Peer , William Douglas Figg , Jacqueline M. Walling , Joel Robert Eisner , Matthew Sharp , Robert J. Schotzinger , William R. Moore , Ronald F. Tutrone
Background: PRL-02 is a long-acting IM depot injection of abiraterone decanoate, a novel prodrug of abiraterone delivered through the lymphatic system. PRL-02 potently blocks androgen production with minimal increases in mineralocorticoids or decreases in glucocorticoids through preferential inhibition of Cytochrome P450 (CYP)17 lyase versus CYP17 hydroxylase. Phase 1 is a standard 3+3 design intended to identify a recommended Phase 2 dose (RP2D). PRL-02 is administered every 84 days (1 cycle). As of 9/8/22, 17 pts (6 mCRPC, 11 mCSPC) were treated across 5 dose cohorts (180, 360, 720, 1260, 1800mg). At 720mg and above, 9 of 11 had a 90% reduction in testosterone (T), including 2 pts with T≤ Lower Limit of Quantitation (LLOQ) of 0.1ng/dL. A PSA decline of ≥50% from baseline (PSA50) was observed in 8 of 10pts. PRL-02 was very well tolerated. Only minimal and transient changes in ‘upstream’ steroids (e.g., progesterone) were observed at doses of 1260 mg (the RP2D) and lower. Methods: Phase 2a is an A'Hern single-stage design. Group 1 includes pts with mCSPC divided into 2 groups (1A: previously untreated high-volume disease and 1B: previously untreated, low-volume disease). Group 2 includes pts with mCRPC. Enrollment of 66 pts is planned across 30 sites in the U.S. (NCT04729114). Patient populations, interventions and study design are described below. Clinical trial information: Clinical Trial information: NCT04729114.
Group | 1A | 1B | 2 |
---|---|---|---|
Patient Population | mCSPC, previously untreated high-volume disease | mCSPC, previously untreated, low-volume disease | Chemotherapy-naïve, mCRPC |
Treatment | PRL-02 + dexamethasone (Dex) + docetaxel +Androgen Deprivation Therapy (ADT) | PRL02 + Dex + ADT | PRL02 + Dex + ADT |
Primary Endpoint | Undetectable PSA (≤0.2ng/mL) at 8 months | Undetectable PSA (≤0.2ng/mL) at any time | PSA50 confirmed by a second consecutive PSA at least 3 weeks later |
H0 and Ha | 0.51, 0.70 | 0.51, 0.70 | 0.50, 0.75 |
Rationale/ Precedent | PEACE-1 trial (NCT01957436) (Mescam 2022; Klaassen 2022), which showed a strong correlation between undetectable PSA at 8 months and clinical benefit. (overall survival and Radiographic progression-free survival) The combination of abiraterone + prednisone + docetaxel + ADT had a 51% rate of undetectable PSA at months | Null hypothesis based on the LATITUDE study (NCT01715285) (Fizazi 2019; Tran 2019) in which the undetectable PSA rate at any time was 0.55 | Null hypothesis based on the activity of the ACIS study control arm abiraterone + prednisone (NCT02257736) (Saad 2021) |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Genitourinary Cancers Symposium
First Author: Jose W. Avitia
2024 ASCO Genitourinary Cancers Symposium
First Author: Jose W. Avitia
2024 ASCO Genitourinary Cancers Symposium
First Author: Gordon Andrew Brown
2021 ASCO Annual Meeting
First Author: Tim Warneke