This phase IIb study is a randomized, double-blind, placebo-controlled multi-center study evaluating efficacy and tolerability of Osteodex of patients with metastatic castration resistant prostate cancer (CRPC). Osteodex is a poly-bisphosphonate containing three known substances; dextran, alendronate and guanidine. The objective of the study is to evaluate the relative change of response markers to bone metabolism (B-ALP and S-P1NP) The following objectives will also be evaluated: overall survival, PSA response, other response markers related to bone metabolism (S-CTX and osteocalcin), safety, tolerability, pain and quality of life.
Males, diagnosed with CRPC, who fulfil the inclusion criteria and does not have any exclusion criteria, will be asked to participate in the study. The subject will be informed orally and in writing about the study procedures and give written informed consent, prior to study start. At the screening visit the following examinations are performed: Physical examination, medical history and concomitant medication. Heart rate, blood pressure, weight, height, body temperature and respiratory rate are measured. Blood samples are drawn and urine sample is collected. ECG is recorded. Bone scan and PET-CT are also performed. At the next visit, baseline, the subject is examined physically and heart rate, blood pressure, weight, body temperature and respiratory rate are measured, ECG is recorded, blood samples drawn and urine sample collected. FACT-P and EQ-5D-5L questionnaire are filled out by the subject. Adverse events and concomitant medication is documented and the first dose of the investigational product is given. The subject is surveyed for 3 hours at the hospital. The duration of the study for the individual subject will be approximately 30 weeks from screening to the follow-up visit 2 weeks after the last dose. Each subject will receive at least 7 doses and maximum 13 doses of investigational product. A Data Monitoring Committee (DMC) will be designated and will be responsible to monitor/review all study related safety data. After review of safety data the DMC will provide recommendation as to whether the dose escalation can proceed as planned according to the protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
3
Oncology clinic, Norrlands Universitetssjukhus
Umeå, Umeå, Sweden
Relative change in response markers related to bone metabolism (B-ALP and S-P1NP)
Time frame: Baseline and 24 weeks of treatment
Relative change in response markers related to bone metabolism (B-ALP and S-P1NP)
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22 weeks of treatment and at 2 weeks post-treatment.
Relative change in response markers related to bone metabolism (S-CTX and osteocalcin)
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment.
PSA response
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment.
Overall survival
Life expectancy for participating subjects ≥ 6 months
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment. Long-term follow-up will be conducted every 3rd month, up to 12 months.
Pain
FACT-P questionnaire
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment.
Analgesic consumption
Life expectancy for participating subjects ≥ 6 months
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment. Long-term follow-up will be conducted every 3rd month, up to 12 months.
Changes in tumor cell metabolism measured
PET-CT
Time frame: Baseline, 12 and 24 weeks of treatment
Changes in bone metastasis
Bone scan
Time frame: Baseline, 12 and 24 weeks of treatment
Incidence, causality and intensity of AEs
Life expectancy for participating subjects ≥ 6 months
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment. Long-term follow-up will be conducted every 3rd month, up to 12 months
Dose and duration of medications required for the treatment of AEs
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and at 2 weeks post-treatment. Long-term follow-up will be conducted every 3rd month, up to 12 months.
Change from baseline in Quality of life
EQ-5D-5L questionnaire, FACT-P questionnaire
Time frame: Baseline and at 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 weeks of treatment and 2 weeks post-treatment.
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