This is a multicenter phase 2 open label study of pembrolizumab in patients with metastatic castrate resistant prostate cancer (mCRPC) with or without DNA damage repair defects.
This is a multicenter phase 2 open label study of pembrolizumab in patients with metastatic castrate resistant prostate cancer (mCRPC) with or without DNA damage repair defects. All subjects will receive pembrolizumab 200mg intravenously (IV) every 3 weeks until disease progression or unacceptable toxicity. The primary endpoint of the study is objective response rate (ORR) according to immune-mediated response criteria (irRC).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
26
All subjects will receive pembrolizumab 200mg IV every 3 weeks until disease progression or unacceptable toxicity.
At time of progression, all subjects will also have the option of receiving taxane-based chemotherapy followed by repeat pembrolizumab for those who have a clinical response to chemotherapy. Chemotherapy regimen will be at the discretion of the treating physician, and may consist of docetaxel or cabazitaxel with or without a platinum agent (e.g. carboplatin). A minimum of 4 cycles and a maximum of 8 cycles of chemotherapy will be given.
University of California, San Francisco
San Francisco, California, United States
Radiographic Progression-Free Survival Rate (rPFS) at 6 Months
The rPFS rate is defined as the proportion of participants still alive at 6 months starting from the first day of study treatment with pembrolizumab. Participants will be censored on the date of documented tumor progression according to the Prostate Cancer Clinical Trials Working Group 3 (PCWG3) guidelines or death due to any cause at 6 months. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The 6-month rPFS rate and the 95% confidence interval will be reported by study group.
Time frame: Up to 6 months
Median Overall Radiographic Progression-free Survival (rPFS)
The median overall radiographic progression free survival (rPFS) is defined as the time from the first day of study treatment with pembrolizumab to the date of documented radiographic tumor progression according to the Prostate Cancer Clinical Trials Working Group 3 (PCWG3) guidelines or death due to any cause, whichever occurs first. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The median time in months and the 95% confidence interval will be reported by study group.
Time frame: Up to 24 months
Immune-related Progression-free Survival Rate (irPFS) at 20 Weeks
The immune-related Progression Free Survival rate (irPFS) is defined as the proportion of participants still alive at 20 weeks from the first day of study treatment with pembrolizumab. Participants will be censored on the date of documented tumor progression according to the immune-related response criteria (irRC) for immune-related progression or death due to any cause at 20 weeks. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The 20-week irPFS rate and the 95% confidence interval will be reported by study group.
Time frame: Up to 20 weeks
Immune-related Progression-free Survival Rate (irPFS) at 28 Weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
The immune-related Progression Free Survival rate (irPFS) is defined as the proportion of participants still alive at 28 weeks from the first day of study treatment with pembrolizumab. Participants will be censored on the date of documented tumor progression according to the immune-related response criteria (irRC) for immune-related progression or death due to any cause at 28 weeks. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The 28-week irPFS rate and the 95% confidence interval will be reported by study group.
Time frame: Up to 28 weeks
Overall Progression-Free Survival Rate (PFS) at 20 Weeks
The overall progression free survival rate (PFS) is defined as the proportion of participants still alive from the first day of study treatment with pembrolizumab at 20 weeks. Participants will be censored on the date of documented tumor progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines or death due to any cause at 20 weeks. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The 20-week overall PFS rate and the 95% confidence interval will be reported by study group.
Time frame: Up to 20 weeks
Overall Progression-Free Survival Rate (PFS) at 28 Weeks
The overall progression free survival rate (PFS) is defined as the proportion of participants still alive from the first day of study treatment with pembrolizumab at 28 weeks. Participants will be censored on the date of documented tumor progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 guidelines or death due to any cause at 28 weeks. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. The 28-week overall PFS rate and the 95% confidence interval will be reported by study group.
Time frame: Up to 28 weeks
Percentage of Participants Achieving Any Prostate Specific Antigen (PSA) Response
The percentage of participants with a demonstrated PSA response will be reported for each group along with the 95% confidence interval.
Time frame: Up to 24 months
Percentage of Participants Achieving Any PSA Decline ≥ 50%
The percentage of participants with a demonstrated PSA decline \>= 50% will be reported for each group along with the 95% confidence interval.
Time frame: Up to 24 months
Number of Participants Reporting Any Pembrolizumab Treatment-related Adverse Events
All participants will be evaluated for toxicity from the time of the first treatment with pembrolizumab. The number of participants with adverse events defined by the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and categorized as having a possible, probable, or definite attribution to the administration of pembrolizumab from the start of treatment until 30 days after the end of treatment will be reported for each group.
Time frame: Up to 24 months
Median Time to Progression After Taxane-based Chemotherapy
For participants who undergo taxane-based chemotherapy after progression on pembrolizumab followed by repeat pembrolizumab after chemotherapy, time from the first chemotherapy treatment to disease progression will be estimated in both study groups. Disease progression will be defined by confirmed PSA progression on two consecutive measurements at least 2 weeks apart, or radiographic progression by irRC. The Kaplan-Meier method will be used to estimate the median time to progression with 95% confidence interval by study group.
Time frame: Up to 24 months