This is a multicenter, single-arm, two-stage open-label phase 2 study of the combination of cabozantinib + nivolumab in subjects with advanced castration-resistant prostate cancer (CRPC).
Eligible subjects will undergo a baseline biopsy prior to treatment initiation. They will then initiate treatment with cabozantinib (40 mg orally daily) and nivolumab (480 mg intravenously every four weeks). An on-treatment biopsy will be performed during Cycle 2. Subjects will continue treatment until radiographic progression, toxicity or withdrawal. Prostate-specific antigen (PSA) levels will be evaluated once every cycle. Radiographic assessments will occur every two cycles for one year and then every three cycles thereafter. Cycle length is 28 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
47
40 mg taken orally
480 mg by infusion
University of California San Diego
La Jolla, California, United States
RECRUITINGUniversity of Chicago Medical Center
Chicago, Illinois, United States
RECRUITINGUniversity of Texas Southwestern Medical Center
Dallas, Texas, United States
Radiographic Progression Free Survival (rPFS)
The primary endpoint is the efficacy of treatment via assessment of 6 month rPFS defined by RECIST version 1.1 for soft tissue and Prostate Cancer Working Group 3 (PCWG3) criteria for bone metastases. rPFS is defined as the duration of time from the first day of the start of study treatment to time of radiographic progression or death due to any cause, whichever occurs first.
Time frame: 6 months
PSA Response
PSA response per PCWG3. PSA response defined as a ≥50% decline in PSA from baseline (measured twice at least 3 weeks apart).
Time frame: 3 years
Overall Response Rate (ORR)
ORR by RECIST version 1.1 in subjects with measurable disease. ORR will be defined using RECIST version 1.1 criteria for subjects with measurable disease.
Time frame: 3 years
6-month rPFS in predefined subgroups
Defined as 1) subjects with and without visceral metastases and 2) subjects with and without bone metastases. 6 month rPFS defined by RECIST version 1.1 for soft tissue and Prostate Cancer Working Group 3 (PCWG3) criteria for bone metastases. rPFS is defined as the duration of time from the first day of the start of study treatment to time of radiographic progression or death due to any cause, whichever occurs first.
Time frame: 6 months
6-month PSA response in predefined subgroups
Defined as 1) subjects with and without visceral metastases and 2) subjects with and without bone metastases. PSA response per PCWG3. PSA response defined as a ≥50% decline in PSA from baseline (measured twice at least 3 weeks apart).
Time frame: 6 months
6-month ORR in predefined subgroups
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University of Wisconsin
Madison, Wisconsin, United States
RECRUITINGDefined as 1) subjects with and without visceral metastases and 2) subjects with and without bone metastases. ORR by RECIST version 1.1 in subjects with measurable disease.
Time frame: 6 months
rPFS
Defined by radiographic progression by RECIST 1.1 for soft tissue and PCWG3 version 1.1 for bone metastases.
Time frame: 3 years
Overall Survival (OS)
Overall survival (OS) is defined as time from start of study treatment to the date of death from any cause. Subjects who are alive will be censored at last follow up date.
Time frame: 3 years
Assess conversion of circulating tumor cell (CTC) count
Conversion of CTC count from ≥ 5 cells/7.5 mL blood at baseline to \< 5 cells/7.5 mL blood confirmed by at least two readings 4 weeks apart.
Time frame: 3 years
Assess adverse events
Safety and tolerability as determined by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Time frame: 3 months
Time to PSA Progression
Time to PSA progression as defined by PCWG3 criteria.
Time frame: 3 years
Time to occurrence of first symptomatic skeletal event.
A skeletal related event is the use of external beam radiotherapy to relieve skeletal symptoms or the occurrence of new symptomatic pathological bone fractures (vertebral or non-vertebral) or the occurrence of spinal cord compression or a tumor related orthopedic surgical intervention.
Time frame: 3 years
Time from treatment discontinuation to first subsequent anti-cancer therapy
Evaluate time from treatment discontinuation to first subsequent anti-cancer therapy (including androgen receptor signaling agents, cytotoxic chemotherapy, immunotherapy, or investigational agents) or death.
Time frame: 3 years