A Single-Arm Phase II Study of Neoadjuvant Intensified Androgen Deprivation (Leuprolide and Abiraterone Acetate) in Combination With AKT Inhibition (Capivasertib) for High-Risk Localized Prostate Cancer With PTEN Loss

Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexMale
Age18+
SponsorVA Office of Research and Development

About this trial

The purpose of this study is to learn about how an investigational drug intervention completed before doing prostate surgery (specifically, radical prostatectomy with lymph node dissection) may help in treatment of high risk localized prostate cancers that are most resistant to standard treatments. This is a phase II research study. For this study, capivasertib, the study drug, will be taken with intensified androgen deprivation drugs (iADT; abiraterone and leuprolide) prior to radical prostatectomy. This study drug treatment will be evaluated to see if it is effective in shrinking and destroying prostate cancer tumors prior to surgery and to further evaluate its safety prior to prostate cancer surgery.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Informed Consent: provision of signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Members of all races and ethnic groups will be included.

Participants must have histologically confirmed non-metastatic adenocarcinoma of the prostate

Gleason sum >7 (ISUP Grade Group >3)

Disqualifiers

As judged by the investigator, any evidence of diseases (such as severe or uncontrolled systemic diseases, including uncontrolled hypertension, renal transplant and active bleeding diseases, uncontrolled pulmonary, renal, or hepatic dysfunction, uncontrolled infection, cardiac disease) which, in the investigator's opinion, makes it undesirable for the participant to participate in the study or that would jeopardize compliance with the protocol.

Any other disease, physical examination finding, or clinical laboratory finding that, in the investigator's opinion, gives reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug, may affect the interpretation of the results, render the patient at high risk from treatment complications or interferes with obtaining informed consent.

Known to have active hepatitis infection, positive hepatitis C antibody, hepatitis B virus surface antigen or hepatitis B virus core antibody, at screening. Known to have human immunodeficiency virus (HIV) with a CD4+ T-cell count < 350 cells/uL or a history of an acquired immunodeficiency syndrome (AIDS)-defining opportunistic infection within the past 12 months. Known to have active tuberculosis infection (clinical evaluation that may include clinical history, physical examination and radiographic findings, or tuberculosis testing in line with local practice).

Anti-androgen therapy including orchiectomy, luteinizing hormone-releasing hormone (LHRH) therapy, abiraterone, ketoconazole, estrogen therapy (Short-term ADT allowed, less than or equal to 2 months)

Trial design

Design model

Single group

Treatments tested in this trial

  • Capivasertib

    Drug

    400 milligrams (2 tablets) BID given on an intermittent weekly dosing schedule. Patients will be dosed on Days 1 to 4 in each week (4 days on, 3 days off). Treatment will be given in combination with abiraterone for 16 weeks duration (+/- 1 week for surgery window).

  • abiraterone acetate

    Drug

    Administered orally as tablets at a dosage of 1000 mg daily. To be administered with prednisone 5 milligrams po daily. Subjects will be on concurrent GNRH agonist therapy (leuprolide, administered as standard of care). Intensified androgen deprivation (iADT) consisting of abiraterone and leuprolide will be administered for a 4 week run-in prior to addition of capivasertib.

Treatment groups

30 Participants
are divided into 1 treatment group
Group A: Single ArmExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Pathologic Complete Response or Minimal Residual Disease (MRD)

No cancer detected on radical prostatectomy specimen, or minimal residual disease 5 millimeters (mm).

Time frame
5 months

Secondary outcomes

1

Surgical Complications

Incidence of Surgical Complications \[ Time Frame: 4 months \] Clavien-Dindo Classification of Surgical Complications compared to historical department incidence rates within 90 days after surgery.

Time frame
5 months + 90 days
2

ERG Expression and Pathologic Response

No cancer detected on radical prostatectomy specimen, or minimal residual disease 5 millimeters (mm), stratified by normal versus increased ERG expression by immunohistochemistry in prostatectomy specimen

Time frame
5 months

Other outcomes

1

Treatment related adverse events

Grade 3 or higher adverse event (AE) possibly related or related to any of three treatment drugs (capivasertib, abiraterone, leuprolide) per CTCAE v5, evaluated up until 90 days after prostatectomy

Time frame
5 months + 90 days

Sponsors and contacts

Click on the lead sponsor to view all of their trials.