The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT02023697




Registration number
NCT02023697
Ethics application status
Date submitted
24/12/2013
Date registered
30/12/2013
Date last updated
12/07/2019

Titles & IDs
Public title
Standard Dose Versus High Dose and Versus Extended Standard Dose Radium-223 Dichloride in Castration-resistant Prostate Cancer Metastatic to the Bone
Scientific title
A Three Arm Randomized, Open-label Phase II Study of Radium-223 Dichloride 50 kBq/kg (55 kBq/kg After Implementation of NIST Update) Versus 80 kBq/kg (88 kBq/kg After Implementation of NIST Update), and Versus 50 kBq/kg (55 kBq/kg After Implementation of NIST Update) in an Extended Dosing Schedule in Subjects With Castration-resistant Prostate Cancer Metastatic to the Bone
Secondary ID [1] 0 0
2013-003118-42
Secondary ID [2] 0 0
16507
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Prostatic Neoplasms 0 0
Condition category
Condition code
Cancer 0 0 0 0
Prostate

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Radium-223 dichloride (Xofigo, BAY88-8223)

Experimental: Radium-223 dichloride (Standard dose) - One injection to be administered every 4 weeks up to 6 injections. The dose per injection is 50 kBq/kg body weight (55 kBq/kg after implementation of NIST update).

Experimental: Radium-223 dichloride (High dose) - One injection to be administered every 4 weeks up to 6 injections. The dose per injection is 80 kBq/kg body weight (88 kBq/kg after implementation of NIST update).

Experimental: Radium-223 dichloride (Extended standard dose) - One injection to be administered every 4 weeks up to 12 injections. The dose per injection is 50 kBq/kg body weight (55 kBq/kg after implementation of NIST update).


Treatment: Drugs: Radium-223 dichloride (Xofigo, BAY88-8223)


Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Number of Participants With an Event Defining SSE Free Survival - High Dose vs. Standard Dose
Timepoint [1] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Primary outcome [2] 0 0
Symptomatic Skeletal Event-Free Survival - High Dose vs. Standard Dose
Timepoint [2] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Primary outcome [3] 0 0
Number of Participants With an Event Defining SSE Free Survival - Extended Dose vs. Standard Dose
Timepoint [3] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Primary outcome [4] 0 0
Symptomatic Skeletal Event-Free Survival - Extended Dose vs. Standard Dose
Timepoint [4] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Primary outcome [5] 0 0
Number of Participants With an Event Defining SSE Free Survival - Three Dose Groups As Randomized
Timepoint [5] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Primary outcome [6] 0 0
Symptomatic Skeletal Event Free Survival - Three Dose Groups As Randomized
Timepoint [6] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [1] 0 0
Number of Participants With an Overall Survival Event - High Dose vs. Standard Dose
Timepoint [1] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [2] 0 0
Overall Survival - High Dose vs. Standard Dose
Timepoint [2] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [3] 0 0
Number of Participants With an Overall Survival Event - Extended Dose vs. Standard Dose
Timepoint [3] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [4] 0 0
Overall Survival - Extended Dose vs. Standard Dose
Timepoint [4] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [5] 0 0
Number of Participants With an Overall Survival - Three Dose Groups As Randomized
Timepoint [5] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [6] 0 0
Overall Survival Event - Three Dose Groups as Randomized
Timepoint [6] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [7] 0 0
Number of Participants With First Symptomatic Skeletal Event - High Dose vs. Standard Dose
Timepoint [7] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [8] 0 0
Time to First Symptomatic Skeletal Event - High Dose vs. Standard Dose
Timepoint [8] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [9] 0 0
Number of Participants With First Symptomatic Skeletal Event - Extended Dose vs. Standard Dose
Timepoint [9] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [10] 0 0
Time to First Symptomatic Skeletal Event - Extended Dose vs. Standard Dose
Timepoint [10] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [11] 0 0
Number of Participants With First Symptomatic Skeletal Event - Three Dose Groups as Randomized
Timepoint [11] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [12] 0 0
Time to First Symptomatic Skeletal Event - Three Dose Groups as Randomized
Timepoint [12] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [13] 0 0
Number of Participants With a Radiological Progression Event-Free - High Dose vs. Standard Dose
Timepoint [13] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [14] 0 0
Radiological Progression Free Survival - High Dose vs. Standard Dose
Timepoint [14] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [15] 0 0
Number of Participants With a Radiological Progression Event-Free - Extended Dose vs. Standard Dose
Timepoint [15] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [16] 0 0
Radiological Progression Free Survival - Extended Dose vs. Standard Dose
Timepoint [16] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [17] 0 0
Number of Participants With a Radiological Progression Event-Free - Three Dose Groups as Randomized
Timepoint [17] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [18] 0 0
Radiological Progression Free Survival - Three Dose Groups as Randomized
Timepoint [18] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [19] 0 0
Number of Participants With a Radiological Progression Event - High Dose vs. Standard Dose
Timepoint [19] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [20] 0 0
Time to Radiological Progression - High Dose vs. Standard Dose
Timepoint [20] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [21] 0 0
Number of Participants With a Radiological Progression Event - Extended Dose vs. Standard Dose
Timepoint [21] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [22] 0 0
Time to Radiological Progression - Extended Dose vs. Standard Dose
Timepoint [22] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [23] 0 0
Number of Participants With a Radiological Progression Event - Three Dose Groups as Randomized
Timepoint [23] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [24] 0 0
Time to Radiological Progression - Three Dose Groups as Randomized
Timepoint [24] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [25] 0 0
Timepoint Pain Improvement Rate - Three Dose Groups as Randomized
Timepoint [25] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [26] 0 0
Timepoint Pain Improvement Rate - Extended Dose vs. Standard Dose
Timepoint [26] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [27] 0 0
Number of Participants With a Pain Progression Event - High Dose vs. Standard Dose
Timepoint [27] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [28] 0 0
Time to Pain Progression - High Dose vs. Standard Dose
Timepoint [28] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [29] 0 0
Number of Participants With a Pain Progression Event - Extended Dose vs. Standard Dose
Timepoint [29] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [30] 0 0
Time to Pain Progression - Extended Dose vs. Standard Dose
Timepoint [30] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [31] 0 0
Number of Participants With a Pain Progression Event - Three Dose Groups as Randomized
Timepoint [31] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [32] 0 0
Time to Pain Progression - Three Dose Groups as Randomized
Timepoint [32] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)
Secondary outcome [33] 0 0
Number of Participants With Treatment-Emergent Adverse Events
Timepoint [33] 0 0
From randomization to 135 SSE-FS events have been observed in comparison 1 or 75 SSE-FS events observed in comparison 2, whichever occurred last (approximately 36 months from first patient randomization)

Eligibility
Key inclusion criteria
- Histologically or cytologically confirmed adenocarcinoma of the prostate

- Castration-resistant disease defined as:

- Serum testosterone level: = 50 ng/dL (1.7 nmol/L)

- Bilateral orchiectomy or maintenance on androgen ablation therapy with
luteinizing-hormone-releasing hormone (LHRH) agonist or antagonist, or
polyestradiol phosphate

- Serum PSA (Prostate specific antigen) progression defined as 2 subsequent
increases in PSA over a previous reference value (a minimum of 2 ng/mL [µg/L]) OR

- Radiographic evidence of disease progression in bone (according to Prostate
Cancer Clinical Trials Working Group 2 [PCWG2] criteria) with or without PSA
progression

- Eastern Cooperative Oncology Group performance status (ECOG PS) 0 to 2. In case of
ECOG PS 2, the PS has to be due to metastatic prostate cancer to the bone.

- Two or more skeletal metastases (= 2 hot spots) on bone scintigraphy within 8 weeks of
randomization
Minimum age
18 Years
Maximum age
No limit
Sex
Males
Can healthy volunteers participate?
No
Key exclusion criteria
- History of visceral metastasis, or visceral metastases

- Lymphadenopathy with lymph nodes exceeding 3 cm in short axis diameter

- Central nervous system (CNS) metastases

- Treatment with cytotoxic chemotherapy for prostate cancer within the previous 4 weeks
prior to randomization, or planned treatment with cytotoxic chemotherapy agents for
prostate cancer during the treatment period or follow-up

- Chronic conditions associated with non-malignant abnormal bone growth (e.g. confirmed
Paget's disease of bone)

- Prior treatment with radium-223 dichloride

- Prior systemic radiotherapy and hemibody external radiotherapy

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
SA,VIC
Recruitment hospital [1] 0 0
- Adelaide
Recruitment hospital [2] 0 0
- Melbourne
Recruitment hospital [3] 0 0
- Box Hill
Recruitment hospital [4] 0 0
- Darlinghurst
Recruitment hospital [5] 0 0
- Westmead
Recruitment postcode(s) [1] 0 0
5000 - Adelaide
Recruitment postcode(s) [2] 0 0
3052 - Melbourne
Recruitment postcode(s) [3] 0 0
3128 - Box Hill
Recruitment postcode(s) [4] 0 0
2010 - Darlinghurst
Recruitment postcode(s) [5] 0 0
2145 - Westmead
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Arizona
Country [2] 0 0
United States of America
State/province [2] 0 0
Connecticut
Country [3] 0 0
United States of America
State/province [3] 0 0
Florida
Country [4] 0 0
United States of America
State/province [4] 0 0
Maryland
Country [5] 0 0
United States of America
State/province [5] 0 0
Michigan
Country [6] 0 0
United States of America
State/province [6] 0 0
Missouri
Country [7] 0 0
United States of America
State/province [7] 0 0
Nebraska
Country [8] 0 0
United States of America
State/province [8] 0 0
New York
Country [9] 0 0
United States of America
State/province [9] 0 0
Oregon
Country [10] 0 0
United States of America
State/province [10] 0 0
Pennsylvania
Country [11] 0 0
Brazil
State/province [11] 0 0
Rio Grande Do Sul
Country [12] 0 0
Brazil
State/province [12] 0 0
Sao Paulo
Country [13] 0 0
Canada
State/province [13] 0 0
Ontario
Country [14] 0 0
Canada
State/province [14] 0 0
Quebec
Country [15] 0 0
Chile
State/province [15] 0 0
Santiago
Country [16] 0 0
Czechia
State/province [16] 0 0
Chomutov
Country [17] 0 0
Czechia
State/province [17] 0 0
Praha 5
Country [18] 0 0
France
State/province [18] 0 0
Nantes
Country [19] 0 0
France
State/province [19] 0 0
Vandoeuvre les Nancy
Country [20] 0 0
France
State/province [20] 0 0
Villejuif Cedex
Country [21] 0 0
Germany
State/province [21] 0 0
Baden-Württemberg
Country [22] 0 0
Germany
State/province [22] 0 0
Bayern
Country [23] 0 0
Germany
State/province [23] 0 0
Sachsen
Country [24] 0 0
Israel
State/province [24] 0 0
Beer Sheva
Country [25] 0 0
Israel
State/province [25] 0 0
Haifa
Country [26] 0 0
Israel
State/province [26] 0 0
Jerusalem
Country [27] 0 0
Israel
State/province [27] 0 0
Kfar Saba
Country [28] 0 0
Israel
State/province [28] 0 0
Petah Tikva
Country [29] 0 0
Israel
State/province [29] 0 0
Ramat Gan
Country [30] 0 0
Italy
State/province [30] 0 0
Emilia-Romagna
Country [31] 0 0
Italy
State/province [31] 0 0
Lazio
Country [32] 0 0
Italy
State/province [32] 0 0
Piemonte
Country [33] 0 0
Italy
State/province [33] 0 0
Toscana
Country [34] 0 0
Korea, Republic of
State/province [34] 0 0
Busan Gwang''yeogsi
Country [35] 0 0
Korea, Republic of
State/province [35] 0 0
Seoul Teugbyeolsi
Country [36] 0 0
Korea, Republic of
State/province [36] 0 0
Seoul
Country [37] 0 0
Spain
State/province [37] 0 0
Barcelona
Country [38] 0 0
Spain
State/province [38] 0 0
Illes Baleares
Country [39] 0 0
Spain
State/province [39] 0 0
Madrid
Country [40] 0 0
Spain
State/province [40] 0 0
Pamplona
Country [41] 0 0
Sweden
State/province [41] 0 0
Göteborg
Country [42] 0 0
Sweden
State/province [42] 0 0
Karlstad
Country [43] 0 0
Sweden
State/province [43] 0 0
Sundsvalls
Country [44] 0 0
Sweden
State/province [44] 0 0
Umeå
Country [45] 0 0
Taiwan
State/province [45] 0 0
Taipei
Country [46] 0 0
Taiwan
State/province [46] 0 0
Taoyuan
Country [47] 0 0
Taiwan
State/province [47] 0 0
Kaohsiung
Country [48] 0 0
Taiwan
State/province [48] 0 0
Taichung
Country [49] 0 0
United Kingdom
State/province [49] 0 0
Merseyside
Country [50] 0 0
United Kingdom
State/province [50] 0 0
Somerset
Country [51] 0 0
United Kingdom
State/province [51] 0 0
Northwood

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Bayer
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This study will assess different doses and regimens of radium-223 dichloride on the incidence
of symptomatic skeletal events. Eligible subjects must have castration resistant prostate
cancer with 2 or more skeletal metastases documented within 8 weeks of randomization.
Subjects will be randomized to one of 3 treatment arms in a 1:1:1 fashion: a standard regimen
of radium-223 dichloride of 50 kBq/kg (55 kBq/kg after implementation of NIST update)
injections every month for 6 months, a high dose regimen of 80 kBq/kg (88 kBq/kg after
implementation of NIST update)injections every month for 6 months or an extended duration
regimen of 50 kBq/kg (55 kBq/kg after implementation of NIST update) injections every month
for 12 months. Following the treatment phase, subjects will be followed up every 12 weeks for
a minimum of 2 years, at which point they will enter a long term follow-up period during
which they are seen every 6 months for up to 7 years after the last dose of radium
dichloride. Symptomatic skeletal event and safety endpoints will be assessed at each clinic
visit. Pain and analgesic use data will be collected every 4 weeks through Week 48.
Additionally, radiological assessments including MRI/CT of the abdomen and pelvis and chest
CT, as well as technetium-99 bone scans will be performed at Weeks 8, 16, and 24 and continue
every 12 weeks thereafter until disease progression is documented in either the bone or in
soft tissue. Radiological imaging will be evaluated by blinded central review.
Trial website
https://clinicaltrials.gov/ct2/show/NCT02023697
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Bayer Study Director
Address 0 0
Bayer
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT02023697