Trial Outcomes & Findings for Non-Randomized Trial Assessing Pain Efficacy With Radium-223 in Symptomatic Metastatic Castration-Resistant Prostate Cancer (NCT NCT02278055)

NCT ID: NCT02278055

Last Updated: 2023-04-07

Results Overview

Defined as a 30% decline in the Brief Pain Inventory/BPI worse pain item from baseline to week 8, with a confirmed reduction at week 12 without an escalation of the subject's pain regimen from Step 1 to Step 2 or Step 2 to Step 3 of the WHO analgesic ladder.) The baseline BPI worst pain score average will be based on the worst pain scores completed by the participant in the 7 consecutive pretreatment days. A minimum of 4 days of pain scores must be completed by the participant in the 7 day window in order to calculate the average worst pain score. The BPI scale defines pain as follows: Worst Pain Score: 1 - 4 = Mild Pain. Worst Pain Score: 5 - 6 = Moderate Pain. Worst Pain Score: 7 - 10 = Severe Pain.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

29 participants

Primary outcome timeframe

8 weeks

Results posted on

2023-04-07

Participant Flow

Participant milestones

Participant milestones
Measure
Radium-223
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Overall Study
STARTED
29
Overall Study
COMPLETED
21
Overall Study
NOT COMPLETED
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Radium-223
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Overall Study
Adverse Event
1
Overall Study
Lost to Follow-up
1
Overall Study
Withdrawal by Subject
2
Overall Study
Progressive Disease
4

Baseline Characteristics

Non-Randomized Trial Assessing Pain Efficacy With Radium-223 in Symptomatic Metastatic Castration-Resistant Prostate Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Radium-223
n=29 Participants
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Age, Continuous
69 years
n=99 Participants
Sex: Female, Male
Female
0 Participants
n=99 Participants
Sex: Female, Male
Male
29 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
21 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
6 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
1 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=99 Participants
Race (NIH/OMB)
White
23 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Region of Enrollment
United States
29 Participants
n=99 Participants

PRIMARY outcome

Timeframe: 8 weeks

Defined as a 30% decline in the Brief Pain Inventory/BPI worse pain item from baseline to week 8, with a confirmed reduction at week 12 without an escalation of the subject's pain regimen from Step 1 to Step 2 or Step 2 to Step 3 of the WHO analgesic ladder.) The baseline BPI worst pain score average will be based on the worst pain scores completed by the participant in the 7 consecutive pretreatment days. A minimum of 4 days of pain scores must be completed by the participant in the 7 day window in order to calculate the average worst pain score. The BPI scale defines pain as follows: Worst Pain Score: 1 - 4 = Mild Pain. Worst Pain Score: 5 - 6 = Moderate Pain. Worst Pain Score: 7 - 10 = Severe Pain.

Outcome measures

Outcome measures
Measure
Radium-223
n=21 Participants
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Percentage of Participants With 30% Decline in the Brief Pain Inventory (BPI) Worst Pain Item From Baseline to Week 8
11 Percentage of pts w/pain improvement

SECONDARY outcome

Timeframe: 12 weeks

Number of participants with changes from baseline to 12 weeks (or earlier for those who discontinue study therapy). Maximum change (rise or fall) in bone Alkaline phosphatase (ALP) during the treatment period reported.

Outcome measures

Outcome measures
Measure
Radium-223
n=29 Participants
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Number of Participants With Changes in Bone Alkaline Phosphatase (ALP)
Count of non pain responders with consecutive decrease in Bone Alkaline Phosphatase
18 Participants
Number of Participants With Changes in Bone Alkaline Phosphatase (ALP)
Count of pain responders with consecutive decrease in Bone Alkaline Phosphatase
9 Participants
Number of Participants With Changes in Bone Alkaline Phosphatase (ALP)
Count of participants with no change
2 Participants

SECONDARY outcome

Timeframe: 1 year

Serum C-telopeptide (sCTX-1) N-terminal propeptide of procollagen type 1 (PINP) Changes in total-ALP will be defined as for bone-ALP above

Outcome measures

Outcome measures
Measure
Radium-223
n=29 Participants
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Number of Participants With Changes in Other Bone Markers:
Count of pain responder participants with consecutive decrease in N-terminal propeptide
9 Participants
Number of Participants With Changes in Other Bone Markers:
Count of participants with no consecutive decrease in N-terminal propeptide
20 Participants

Adverse Events

Radium-223

Serious events: 11 serious events
Other events: 22 other events
Deaths: 5 deaths

Serious adverse events

Serious adverse events
Measure
Radium-223
n=29 participants at risk
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Gastrointestinal disorders
Diarrhea
3.4%
1/29 • 1 year
Gastrointestinal disorders
Esophageal perforation
3.4%
1/29 • 1 year
Gastrointestinal disorders
Nausea
6.9%
2/29 • 1 year
Gastrointestinal disorders
Vomiting
3.4%
1/29 • 1 year
General disorders
Chills
3.4%
1/29 • 1 year
General disorders
Fatigue
10.3%
3/29 • 1 year
General disorders
Fever
3.4%
1/29 • 1 year
General disorders
Malaise
6.9%
2/29 • 1 year
General disorders
Non-cardiac chest pain
3.4%
1/29 • 1 year
General disorders
Pain
13.8%
4/29 • 1 year
Injury, poisoning and procedural complications
Fracture
3.4%
1/29 • 1 year
Investigations
Weight loss
3.4%
1/29 • 1 year
Metabolism and nutrition disorders
Anorexia
3.4%
1/29 • 1 year
Musculoskeletal and connective tissue disorders
Back pain
10.3%
3/29 • 1 year
Musculoskeletal and connective tissue disorders
Bone Pain
6.9%
2/29 • 1 year
Musculoskeletal and connective tissue disorders
Buttock pain
3.4%
1/29 • 1 year
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms ben/mal/unk
3.4%
1/29 • 1 year
Nervous system disorders
Radiculitis
3.4%
1/29 • 1 year
Vascular disorders
Hypertension
3.4%
1/29 • 1 year
Vascular disorders
Hypotension
3.4%
1/29 • 1 year

Other adverse events

Other adverse events
Measure
Radium-223
n=29 participants at risk
Radium Ra 223 dichloride will be administered as a bolus intravenous (IV) injection (up to 1 minute) at intervals of every 4 weeks for up to 6 cycles. The dosage of Radium Ra 223 dichloride after implementation of the new 2015 NIST standard is 55kBq/kg body weight. Radium-223
Blood and lymphatic system disorders
Anemia
20.7%
6/29 • 1 year
Metabolism and nutrition disorders
Hyperglycemia
20.7%
6/29 • 1 year
Metabolism and nutrition disorders
Hypoalbuminemia
17.2%
5/29 • 1 year
Investigations
Alkaline phosphatase increased
10.3%
3/29 • 1 year
Metabolism and nutrition disorders
Hypocalcemia
10.3%
3/29 • 1 year
Metabolism and nutrition disorders
Hypomagnesemia
10.3%
3/29 • 1 year
Investigations
White blood cell decreased
10.3%
3/29 • 1 year
Investigations
Creatinine increased
6.9%
2/29 • 1 year
Metabolism and nutrition disorders
Hyperkalemia
6.9%
2/29 • 1 year
Metabolism and nutrition disorders
Hyponatremia
6.9%
2/29 • 1 year
Metabolism and nutrition disorders
Hypophosphatemia
6.9%
2/29 • 1 year
Investigations
INR increased
6.9%
2/29 • 1 year
Investigations
Platelet count decreased
6.9%
2/29 • 1 year

Additional Information

Dr. Michael Morris, MD

Memorial Sloan Kettering Cancer Center

Phone: 646-422-4469

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place