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Brief Title: Niraparib With Standard Combination Radiation Therapy and Androgen Deprivation Therapy in Treating Patients With High Risk Prostate Cancer
Official Title: Randomized Phase II Trial of Niraparib With Standard Combination Radiotherapy and Androgen Deprivation Therapy (ADT) in High Risk Prostate Cancer (With Initial Phase I)
Study ID: NCT04037254
Brief Summary: This phase II trial studies the side effects and best dose of niraparib, and to see how well it works in combination with standard of care radiation therapy and hormonal therapy (androgen deprivation therapy) in treating patients with prostate cancer that has a high chance of coming back (high risk). Niraparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Adding niraparib to the usual treatments of radiation therapy and hormonal therapy may lower the chance of prostate cancer growing or returning.
Detailed Description: PRIMARY OBJECTIVES: I. To establish the preferred dose of niraparib in combination with radiation and antiandrogen therapy (ADT). (Phase I) II. To compare the disease-free state, defined as PSA remaining \< 0.1 ng/ml at the end of ADT therapy in men with high risk prostate cancer treated with standard therapy with or without the addition of niraparib. (Phase IIR) SECONDARY OBJECTIVES: I. To further establish the safety and toxicity profile of standard treatment with radiation and androgen deprivation therapy specifically, two years from initiation of ADT, plus niraparib at the phase II dose. II. To compare the overall survival, prostate cancer-specific survival, local/regional or distant progression, and distant metastatic disease rates of standard therapy with or without the addition of niraparib. EXPLORATORY OBJECTIVES: I. To identify genomic biomarkers of response to combination therapy with radiation, ADT and PARP inhibition. OUTLINE: This is a phase I, dose-escalation study of niraparib, followed by a phase II study. PHASE I: Patients receive niraparib orally (PO) once daily (QD) and receive standard of care gonadotrophin releasing hormone (GnRH) agonist androgen suppression therapy. Treatment with niraparib continues for 12 months, and GnRH agonist therapy for 24 months in the absence of disease progression or unacceptable toxicity. Beginning 8 weeks after starting niraparib and GnRH agonist, patients undergo standard of care intensity-modulated radiation therapy (IMRT) 5 days per week for about 6-9 weeks, depending on type of radiation therapy given, in the absence of disease progression or unacceptable toxicity. PHASE II: Patients are randomized to 1 of 2 arms: ARM I: Patients undergo standard of care GnRH agonist androgen suppression therapy for 24 months in the absence of disease progression or unacceptable toxicity. Beginning 8-28 weeks after starting GnRH agonist, patients undergo IMRT 5 days per week for about 6-9 weeks depending on type of radiation therapy given in the absence of disease progression or unacceptable toxicity. ARM II: Patients undergo standard of care GnRH agonist androgen suppression therapy for 24 months, and niraparib PO QD for 12 months in the absence of disease progression or unacceptable toxicity. Beginning 8 weeks after starting niraparib, patients undergo standard of care IMRT 5 days per week for about 6-9 weeks depending on type of radiation therapy given in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months for 3 years, then annually for 3 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: MALE
Healthy Volunteers: No
Banner MD Anderson Cancer Center, Gilbert, Arizona, United States
University of Arizona Cancer Center-Orange Grove Campus, Tucson, Arizona, United States
University of Arizona Cancer Center-North Campus, Tucson, Arizona, United States
City of Hope Comprehensive Cancer Center, Duarte, California, United States
Cedars Sinai Medical Center, Los Angeles, California, United States
Fremont - Rideout Cancer Center, Marysville, California, United States
University of California Davis Comprehensive Cancer Center, Sacramento, California, United States
City of Hope Upland, Upland, California, United States
Helen F Graham Cancer Center, Newark, Delaware, United States
Medical Oncology Hematology Consultants PA, Newark, Delaware, United States
George Washington University Medical Center, Washington, District of Columbia, United States
Grady Health System, Atlanta, Georgia, United States
Emory University Hospital/Winship Cancer Institute, Atlanta, Georgia, United States
Emory Saint Joseph's Hospital, Atlanta, Georgia, United States
CTCA at Southeastern Regional Medical Center, Newnan, Georgia, United States
Alton Memorial Hospital, Alton, Illinois, United States
Northwestern University, Chicago, Illinois, United States
Rush University Medical Center, Chicago, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
University of Iowa/Holden Comprehensive Cancer Center, Iowa City, Iowa, United States
University of Kansas Cancer Center, Kansas City, Kansas, United States
University of Kansas Cancer Center-Overland Park, Overland Park, Kansas, United States
University of Kansas Hospital-Westwood Cancer Center, Westwood, Kansas, United States
University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland, United States
Central Maryland Radiation Oncology in Howard County, Columbia, Maryland, United States
UM Baltimore Washington Medical Center/Tate Cancer Center, Glen Burnie, Maryland, United States
Massachusetts General Hospital Cancer Center, Boston, Massachusetts, United States
McLaren Cancer Institute-Bay City, Bay City, Michigan, United States
Henry Ford Cancer Institute-Downriver, Brownstown, Michigan, United States
McLaren Cancer Institute-Clarkston, Clarkston, Michigan, United States
Henry Ford Macomb Hospital-Clinton Township, Clinton Township, Michigan, United States
Henry Ford Medical Center-Fairlane, Dearborn, Michigan, United States
Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, United States
Henry Ford Hospital, Detroit, Michigan, United States
Weisberg Cancer Treatment Center, Farmington Hills, Michigan, United States
McLaren Cancer Institute-Flint, Flint, Michigan, United States
Singh and Arora Hematology Oncology PC, Flint, Michigan, United States
Karmanos Cancer Institute at McLaren Greater Lansing, Lansing, Michigan, United States
Mid-Michigan Physicians-Lansing, Lansing, Michigan, United States
McLaren Cancer Institute-Lapeer Region, Lapeer, Michigan, United States
McLaren Cancer Institute-Macomb, Mount Clemens, Michigan, United States
Henry Ford Medical Center-Columbus, Novi, Michigan, United States
McLaren Cancer Institute-Northern Michigan, Petoskey, Michigan, United States
McLaren-Port Huron, Port Huron, Michigan, United States
Henry Ford Macomb Health Center - Shelby Township, Shelby, Michigan, United States
Henry Ford West Bloomfield Hospital, West Bloomfield, Michigan, United States
University of Mississippi Medical Center, Jackson, Mississippi, United States
Siteman Cancer Center at West County Hospital, Creve Coeur, Missouri, United States
University of Kansas Cancer Center - North, Kansas City, Missouri, United States
University of Kansas Cancer Center - Lee's Summit, Lee's Summit, Missouri, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Siteman Cancer Center-South County, Saint Louis, Missouri, United States
Siteman Cancer Center at Saint Peters Hospital, Saint Peters, Missouri, United States
Benefis Healthcare- Sletten Cancer Institute, Great Falls, Montana, United States
AtlantiCare Health Park-Cape May Court House, Cape May Court House, New Jersey, United States
AtlantiCare Surgery Center, Egg Harbor Township, New Jersey, United States
Rutgers New Jersey Medical School, Newark, New Jersey, United States
Holy Name Hospital, Teaneck, New Jersey, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
The New York Hospital Medical Center of Queens, Flushing, New York, United States
Highland Hospital, Rochester, New York, United States
University of Rochester, Rochester, New York, United States
Stony Brook University Medical Center, Stony Brook, New York, United States
Summa Health System - Akron Campus, Akron, Ohio, United States
Summa Health System - Barberton Campus, Barberton, Ohio, United States
University of Cincinnati Cancer Center-UC Medical Center, Cincinnati, Ohio, United States
Case Western Reserve University, Cleveland, Ohio, United States
Summa Health Medina Medical Center, Medina, Ohio, United States
University of Cincinnati Cancer Center-West Chester, West Chester, Ohio, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Christiana Care Health System-Concord Health Center, Chadds Ford, Pennsylvania, United States
Geisinger Medical Center, Danville, Pennsylvania, United States
Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
Geisinger Medical Oncology-Lewisburg, Lewisburg, Pennsylvania, United States
Lewistown Hospital, Lewistown, Pennsylvania, United States
Eastern Regional Medical Center, Philadelphia, Pennsylvania, United States
University of Pittsburgh Cancer Institute (UPCI), Pittsburgh, Pennsylvania, United States
UPMC-Shadyside Hospital, Pittsburgh, Pennsylvania, United States
Geisinger Wyoming Valley/Henry Cancer Center, Wilkes-Barre, Pennsylvania, United States
Medical University of South Carolina, Charleston, South Carolina, United States
Prisma Health Cancer Institute - Faris, Greenville, South Carolina, United States
Saint Francis Cancer Center, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside, Greenville, South Carolina, United States
Self Regional Healthcare, Greenwood, South Carolina, United States
Prisma Health Cancer Institute - Greer, Greer, South Carolina, United States
Prisma Health Cancer Institute - Seneca, Seneca, South Carolina, United States
West Virginia University Healthcare, Morgantown, West Virginia, United States
Froedtert Menomonee Falls Hospital, Menomonee Falls, Wisconsin, United States
Medical College of Wisconsin, Milwaukee, Wisconsin, United States
Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin, United States
Drexel Town Square Health Center, Oak Creek, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital, Oconomowoc, Wisconsin, United States
UW Cancer Center at ProHealth Care, Waukesha, Wisconsin, United States
Froedtert West Bend Hospital/Kraemer Cancer Center, West Bend, Wisconsin, United States
Tom Baker Cancer Centre, Calgary, Alberta, Canada
Name: M. D Michaelson
Affiliation: NRG Oncology
Role: PRINCIPAL_INVESTIGATOR