Darolutamide vs ADT in hormone naïve Pca
- Conditions
- Hormone Naive Prostate Cancer
- Registration Number
- 2024-510840-30-00
- Lead Sponsor
- European Organisation For Research And Treatment Of Cancer
- Brief Summary
The primary trial objective is to demonstrate that darolutamide produces prostate-specific antigen (PSA) response rates at 24 weeks (defined as ≥ 80% reduction compared to baseline) that are in the range of those achieved with 24 weeks of ADT.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Ongoing, recruitment ended
- Sex
- Male
- Target Recruitment
- 169
Aged 18 years or older
Able to swallow the study drug whole as a tablet
Adequate bone marrow function • absolute neutrophil count (ANC) ≥ 1.5 109/L. • hemoglobin ≥ 10.0 g/dl. • platelets ≥ 100 109/L.
Adequate renal function: creatinine ≤ 1.5 x ULN
Albumin > 25 g/L
Adequate hepatic function: • Bilirubin: total bilirubin ≤ 1.5 × upper limit of normal (ULN). • AST and/or ALT ≤ 2.5 × ULN.
Normal 12-lead ECG as per local standard
Patients of reproductive potential should use adequate birth control measures, during the study treatment period and for at least 3 months after the last study treatment. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly
Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations.
Histologically confirmed prostate cancer (all stages) for whom continuous ADT is indicated for a minimum period of 24 weeks
M0 patients or those presenting with a maximum of 4 confirmed metastatic lesions, including bone, extra-pelvic lymph nodes, and > 2 cm pelvic lymph nodes by imaging (contrast enhanced CT scans or MRI, Tc-99m BS according to local practice, see section 6.1.1). Visceral metastases are excluded
Asymptomatic for metastatic prostate cancer; urinary symptoms are allowed
Baseline total testosterone ≥ 8 nmol/L or 230 ng/dL
Two subsequent PSA values ≥ 2 ng/ml, done in the past 3 months (prior to enrollment) with a minimum of 2 weeks between the two, with the second being equal to or higher than the first
WHO performance status (PS) of 0-1
G8 score ≥ 14 for patients aged ≥ 70 years old
A life expectancy of at least 12 months
Previously or currently receiving hormonal therapy with intent to treat prostate cancer disease (surgical castration or other hormonal manipulation, e.g. LHRH agonists, LHRH antagonists, anti-androgens, oestrogens, 5α-reductase inhibitor). For patients that have received (neo)adjuvant ADT before radiotherapy, it should have been stopped for more than 1 year
History of prior malignancy. Adequately treated basal cell or squamous cell carcinoma of skin or superficial bladder cancer that has not spread behind the connective tissue layer (i.e. pTis, pTa, and pT1) is allowed, as well as any other cancer from which the patient has been disease-free for a period of at least 5 years.
Clinically significant cardiovascular disease including: • Myocardial infarction within 6 months prior to randomization • Uncontrolled angina within 3 months prior to randomization • Coronary/peripheral artery bypass within 6 months prior to randomization • Stroke within 6 months prior to randomization • Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or subjects with history of congestive heart failure NYHA class 3 or 4 in the past, unless a screening echocardiogram or multi-gated acquisition scan (MUGA) performed within 3 months results in a left ventricular ejection fraction that is ≥ 45% • History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes) • History of Mobitz II second degree or third degree heart block without a permanent pacemaker in place
Uncontrolled hypertension as indicated by a resting systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg at the screening visit
Prior use of investigational agents that block androgen synthesis or block androgen receptor
Use of herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (e.g. saw palmetto)
Has received systemic glucocorticoids within 24 weeks prior to enrollment or is expected to require systemic glucocorticoids during the study period, unless determined to be medically necessary by the investigator for other indications than prostate cancer
Radiation therapy for treatment of the primary tumor within 3 months prior to enrollment
Use of an investigational agent within 4 weeks prior to enrollment is not allowed
Gastrointestinal disorder affecting absorption (e.g. gastrectomy, active peptic ulcer disease) within 3 months prior to enrollment
Known hypersensitivity to the study treatment or any of its ingredients (refer to Investigator's brochure).
Severe or uncontrolled concurrent disease, infection or co-morbidity including active viral hepatitis, known human immunodeficiency virus infection with detectable viral load (HIV) or chronic liver disease (Child Pugh C)
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The primary endpoint is the PSA response assessed at 24 weeks. PSA response is defined as a ≥ 80% decline in PSA measurement taken at week 24 relative to the measurement taken at baseline, in the darolutamide study arm. The ADT arm is used as an internal control. The primary endpoint is the PSA response assessed at 24 weeks. PSA response is defined as a ≥ 80% decline in PSA measurement taken at week 24 relative to the measurement taken at baseline, in the darolutamide study arm. The ADT arm is used as an internal control.
- Secondary Outcome Measures
Name Time Method The main key secondary endpoint in this study is the change in hormone-treatment related symptoms scale of the EORTC QLQ-PR25 at 24 weeks compared to baseline in the darolutamide study arm. A 10-point difference is regarded as a clinically meaningful benefit. The main key secondary endpoint in this study is the change in hormone-treatment related symptoms scale of the EORTC QLQ-PR25 at 24 weeks compared to baseline in the darolutamide study arm. A 10-point difference is regarded as a clinically meaningful benefit.
Safety according to NCI-CTC version 4.0 Safety according to NCI-CTC version 4.0
Objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline Objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline
PSA complete response rate at 24 weeks defined as a ≥ 90% decline in PSA measurement at week 24 relative to the measurement taken at baseline PSA complete response rate at 24 weeks defined as a ≥ 90% decline in PSA measurement at week 24 relative to the measurement taken at baseline
Trial Locations
- Locations (12)
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
🇮🇹Turin, Italy
Fundacion Instituto Valenciano De Oncologia
🇪🇸Valencia, Spain
Institut Catala D'oncologia
🇪🇸Badalona, Spain
Hospital Universitario Virgen De La Victoria
🇪🇸Malaga, Spain
Hospital Universitario De Salamanca
🇪🇸Salamanca, Spain
Hospital Universitario Ramon Y Cajal
🇪🇸Madrid, Spain
Institut Gustave Roussy
🇫🇷Villejuif, France
Centr Georges Francois Leclerc
🇫🇷Dijon, France
Cliniques Universitaires Saint-Luc
🇧🇪Sint-Lambrechts-Woluwe, Belgium
Hopital Erasme
🇧🇪Anderlecht, Belgium
Scroll for more (2 remaining)Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino🇮🇹Turin, ItalyPaolo GonteroSite contact+390116335581paolo.gontero@unito.it