Salvage Radiotherapy Combined With Androgen Deprivation Therapy (ADT) With or Without Rezvilutamide in the Treatment of Biochemical Recurrence After Radical Prostatectomy for Prostate Cancer

Phase 2

Recruiting

• Conditions: Prostate Cancer; Biochemical Recurrence
• Interventions: Drug: Androgen deprivation therapy (ADT); Drug: Rezvilutamide; Radiation: SRT

• Registration Number: NCT06305832
• Lead Sponsor: The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

Brief Summary

To evaluate the efficacy and safety of rezvilutamide in combination with androgen deprivation therapy(ADT) and standard salvage radiation therapy(SRT) or SRT combination with ADT in prostate cancer patients with biochemical recurrence of prostate-specific antigen(PSA) persistence after radical prostatectomy(RP).

Detailed Description

Not available

Study Timeline

• Study Start: 2023-09-07
• Status Verified: 2024-03
• Study First Submitted: 2024-03-05
• Study First Submitted QC: 2024-03-05
• Last Update Submitted: 2024-03-05
• Study First Posted: 2024-03-12
• Last Update Posted: 2024-03-12
• Primary Completion: 2028-03
• Study Completion: 2028-03

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Male
• Target Recruitment: 102

Inclusion Criteria

• 1. ≥40 years old, male;
• 2. Postoperative pathology showed prostate adenocarcinoma;
• 3. Postoperative pathological stage pN0 or pNx;
• 4. PSA decline < 0.1ng/ml within 8 weeks after radical prostate cancer surgery for at least 6 months
• 5. Biochemical recurrence (PSA rose twice in a row, with an interval of ≥2 weeks and absolute value > 0.2ng/ml), and traditional imaging (bone scan and CT/MRI scan) did not show local recurrence and distant metastasis.
• 6. Have one or more of the following risk factors:
  • Postoperative CAPRA-S score ≥6 points;
  • The pathological score of radical surgery for prostate cancer was Gleason 8-10;
  • The highest postoperative biochemical recurrence PSA > 0.5ng/ml;
  • Postoperative pathological stage PT3/T4;
  • PSADT < 10 months;
• 7. ECOG status is 0-1;
• 8. Life expectancy greater than 10 years;
• 9. Adequate hematological and organ function tests within 4 weeks prior to the first study treatment, as defined below:
  • Neutrophil count (ANC)≥1.5×10^9/L (no granulocyte colony-stimulating factor for 2 weeks prior to cycle 1, day 1);
  • Platelet count (PLT)≥100×10^9/L (no transfusion within 2 weeks prior to day 1 of cycle 1);
  • Hemoglobin (Hb) ≥90g/L
  • Serum creatinine (Cr)≤1.5×ULN or creatinine clearance > 50ml/min;
  • Total bilirubin (BIL)≤1.5×ULN;
  • Aspartate aminotransferase (AST/SGOT) or alanine aminotransferase (ALT/SGPT) level ≤2.5×ULN;
  • International Standardized ratio (INR) ≤1.5, prothrombin time (PT) and activated partial thromboplastin time (APTT) ≤1.5×ULN;
  • Left ventricular ejection fraction (LVEF) ≥50%;
• 10. The subject is willing and understands to sign the informed consent and is able to comply with the agreement.

Exclusion Criteria

• 1. Previously received endocrine therapy for prostate cancer (including but not limited to goserrelin, levoprorelin, digarek, bicalutamide, abiraterone acetate, darotamine, apatamide, enzalutamide, etc.) or pelvic radiotherapy;
• 2. Postoperative biochemical recurrence, but PSA more than 2 ng/ml;
• 3. Postoperative pathology contains non-adenocarcinoma components, such as neuroendocrine differentiation or small cell features;
• 4. Is currently participating in or has participated in an investigational drug study;
• 5. Known or suspected allergy to reverumide and reverumide excipients;
• 6. Inability to swallow, chronic diarrhea, intestinal obstruction, or other factors that affect drug use and absorption;
• 7. Have a history of epilepsy, or a medical condition that can induce seizures within the 12 months prior to C1D1 (including a history of transient ischemic attacks, cerebral stroke, traumatic brain injury with disturbance of consciousness requiring hospitalization);
• 8. Active heart disease in the 6 months prior to C1D1, including severe/unstable angina, myocardial infarction, symptomatic congestive heart failure, and medically treatable ventricular arrhythmias;
• 9. Have had any other malignancies within the 3 years prior to C1D1 (except for carcinoma in situ that has been in complete remission and malignancies that the investigator determined to be slowly progressing);
• 10. Granulocyte colony-stimulating factor was used for support 2 weeks before C1D1;
• 11. Blood transfusion within 2 weeks before C1D1;
• 12. Active HBV and HCV infected persons (HBV copy number ≥10^4 copies /mL, HCV copy number ≥10^3 copies /mL);
• 13. A history of immunodeficiency (including HIV positive, other acquired, congenital immunodeficiency diseases) or a history of organ transplantation;
• 14. Male subjects whose partner is a fertile woman refuse surgical sterilization or use of effective contraception during the trial period and for 3 months after the last dose of riverutamide.
• 15. The investigator determines subjects who may affect the conduct of clinical studies, who may not be able to comply with the protocol or cooperate with the protocol, and who pose research risks.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ADT+ SRT	Androgen deprivation therapy (ADT)	ADT for 6 cycles (28 days for each cycle) in combination with salvage radiation therapy (SRT) according to standard of care
ADT+ SRT	SRT	ADT for 6 cycles (28 days for each cycle) in combination with salvage radiation therapy (SRT) according to standard of care
Rezvilutamide +ADT+ SRT	Androgen deprivation therapy (ADT)	Rezvilutamide along with ADT for 6 cycles (28 days for each cycle) in combination with salvage radiation therapy (SRT) according to standard of care
Rezvilutamide +ADT+ SRT	SRT	Rezvilutamide along with ADT for 6 cycles (28 days for each cycle) in combination with salvage radiation therapy (SRT) according to standard of care
Rezvilutamide +ADT+ SRT	Rezvilutamide	Rezvilutamide along with ADT for 6 cycles (28 days for each cycle) in combination with salvage radiation therapy (SRT) according to standard of care

Primary Outcome Measures

Name	Time	Method
3-year biochemical progression-free survival	48 months	biochemical progression is defined as a confirmed prostate specific antigen (PSA) greater than (\>) 0.2 nanogram per milliliter (ng/ml) ( the time interval should be over 2 weeks)

Secondary Outcome Measures

Name	Time	Method
Adverse Events	48 months	According to NCI-CTCAE v5.0
metastasis-free survival (MFS)	48 months	Time from entry to radiologically confirmed metastasis disease or death due to any cause.
percentage of undetectable PSA	48 months	percentage of undetectable PSA is defined as the proportion of subjects with a PSA level ≤ 0.1 ng/mL after enrollment
ctDNA clearance rate	48 months	Defined as the number of patients who were ctDNA-positive at enrollment to ctDNA-negative after treatment as a proportion of ctDNA-positive patients enrolled
progression-free survival (PFS)	48 months	Time from entry to biochemical progression or radiologically confirmed progressive disease or death due to any cause
ctDNA-positive rate	48 months	ctDNA-positive rate was defined as the number of ctDNA subjects detected in the total enrolled population

Trial Locations

Locations (2)

Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University; 🇨🇳 Nanjing, Jiangsu, China

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School; 🇨🇳 Nanjing, Jiangsu, China