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A study to compare the study treatment darolutamide in combination with androgen deprivation therapy (ADT) to placebo in combination with ADT in men with elevated blood levels of a specific protein called PSA, which is a marker for high-risk of prostate cancer recurrence

Phase 1
Recruiting
Conditions
Biochemically recurrent prostate cancer
Therapeutic area: Diseases [C] - Male Urogenital Diseases [C12]
Registration Number
CTIS2022-501343-33-00
Lead Sponsor
Bayer Consumer Care AG
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
Male
Target Recruitment
938
Inclusion Criteria

Capable of giving signed informed consent as described which includes compliance with the requirements, restrictions listed in the informed consent form (ICF), and in this protocol, Screening values of: Alanine aminotransferase (ALT) =1.5 x upper limit of normal (ULN); Aspartate aminotransferase (AST) =1.5 x ULN; Total bilirubin (TBL) =1.5 ULN, (except participants with a diagnosis of Gilbert's disease); Estimated glomerular filtration rate (eGFR) >40 ml/min/1.73 ^m2 calculated by the CKD-EPI formula, Sexually active male participants must agree to use contraception as detailed in the protocol during the Treatment period and for at least 1 week after the last dose of study treatment, and refrain from donating sperm during this period., Male =18 years of age at the time of signing the informed consent, Histologically or cytologically confirmed adenocarcinoma of prostate, Prostate cancer initially treated by: radical prostatectomy (RP) followed by adjuvant radiotherapy (ART), or salvage radiotherapy (SRT), or RP in participants who are unfit (or refused) for ART or SRT, or primary radiotherapy (RT)., High-risk biochemical recurrence (BCR), defined as Prostate-specific antigen doubling time (PSADT) <12 months calculated using the formula provided by the Sponsor, and PSA =0.2 ng/mL after ART or SRT post RP or after RP in participants who are unfit for ART or SRT (local or central values accepted) , or PSA =2 ng/mL above the nadir after primary RT only (local or central values accepted)., Participants must undergo prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) within the 42-day Screening period using either 18F-DCFPyL (piflufolastat F 18) or 68Ga-PSMA-11 which will be assessed by BICR to identify at least one PSMA PET positive lesion of prostate cancer, and the number and the location of lesions to be used as baseline reference., Serum testosterone =150 ng/dL (5.2 nmol/L) (local or central values accepted)., Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, Blood counts at screening: Hemoglobin =9.0 g/dL (participant must not have received blood transfusion within 7 days prior to sample being taken); Absolute neutrophil count (ANC) =1.5x1^09/L (participant must not have received any growth factor within 4 weeks prior to sample being taken); Platelet count =100x109/

Exclusion Criteria

Pathological finding consistent with small cell, ductal or =50 % component of neuroendocrine carcinoma of the prostate, History of pelvic radiotherapy for other malignancy, History of bilateral orchiectomy, Metastases or recurrent /new malignant lesions in prostate gland/bed seminal vesicles, lymph nodes below the CIA bifurcation on conventional imaging (CI) as assessed by BICR during screening, Brain metastasis on PSMA PET /CT by BICR at screening, High-risk BCR after primary radiotherapy with new loco-regional lesions on screening PSMA PET/CT who are eligible for curative salvage prostatectomy, Prior treatment with second generation (e.g. enzalutamide, apalutamide) androgen receptor inhibitors (ARIs) and CYP 17 inhibitors (e.g., abiraterone) within 18 months prior to signing of the ICF, Prior treatments with PSMA-radiotherapeutics within 12 months prior to randomization, Prior radiotherapy (including image-guided radiotherapy) as primary, adjuvant or salvage treatment completed within 8 weeks prior to signing of the ICF, Any prior malignancy (other than adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or any other cancer in situ currently in complete remission) within 5 years

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To determine if darolutamide plus ADT given for a pre-specified duration of 24 months improves rPFS by PSMA PET/CT compared with placebo plus ADT given for 24 months;Secondary Objective: To further evaluate efficacy and to measure the treatment impact on patients’ quality of life, To assess the safety of darolutamide plus ADT compared with placebo plus ADT;Primary end point(s): rPFS by PSMA PET/CT assessed by BICR
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s):MFS by CI assessed by BICR;Secondary end point(s):Time to CRPC assessed by investigator;Secondary end point(s):Time to initiation of first subsequent systemic antineoplastic therapy;Secondary end point(s):Time to loco-regional progression by PSMA PET/CT;Secondary end point(s):Time to first SSE;Secondary end point(s):OS;Secondary end point(s):PSA undetectable rates (<0.2 ng/mL) at 12 months;Secondary end point(s):Time to deterioration in the FACT-P total score;Secondary end point(s):Number of participants with TEAEs and TESAEs categorized by severity;Secondary end point(s):Number of participants who discontinue study treatment due to a TEAE;Secondary end point(s):Time to symptomatic progression
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