Phase 3 Study of Xaluritamig vs Cabazitaxel or Second Androgen Receptor-Directed Therapy in Participants With Progressive Metastatic Castration-Resistant Prostate Cancer (XALute)
- Conditions
- Metastatic Castration-resistant Prostate Cancer
- Interventions
- Registration Number
- NCT06691984
- Lead Sponsor
- Amgen
- Brief Summary
The main objective of the study is to compare overall survival in participants receiving xaluritamig versus investigator's choice (cabazitaxel or second androgen receptor-directed therapy \[ARDT\]).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- Male
- Target Recruitment
- 675
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Participant has provided informed consent prior to initiation of any study-specific activities/procedures.
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Age ≥ 18 years (or ≥ legal age within the country if it is older than 18 years) at the time of signing the informed consent.
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Participant must have histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate. Mixed histologies (eg, adenocarcinoma with neuroendocrine component) are not permitted.
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mCRPC with ≥ 1 metastatic lesion that is present on baseline computed tomography (CT), magnetic resonance imaging (MRI), or bone scan imaging obtained within 28 days prior to enrollment.
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Evidence of progressive disease, defined as 1 or more PCWG3 criteria:
- Serum PSA progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL.
- Soft-tissue progression defined as an increase ≥ 20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions or unequivocal progression of existing non-target lesions.
- Progression of bone disease: defined by the appearance of at least 2 new bone lesion(s) by bone scan (as per the 2+2 PCWG3 criteria).
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Participants must have had a prior orchiectomy and/or ongoing androgen-deprivation therapy and a castrate level of serum testosterone (< 50 ng/dL or < 1.7 nmol/L).
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Prior progression on at least one ARDT (enzalutamide, abiraterone, apalutamide, darolutamide).
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Prior treatment with only one taxane therapy in the mCRPC setting. Note: Prior treatment with docetaxel in the metastatic hormone-sensitive prostate cancer (mHSPC) setting is permitted; however, participants must have also received one, and only one, taxane therapy in the mCRPC setting.
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Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1.
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Adequate organ function.
Key
Prior & Concomitant Therapy:
- Prior six transmembrane epithelial antigen of the prostate 1 (STEAP1)-targeted therapy.
- Any anticancer therapy, immunotherapy, or investigational agent within 4 weeks prior to the first dose of study treatment, not including androgen suppression therapy (eg, luteinizing hormone-releasing hormone/gonadotropin-releasing hormone [LHRH/GnRH] analogue [agonist/antagonist]).
- Prior Prostate-Specific Membrane Antigen (PSMA) radioligand therapy (RLT) within 3 months of the first dose of study treatment unless participants received < 2 cycles of therapy.
- Prior palliative radiotherapy within 2 weeks of first dose of study treatment. Participants must have recovered from all radiation-related toxicities.
- Concurrent cytotoxic chemotherapy, ARDT, immunotherapy, radioligand therapy, PARP inhibitor, biological therapy, investigational therapy. Note: Prior treatment with a PARP inhibitor is permitted as long as not within 4 weeks before first dose of study treatment.
- Prior radionuclide therapy (Radium-223) within 2 months of first dose of study treatment.
- Treatment with live and live-attenuated vaccines within 4 weeks before the first dose of study treatment.
Disease Related:
- Participants with a history of central nervous system (CNS) metastasis. Note: Participants with treated, asymptomatic, and clinically stable dural metastases are eligible.
- Unresolved toxicities from prior anti-tumor therapy not having resolved to CTCAE version 5.0 events grade above 1 or baseline, with the exception of alopecia or toxicities that are stable and well controlled AND there is an agreement to allow inclusion by both the investigator and the sponsor.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Xaluritamig Xaluritamig Participants with metastatic castration-resistant prostate cancer (mCRPC) will be randomized to receive Xaluritamig as an intravenous (IV) infusion. Cabazitaxel/Abiraterone/Enzalutamide Abiraterone Participants with mCRPC will be randomized to receive cabazitaxel as an IV infusion, or a second androgen receptor-directed therapy of either abiraterone as oral tablets, or enzalutamide as oral tablets at the investigator's discretion. Cabazitaxel/Abiraterone/Enzalutamide Enzalutamide Participants with mCRPC will be randomized to receive cabazitaxel as an IV infusion, or a second androgen receptor-directed therapy of either abiraterone as oral tablets, or enzalutamide as oral tablets at the investigator's discretion. Cabazitaxel/Abiraterone/Enzalutamide Cabazitaxel Participants with mCRPC will be randomized to receive cabazitaxel as an IV infusion, or a second androgen receptor-directed therapy of either abiraterone as oral tablets, or enzalutamide as oral tablets at the investigator's discretion.
- Primary Outcome Measures
Name Time Method Overall Survival (OS) Up to approximately 43 months
- Secondary Outcome Measures
Name Time Method Radiographic Progression-free Survival (rPFS) per Prostate Cancer Working Group 3 (PCWG3)-modified Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as Assessed by Blinded Independent Central Review (BICR) Up to approximately 43 months Objective Response Rate per Modified RECIST v1.1 as Assessed by BICR Up to approximately 43 months Duration of Response (DOR) per Modified RECIST v1.1 as Assessed by BICR Up to approximately 43 months Disease Control Rate per Modified RECIST v1.1 as Assessed by BICR Up to approximately 43 months Time to Response (TTR) per Modified RECIST v1.1 as Assessed by BICR Up to approximately 43 months Time to First Symptomatic Skeletal Events (SSE) Up to approximately 43 months Number of Participants Experiencing Treatment-emergent Adverse Events (TEAEs) Up to approximately 43 months Change from Baseline in Brief Pain Inventory - Short Form (BPI-SF) Worst Pain Score Baseline and approximately 43 months Change from Baseline in BPI-SF Pain Intensity Scale Score Baseline and approximately 43 months Change from Baseline in BPI-SF Pain Interference Scale Score Baseline and approximately 43 months Change from baseline in the European Quality of Life 5 Domain 5 Level Scale (EQ-5D-5L) Utility Score Baseline and approximately 43 months Change from baseline in the EQ-5D-5L Visual Analogue Scale (VAS) Baseline and approximately 43 months Change from Baseline in Functional Assessment of Cancer Therapy - Prostate (FACT-P) Total Score and Subscale Score Baseline and approximately 43 months Time to Worsening in BPI-SF Worst Pain Score Up to approximately 43 months Time to Worsening in BPI-SF Pain Intensity Scale Score Up to approximately 43 months Time to Worsening in BPI-SF Pain Interference Scale Score Up to approximately 43 months Time to Worsening in FACT-P Total Score Up to approximately 43 months Time to Pain Improvement in Participants with Moderate/Severe Pain at Baseline Up to approximately 43 months Time to Pain Improvement after Worsening in BPI-SF Pain Intensity Scale Score Up to approximately 43 months Time to Pain Improvement after Worsening in BPI-SF Pain Interference Scale Up to approximately 43 months Number of Patient-Reported Symptomatic AEs per Patient-reported Outcome - Common Terminology Criteria for Adverse Events (PRO-CTCAE) Item Library Up to approximately 43 months Patient-Reported Summary Scores for Overall Bother of Side Effects per FACT-P Up to approximately 43 months Percentage of Participants Achieving a ≥50% Reduction in Prostate-specific Antigen (PSA) (PSA50) Up to approximately 43 months Percentage of Participants Achieving a ≥90% Reduction in PSA (PSA90) Up to approximately 43 months Maximum Serum Concentration (Cmax) of Xaluritamig Up to approximately 43 months Time to Cmax (Tmax) of Xaluritamig Up to approximately 43 months Minimum Serum Concentration (Cmin) of Xaluritamig Up to approximately 43 months Area Under the Concentration-time Curve (AUC) of Xaluritamig Up to approximately 43 months Accumulation Following Multiple Dosing of Xaluritamig Up to approximately 43 months Half-life (t1/2) of Xaluritamig Up to approximately 43 months Number of Participants with Anti-xaluritamig Antibody Up to approximately 43 months
Trial Locations
- Locations (139)
City of Hope National Medical Center
🇺🇸Duarte, California, United States
Providence Saint Jude Medical Center
🇺🇸Fullerton, California, United States
University of California Irvine
🇺🇸Irvine, California, United States
University of Florida, College of Medicine
🇺🇸Gainesville, Florida, United States
AdventHealth Orlando
🇺🇸Orlando, Florida, United States
University of Chicago
🇺🇸Chicago, Illinois, United States
Indiana University
🇺🇸Indianapolis, Indiana, United States
University of Louisville Health - James Graham Brown Cancer Center
🇺🇸Louisville, Kentucky, United States
Norton Cancer Institute
🇺🇸Louisville, Kentucky, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
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