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A Study of Lorigerlimab With Docetaxel or Docetaxel Alone in Participants With Metastatic Castration-Resistant Prostate Cancer

Phase 2
Active, not recruiting
Conditions
Androgen-Independent Prostatic Cancer
Androgen-Independent Prostatic Neoplasms
Prostate Cancer Recurrent
Androgen-Insensitive Prostatic Cance
Androgen-Resistant Prostatic Cancer
Hormone Refractory Prostatic Cancer
Immunotherapy
Immune Checkpoint Inhibitor
Inhibitory Checkpoint Molecule
Interventions
Registration Number
NCT05848011
Lead Sponsor
MacroGenics
Brief Summary

The purpose of this study is to determine whether the amount of time before disease progression can be prolonged in participants with metastatic castration-resistant prostate cancer (MCRPC) who receive lorigerlimab in addition to the standard of care (SOC) of docetaxel and prednisone. About 150 participants with mCRPC will be enrolled. Participants will be randomized in a 2:1 ratio to receive lorigerlimab with docetaxel and prednisone (experimental arm) or docetaxel and prednisone alone (standard-of-care arm).

Lorigerlimab+docetaxel or docetaxel will be administered intravenously (IV) in clinic on Day 1 of each 3-week cycle. Prednisone will be administered orally twice daily. Lorigerlimab will be administered for up to 35 cycles. Docetaxel and prednisone will be administered up to 10 cycles until treatment discontinuation criteria are met. Participants will undergo regular testing for signs of disease progression using computed tomography (CT) scans, magnetic resonance imaging (MRI) and prostate-specific antigen (PSA) blood tests. Participants will be asked to complete questionnaires about their health and well-being. Routine examinations and blood tests will be performed and evaluated by the study doctor.

Participants who have disease progression standard-of-care arm have the option of continuing on the study to receive lorigerlimab monotherapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
154
Inclusion Criteria
  • Metastatic castration-resistant adenocarcinoma of the prostate without evidence of neuroendocrine differentiation, signet cell, or small cell features.
  • Participants must have ≥ 1 metastatic (measurable or non-measurable per PCWG3) lesion.
  • Participant has prostate cancer progression at study entry based on PCWG3 criteria.
  • Participant shows evidence of disease progression after receiving at least 1 prior androgen receptor axis-targeted therapy (ARAT) regimen (e.g., abiraterone, enzalutamide, apalutamide, or darolutamide).
  • Patients with known history of documented breast cancer gene (BRCA) mutation (germline or somatic) must have received an approved poly ADP ribose polymerase (PARP) inhibitor regimen.
  • Participants must have adequate performance status, life expectancy and laboratory values.
Exclusion Criteria
  • Any condition preventing participant's ability to receive, tolerate, or comply with the planned treatment or study procedures.
  • Received prior chemotherapy for mCRPC or checkpoint inhibitors for prostate cancer.
  • Current active or chronic infections.
  • Any clinically significant heart, lung, or gastrointestinal disorders.
  • Allergy to any of the study treatments or components of the study treatments.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard of care docetaxel and prednisonedocetaxelDocetaxel 75 mg/m\^2 IV every 3 weeks and prednisone 5 mg orally twice daily.(up to 7 months)
Standard of care docetaxel and prednisonePrednisoneDocetaxel 75 mg/m\^2 IV every 3 weeks and prednisone 5 mg orally twice daily.(up to 7 months)
Lorigerlimab + Docetaxel and PrednisonelorigerlimabLorigerlimab 6 mg/kg IV (up to 2 years) and docetaxel 75 mg/m\^2 IV every 3 weeks (up to 7 months) and prednisone 5 mg orally twice daily (up to 7 months).
Lorigerlimab + Docetaxel and PrednisonedocetaxelLorigerlimab 6 mg/kg IV (up to 2 years) and docetaxel 75 mg/m\^2 IV every 3 weeks (up to 7 months) and prednisone 5 mg orally twice daily (up to 7 months).
Lorigerlimab + Docetaxel and PrednisonePrednisoneLorigerlimab 6 mg/kg IV (up to 2 years) and docetaxel 75 mg/m\^2 IV every 3 weeks (up to 7 months) and prednisone 5 mg orally twice daily (up to 7 months).
Primary Outcome Measures
NameTimeMethod
Median radiographic progression free survival (rPFS) determined by investigator review.Every 9 weeks for the first year, followed by every 12 weeks for up to 3 more years

The rPFS is defined as the time from the date of randomization to the date of first documented PD per Prostate Cancer Working Group 3 (PCWG3) criteria or death from any cause, whichever occurs first.

Secondary Outcome Measures
NameTimeMethod
Objective response rate (ORR) per PCWG3 criteriaEvery 9 weeks for the first year, followed by every 12 weeks for up to 3 more years

ORR is defined as the number of participants who have a best overall response of confirmed complete response (CR) or partial response (PR) without prior confirmed bone progression

Duration of response (DoR)Every 9 weeks for the first year, then every 12 weeks for up to 4 years

DoR is the time from the date of initial tumor response (CR or PR) to the date of first disease progression or death from any cause, whichever occurs first.

Time to response (TTR)Every 9 weeks for the first year, followed by every 12 weeks for up to 3 more years

TTR is defined as the time from the start of treatment to the first objective response (CR or PR).

PSA50 response rateEvery 3 weeks up to 2 years, followed by every 12 weeks for up to 2 more years

PSA50 response is defined as a ≥ 50% decline in PSA from baseline with confirmation at least 3 weeks after the first documented reduction in PSA of ≥ 50%.

PSA90 response rateEvery 3 weeks up to 2 years, followed by every 12 weeks for up to 2 more years

PSA90 response is defined as a ≥ 90% decline in PSA from baseline with confirmation at least 3 weeks after the first documented reduction in PSA of ≥ 90%.

Time to PSA progressionEvery 9 weeks for the first year, followed by every 12 weeks for up to 2 more years

Time to PSA progression is defined as the time from the date of randomization to the first documented PSA progression.

Duration of PSA responseEvery 3 weeks up to 2 years, followed by every 23 weeks for up to 2 more years.

Duration of PSA response is defined as the time from the date of first PSA response to the earliest date of PSA progression.

Overall survival (OS)Throughout the study up to 4 years

OS is defined as the time from the date of randomization to the date of death from any cause.

Time to First Symptomatic Skeletal Event (SSE)Throughout the study up to 4 years

Time to first SSE is defined as the time from the date of randomization to the first occurrence of SSE from any cause.

Time to pain progression using the BPI-sf questionnaireEvery 9 weeks for the first year, followed by every 12 weeks for up to 2 more years

Time to pain progression is defined as the time interval from randomization to the first date a participant experiences pain progression. Higher scores indicate more severe pain.

Pain severity using the Brief Pain Index - short form (BPI-sf) questionnaireEvery 3 weeks up to 2 years

The BPI-sf pain severity score consists of 4 items that assess pain at its worst, least, average, and current pain intensity. The pain severity score is the average of the 4 item scores. Higher scores indicate more severe pain.

Pain interference using the BPI-sf questionnaireEvery 3 weeks up to 2 years

The BPI-sf pain interference score includes 7 items: general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. The pain interference score is the average of the 7 interference items. Higher scores indicate more interference from pain in daily life.

Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaireEvery 3 weeks up to 2 years

The FACT-P consists of 27 items from the Functional Assessment of Cancer Therapy-General (FACT-G) that measure physical, social/family, emotional, and functional well-being and 12 items that compose the Prostate Cancer Subscale (PCS). Higher scores indicate greater impact of prostate cancer on daily life.

Description of types of adverse events (AEs) between treatment groups.Throughout treatment up to 27 months

Number of participants with adverse events (AEs), serious adverse events (SAEs), and AEs leading to study treatment discontinuation

Lorigerlimab maximum concentration or concentration at the end of infusion (Cmax)Every 21-day cycle throughout the study, for an average of 1 year.

The highest measured concentration of lorigerlimab in the bloodstream.

Lorigerlimab area under the concentration time curve (AUC)Every 21-day cycle throughout the study, for an average of 1 year.

AUC is the total amount of lorigerlimab in bloodstream after drug administration

Trough drug concentration (Ctrough or Cmin)Every 21-day cycle throughout the study, for an average of 1 year.

Trough concentration is the concentration measured before a subsequent dose of lorigerlimab

Clearance (CL)Every 21-day cycle throughout the study, for an average of 1 year.

Drug clearance is the amount of drug removed from the bloodstream by the body per unit of time

Volume of distribution (Vz)Every 21-day cycle throughout the study, for an average of 1 year.

The volume of distribution is related to how much drug is distributed to body tissues, or remains in the bloodstream.

Terminal half-lifeEvery 21-day cycle throughout the study, for an average of 1 year.

Terminal elimination half-life is the time it takes for the concentration of the drug in plasma or serum to be reduced by 50%

Number of participants who develop anti-drug antibodiesThroughout the study, up to 2 years

Trial Locations

Locations (58)

Institut Català d'Oncologia Hospitalet_ICO Hospitalet

🇪🇸

Barcelona, Spain

Vall d' Hebron Institute of Oncology (VHIO)

🇪🇸

Barcelona, Spain

Hospital 12 de octubre

🇪🇸

Madrid, Spain

Hospital Parc Tauli

🇪🇸

Barcelona, Spain

Hospital Sant Pau

🇪🇸

Barcelona, Spain

Ltd Gidmedi

🇬🇪

Tbilisi, Georgia

LtD L.M.National Urology Center

🇬🇪

Tbilisi, Georgia

United Medical Group

🇺🇸

Miami, Florida, United States

Orlando Health Cancer Institute

🇺🇸

Orlando, Florida, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Nebraska Cancer Specialists

🇺🇸

Grand Island, Nebraska, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

University of Virginia Health System Cancer Center

🇺🇸

Charlottesville, Virginia, United States

Concord Repatriation General Hospital

🇦🇺

Concord, Australia

Peter MacCallum Cancer Centre

🇦🇺

North Melbourne, Australia

North Shore Private Hospital

🇦🇺

St Leonards, Australia

Westmead Hospital

🇦🇺

Westmead, Australia

Cliniques universitaires Saint-Luc (CUSL), Brussels

🇧🇪

Brussel, Belgium

UZ GENT

🇧🇪

Gent, Belgium

Centre Hospital de l'Ardenne

🇧🇪

Libramont, Belgium

CHU de Liège

🇧🇪

Liège, Belgium

Comprehensive Cancer Center

🇧🇬

Plovdiv, Bulgaria

UMHAT Sv. Ivan Rilski

🇧🇬

Sofia, Bulgaria

Institut Bergonie

🇫🇷

Bordeaux, France

Clinique Victor Hugo

🇫🇷

Le Mans, France

Centre Léon Bérard

🇫🇷

Lyon, France

Centre Antoine Lacassagne

🇫🇷

Nice, France

Institut Mutualiste Montsouris

🇫🇷

Paris, France

Centre Hospitalier Quimper

🇫🇷

Quimper, France

CHP Saint Grégoire

🇫🇷

Saint-Grégoire, France

Hia Begin

🇫🇷

Saint-Mandé, France

Hopital Foch

🇫🇷

Suresnes, France

Institut Gustave Roussy

🇫🇷

Villejuif, France

LTD High Tech Hosp Medcenter

🇬🇪

Batumi, Georgia

First University Clinic TSMU

🇬🇪

Tbilisi, Georgia

LTD Consilium Medulla

🇬🇪

Tbilisi, Georgia

LTD MMT Hospital

🇬🇪

Tbilisi, Georgia

LTD Todua Clinic

🇬🇪

Tbilisi, Georgia

Onc. Scient. Research Center

🇬🇪

Tbilisi, Georgia

Przychodnia Lekarska KOMED

🇵🇱

Konin, Poland

Pratia McM Kraków

🇵🇱

Kraków, Poland

Europejskie Centrum Zdrowia Otwock, Szpital im. Fryderyka Chopina

🇵🇱

Otwock, Poland

LuxMed Onkologia

🇵🇱

Warsaw, Poland

Medical Concierge

🇵🇱

Warsaw, Poland

Szpital Grochowski im. dr med. Rafała Masztaka Sp. z o.o., Oddział Chemioterapii

🇵🇱

Warsaw, Poland

Pan American Center for Oncology Trials, LLC

🇵🇷

Rio Piedras, Puerto Rico

H U Germans Tries i Pujol

🇪🇸

Barcelona, Spain

Hospital Clínic de Barcelona

🇪🇸

Barcelona, Spain

Hospital del Mar

🇪🇸

Barcelona, Spain

Hospital Beata Maria Ana

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

FIVO: Instituto Valenciano de Oncología

🇪🇸

Valencia, Spain

Churchill Hospital

🇬🇧

Headington, United Kingdom

Charing Cross Hospital

🇬🇧

London, United Kingdom

Royal Marsden Hospital

🇬🇧

Sutton, United Kingdom

Musgrove Park Hospital

🇬🇧

Taunton, United Kingdom

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