The metastatic castration-resistant prostate cancer (mCRPC) patients with homologous recombination repair (HRR) gene alterations who have not progressed after docetaxel therapy
- Conditions
- metastatic castration-resistant prostate cancer (mCRPC)Therapeutic area: Diseases [C] - Cancer [C04]MedDRA version: 21.1Level: PTClassification code 10036909Term: Prostate cancer metastaticSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)MedDRA version: 21.1Level: LLTClassification code 10076506Term: Castration-resistant prostate cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
- Registration Number
- EUCTR2021-001205-73-FR
- Lead Sponsor
- IMPACT Therapeutics, Inc.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Authorised-recruitment may be ongoing or finished
- Sex
- Male
- Target Recruitment
- 165
Patients are eligible to be included in the study only if all the following criteria are met (* is for screening part 1, all criteria for screening part 2)
1. Patients must voluntarily participate in this clinical study. Be willing and able to provide
written informed consent form (ICF) prior to any study activity.
2. Male =18 years of age on the day of signing the ICF.
3. Patients must have histologically or cytologically confirmed prostate adenocarcinoma.
4. Patients must have received and failed at least one novel hormonal agent (NHA, such as abiraterone, enzalutamide, etc.) before or in mCRPC stage. In addition, patients are allowed
to have received and failed up to one novel hormonal therapy in mCRPC stage. Treatment
failure is judged by the investigator.
5. Patients confirmed by investigator to be at mCRPC stage when starting the immediate prior treatment with docetaxel. Metastatic disease documented by positive bone scan or metastatic lesions on CT or MRI. Metastatic lesions do not include disease spread to local pelvic lymph nodes or local disease recurrence (e.g., bladder and rectum).
6. Surgically or medically castrated, with serum testosterone levels of =50 ng/dL (=1.73 nmol/L). If the patient is being treated with LHRH agonists/antagonists (patient who have not undergone orchiectomy), this therapy must be continued throughout the study.
7. Completed at least 6 cycles and a maximum of 8 cycles of immediate prior treatment with docetaxel (3 weeks a cycle) with no evidence of PD after last docetaxel treatment.
The investigator must check whether the patient has PD according to the following four criteria, taking the baseline of docetaxel treatment as reference (if there is no radiographic tumor evaluation at baseline, the earliest tumor assessment after the first dose of docetaxel will serve as reference). Patients cannot be enrolled if they meet any of the four criteria for PD.
a. Radiographic soft-tissue lesions progression according to RECIST v1.1.
b. Radiographic bone progression according to Prostate Cancer Clinical Trials Working Group 3 (PCWG3) criteria. Bone progression= appearance of 2 or more new lesions (only positivity on the bone scan defines metastatic disease to bone). Ambiguous results will be confirmed by other imaging modalities (e.g., CT or MRI).
c. PSA progression according to PCWG3 criteria. PSA progression is defined as: PSA progression =25% increase and =2 ng/mL increase from baseline of docetaxel treatment beyond 12 weeks, and which is confirmed by a second value =3 weeks later.
d. Clinical PD judged by investigator, including but not limited to skeletal-related events (SREs, e.g., asymptomatic or symptomatic fractures, surgery or radiation therapy to bone, or spinal cord compression), tumor related pain progression and other tumor related symptoms or signs.
8. Documented germline/somatic mutation in at least one of the homologous recombination repair genes, including BRCA1, BRCA2, ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, and RAD54L that is predicted to be deleterious or suspected deleterious (known or predicted to be detrimental/lead to loss of function) assessed by central laboratory using validated Next-Generation Sequencing (NGS) test from blood samples.
9. Patients have adequate organ functions, as indicated by the following laboratory values (had not received blood transfusion, apheresis infusion, erythropoietin, granulocyte colony- stimulating factor
Patients who meet any of the following criteria will be excluded from the study (* is for screening part 1)
1. *Previous allogenic bone marrow transplant or double umbilical cord blood transplantation
(dUCBT).
2. *Prior treatment with a polyadenosine 5'diphosphoribose polymerisation (PARP) inhibitor,
including Senaparib.
3. *In mCRPC stage, any prior systemic therapy except for docetaxel, NHA or necessary ADT
with LHRH agonists/antagonist for mCRPC.
4. *Patients with a known hypersensitivity to Senaparib or any of the component of Senaparib.
5. Patients who have other new malignancies within 2 years prior to the first dose of Senaparib will be excluded, except for radically treated basal or squamous cell skin cancer. Patients with other malignancies which have been treated with no relapse within 2 years can be
enrolled.
6. Initiating bisphosphonate/denosumab therapy or adjusting bisphosphonate/denosumab
dose/regimen within 28 days prior to the first dose of study drug. Patients on a stable bisphosphonate/denosumab regimen are eligible and may continue.
7. Patients who have received chemotherapy (except for docetaxel), targeted therapy, immunotherapy, endocrine therapy (except for necessary ADT with LHRH
agonists/antagonist for mCRPC), anti-tumor Chinese herbal medicine or proprietary
Chinese medicine treatment or other anti-cancer systemic treatment within 5 half-lives or 28 days (whichever is longer), prior to the first dose of study drug.
8. Patients who have any acute toxicities due to prior chemotherapy and/or radiotherapy that are >2 Grade per National Cancer Institute-Common Terminology Criteria for Adverse
Events (NCI-CTCAE) v5.0 with the exception of alopecia.
9. Patients who have participated in a study of an investigational agent and received study therapy or used an investigational device within 28 days of the first dose of study drug. For investigational drugs, the washout period should be 5 half-lives or 28 days whichever is
longer.
10. Patients who have received strong inhibitors/inducers of CYP3A4 which cannot be discontinued 21 days prior to the first dose of study drug and withheld throughout the study drug treatment. Patients received phenobarbital/enzalutamide will require a 5-week
washout prior to the first dose of study drug.
11. Patients who have undergone a major surgery or radical radiotherapy within 28 days prior to the first dose of study drug, or have undergone a palliative radiotherapy within 14 days
prior to the first dose of study drug.
12. *Patients with MDS or AML, or with clinical features suggestive of MDS or AML.
13. Patients with serious acute or chronic infections.
14. Patients who have acute myocardial infarction, unstable angina, stroke, or transient
ischemic attack within 6 months prior to the first dose of study drug; patients who have congestive heart failure (New York Heart Association [NYHA] Classification Class =II); patients who have severe or uncontrolled hypertension, arrhythmia.
15. Patients with known and symptomatic brain metastasis. Patients with asymptomatic, treated,
stable brain metastases without steroids for at least 28 days are eligible for study entry. A radiographic imaging to confirm the absence of brain metastases is not required.
16. Patients with symptomatic or impending spinal cord compression, unless appropriately
treated for this and clinically stable and asymptomatic for 28 days prior to the first dose of study drug.
17. Patients who are unable to swallow a whole caps
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method