Status:

NOT_YET_RECRUITING

Abiraterone, Enzalutamide, or Apalutamide in Castrate-sensitive Prostate Cancer.

Lead Sponsor:

James J. Peters Veterans Affairs Medical Center

Conditions:

Metastatic Cancer

Neoplasm, Prostate

Eligibility:

MALE

Phase:

PHASE2

Brief Summary

The investigators have used national VHA data to demonstrate real-world efficacy of abiraterone and enzalutamide in Veterans with mCRPC. In the real-world that is the VHA, the investigators have succe...

Eligibility Criteria

Inclusion

  • Veterans must meet the following to be eligible to participate:
  • Be willing and able to provide written informed consent for the trial.
  • Age ≥18 years of age on day of signing informed consent.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (on a scale from 0 to 5, with higher scores indicating greater disability and a score of 5 indicating death).
  • Histologically or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation, signet-cell features, or small-cell features in either a recently obtained sample or in the archival sample at the time of diagnosis.
  • Have been receiving or will receive androgen-deprivation therapy with a gonadotropin releasing hormone agonist or antagonist or have undergone bilateral orchiectomy (i.e., medical, or surgical castration).
  • High risk for the development of progression of disease/metastasis, defined as (i) a minimum of three rising PSA values (PSA1 \< PSA2 \< PSA3) at an interval of at least 1 week apart; (ii) a PSA level of 2 ng per milliliter (2 μg/L) or greater; and (iii) a PSA doubling time of 9 months or less during continuous androgen-deprivation therapy (bilateral orchiectomy or treatment with gonadotropin-releasing hormone analogue agonists or antagonists) as calculated with the use of the method of Pound et al.
  • Has not received abiraterone acetate, enzalutamide, or apalutamide at the time of enrollment.
  • Have a predicted life expectancy of \>12 months.
  • For patients receiving bisphosphonates or denosumab, dose must be stable for at least 4 weeks before randomization.
  • Able to swallow the study drug and comply with study requirements.
  • Laboratory tests meet minimum safety requirements:
  • Hepatic: AST ≤2.5 X institutional ULN, ALT ≤2.5 X institutional ULN
  • Renal: Creatinine clearance ≥30 ml/min or serum creatinine ≤1.8 mg/dl
  • Hematological: Absolute neutrophil count ≥1000/mm3, Platelet count ≥100,000/mm3; Hemoglobin \>9 g/dL Note: The presence of metastatic disease as assessed by any modality is not a contraindication for enrollment.

Exclusion

  • Subjects with any of the following will not be enrolled:
  • Prior cytotoxic chemotherapy, aminoglutethimide, ketoconazole, abiraterone acetate, apalutamide or enzalutamide for the treatment of prostate cancer or participation in a clinical trial of an investigational agent that inhibits the androgen receptor or androgen synthesis (unless treatment was placebo).
  • Treatment with hormonal therapy (e.g., androgen receptor inhibitors, estrogens, 5-alpha reductase inhibitors) or biologic therapy for prostate cancer (other than approved bone targeting agents and GnRH agonist/antagonist therapy) within 4 weeks of randomization
  • Other malignancy except: (a) Subjects who have been successfully treated and are disease free for 3 years; (b) a history of completely resected non-melanoma skin cancer; or (c) successfully treated in situ carcinoma.
  • History of seizure or any condition that may predispose to seizure (e.g., prior cortical stroke or significant brain trauma).
  • Deep vein thrombosis or pulmonary embolism in the past 3 months that in the opinion of the physician makes the patient medically unstable.
  • Patients who are receiving any other investigational agents concurrently.

Key Trial Info

Start Date :

June 30 2022

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 30 2026

Estimated Enrollment :

200 Patients enrolled

Trial Details

Trial ID

NCT05422911

Start Date

June 30 2022

End Date

June 30 2026

Last Update

June 21 2022

Active Locations (1)

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Page 1 of 1 (1 locations)

1

James J. Peters VA Medical Center

The Bronx, New York, United States, 10468