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ODM-201 vs Androgen Deprivation Therapy in Hormone naïve Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
ODM-201
ADT
Sponsored by
European Organisation for Research and Treatment of Cancer - EORTC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring Hormone Naive Prostate Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically confirmed prostate cancer (all stages) for whom continuous androgen-deprivation therapy (ADT) is indicated for a minimum period of 24 weeks
  • Patient presenting with a maximum of 4 confirmed metastatic lesions, including bone, extra-pelvic lymph nodes, and pelvic lymph nodes > 2 cm on baseline Computed tomography(CT) or Magnetic resonance imaging (MRI) and/or Tc bone scintigraphy. Visceral metastases are excluded
  • Asymptomatic for metastatic prostate cancer; urinary symptoms are allowed
  • Baseline testosterone ≥ 8 nmol/L or 230 ng/dL
  • Two subsequent PSA values ≥ 2 ng/ml, taken at minimum 2-week interval, with the second being equal to or higher than the first one
  • WHO performance status (PS) of 0-1
  • G8 score ≥ 14 for patients aged ≥ 70 years old
  • A life expectancy of at least 12 months
  • Able to swallow the study drug and comply with the study requirements
  • Adequate bone marrow function (absolute neutrophil count (ANC) ≥ 1.5 10exp9/L; hemoglobin ≥ 10.0 g/dl, platelets ≥ 100 10exp9/L)
  • Adequate renal function: creatinine clearance/eGFR within normal limits to baseline assessed as per local standard method
  • Albumin > 25 g/L
  • Adequate hepatic function:

Bilirubin: total bilirubin ≤ to 1.5 X upper limit of normal (ULN)

  • Aspartate aminotransferase (AST) and/or Alanine aminotransferase(ALT) ≤ 2.5 X ULN
  • Normal cardiac function according to local standard by 12-lead Electrocardiogram (ECG) (complete, standardized 12-lead recording)
  • Before patient registration/randomization, written informed consent must be given according to International Conference on Harmonization on Good Clinical Practices (ICH/GCP), and national/local regulations.

Exclusion Criteria:

  • any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
  • Previously or currently receiving hormonal therapy with intent to treat prostate cancer disease (surgical castration or other hormonal manipulation, e.g. GnRH agonists, GnRH antagonists, anti-androgens, oestrogens, 5α-reductase inhibitor). For patients that have received (neo)adjuvant ADT before radiotherapy, it should have been stopped for more than 1 year
  • Prior use of investigational agents that block androgen synthesis or block androgen receptor
  • Use of herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (e.g. saw palmetto)
  • Has received systemic glucocorticoids within 24 weeks prior to enrollment or is expected to require systemic glucocorticoids during the study period
  • Radiation therapy for treatment of the primary tumor within 3 months prior to enrollment
  • Use of an investigational agent within 4 weeks prior to enrollment is not allowed. The maximum allowed duration may be extended to comply with national regulations in the participating countries.
  • Gastrointestinal disorder affecting absorption (e.g. gastrectomy, active peptic ulcer disease within 3 months prior to enrollment)
  • Known hypersensitivity to the study treatment or any of its ingredients (refer to Investigator's brochure).
  • Severe or uncontrolled concurrent disease, infection or co-morbidity including active viral hepatitis, known human immunodeficiency virus infection with detectable viral load (Human immunodeficiency virus (HIV)) or chronic liver disease
  • History of prior malignancy. Adequately treated basal cell or squamous cell carcinoma of skin or superficial bladder cancer that has not spread behind the connective tissue layer (i.e. pTis, pTa, and pT1) is allowed, as well as any other cancer for which chemotherapy has been completed ≤ 5 years ago and from which the patient has been disease-free.
  • Clinically significant cardiovascular disease including:
  • Myocardial infarction within six months prior to randomization
  • Uncontrolled angina within 3 months prior to randomization
  • Coronary/peripheral artery bypass within 6 months prior to randomization
  • Stroke within 6 months prior to randomization
  • Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or subjects with history of congestive heart failure NYHA class 3 or 4 in the past, unless a screening echocardiogram or multi-gated acquisition scan (MUGA) performed within 3 months results in a left ventricular ejection fraction that is ≥ 45%
  • History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes)
  • History of Mobitz II second degree or third degree heart block without a permanent pacemaker in place
  • Uncontrolled hypertension as indicated by a resting systolic blood pressure >170 mm Hg or diastolic blood pressure > 105 mm Hg at the screening visit

Sites / Locations

  • Hopitaux Universitaires Bordet-Erasme - Hopital Universitaire Erasme
  • Cliniques Universitaires Saint-Luc
  • Universitair Ziekenhuis Gent
  • CHU Dinant Godinne - UCL Namur
  • CHU de Dijon - Centre Georges-Francois-Leclerc
  • Gustave Roussy
  • Azienda Ospedaliera Citta della Salute e della Scienza di Torino - Ospedale Molinette
  • Institut Catala d'Oncologia - ICO Badalona - Hospital Germans Trias i Pujol
  • Hospital Universitario Ramon y Cajal
  • Hospital Universitario Virgen De La Victoria
  • Hospital Universitario de Salamanca
  • Fundacion Instituto Valenciano De Oncologia

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

ADT

ODM 201

Arm Description

The standard treatment for this stage of the disease is ADT by means of LHRH antagonist for 24 weeks or by LHRH agonist therapy for 24 weeks with 4 weeks of anti-androgen to prevent flare. This includes leuprolide, goserelin, triptorelin, and degarelix. Beyond week 24, the treatment will be left to the discretion of the treating physician.

ODM 201 will be administered as oral 300-mg tablets. The dose of study drug to be administered is 600 mg (2 x 300-mg tablets) bid for a daily dose of 1200 mg. It is recommended that ODM-201 be taken with food. Subjects who have clinical benefit at week 24 may continue to receive ODM-201 at the discretion of the investigator until disease progression, objective or clinical, or occurrence of an unacceptable toxicity. This includes those that will receive external beam radiation therapy. Any anti-cancer therapy other than the study drug given as single agent will not be considered part of the protocol treatment.

Outcomes

Primary Outcome Measures

PSA response
PSA response is defined as a ≥ 80% decline in PSA measurement taken at week 24 relative to the measurement taken at baseline, in the ODM-201 study arm. The ADT arm is used as an internal control.

Secondary Outcome Measures

EORTC QLQ-PR25
Change in hormone-treatment related symptoms scale of the EORTC QLQ-PR25 at 24 weeks compared to baseline in the ODM-201 study arm. A 10-point difference is regarded as a clinically meaningful benefit.
Objective tumor response
Objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline
90% PSA response rate
PSA response at 24 weeks defined as a ≥90% decline in PSA compared to baseline
evaluation of safety
All adverse events will be recorded; the investigator will assess whether those events are drug related (reasonable possibility, no reasonable possibility) and this assessment will be recorded in the database for all adverse events.

Full Information

First Posted
November 21, 2016
Last Updated
September 6, 2023
Sponsor
European Organisation for Research and Treatment of Cancer - EORTC
Collaborators
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT02972060
Brief Title
ODM-201 vs Androgen Deprivation Therapy in Hormone naïve Prostate Cancer
Official Title
A Phase 2 Randomized Open-Label Study of Oral Darolutamide (ODM-201) vs. Androgen Deprivation Therapy (ADT) With LHRH Agonists or Antagonist in Men With Hormone Naive Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 1, 2017 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
May 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
European Organisation for Research and Treatment of Cancer - EORTC
Collaborators
Bayer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open label non-comparative controlled randomized phase II study. The experimental arm is the group receiving ODM-201. The group receiving androgen-deprivation therapy (ADT) is included as an internal control. The primary trial objective is to demonstrate that ODM-201 produces prostate-specific antigen (PSA) response rates at 24 weeks (defined as ≥80% reduction compared to baseline) that are in the range of those achieved with 24 weeks of ADT. In total, this 1:1 randomized study will therefore require randomization of at least 250 patients, 125 to each arm.
Detailed Description
ODM 201 will be administered as oral 300-mg tablets. The dose of study drug to be administered is 600 milligrams (mg) (2 x 300-mg tablets) twice daily (bid) for a daily dose of 1200 mg. It is recommended that ODM-201 be taken with food. Subjects who have clinical benefit at week 24 may continue to receive ODM-201 at the discretion of the investigator until disease progression, objective or clinical, or occurrence of an unacceptable toxicity. This includes those that will receive external beam radiation therapy. Any anti-cancer therapy other than the study drug given as single agent will not be considered part of the protocol treatment. The standard treatment for this stage of the disease is androgen deprivation therapy (ADT) by means of Luteinizing hormone-releasing hormone (LHRH) antagonist for 24 weeks or by LHRH agonist therapy for 24 weeks with 4 weeks of anti-androgen to prevent flare. This includes leuprolide, goserelin, triptorelin, and degarelix. Beyond week 24, the treatment will be left to the discretion of the treating physician. The primary trial objective is to demonstrate that ODM-201 produces prostate-specific antigen (PSA) response rates at 24 weeks (defined as ≥80% reduction compared to baseline) that are in the range of those achieved with 24 weeks of ADT. The secondary objectives are to: To document the effects of ODM-201 compared to ADT in terms of patient-reported side effects of hormonal therapy, based on the Hormonal treatment (HTR) symptom scale of EORTC QLQ PR25 at 24 weeks; To document the effects of ODM-201 compared to ADT in terms of patient-reported side effects of hormonal therapy, based on EORTC QLQ C30 and PR25 at 24 weeks; To document the effect of ODM-201 on PSA complete response at 24 weeks (defined as ≥ 90% reduction from baseline); To document the effect of ODM-201 on objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline; To document the safety and tolerability of ODM-201 vs. ADT in subjects who have not previously received hormone treatment for prostate cancer; To document the effects of ODM-201 on androgen deprivations symptoms using the Aging male symptoms (AMS) questionnaires; To document the proportion of patients who opted to continue treatment with ODM-201 beyond the protocolized 24 weeks The primary endpoint is the PSA response assessed at 24 weeks. PSA response is defined as a ≥ 80% decline in PSA measurement taken at week 24 relative to the measurement taken at baseline, in the ODM-201 study arm. The ADT arm is used as an internal control. Key secondary endpoints: Change in hormone-treatment related symptoms scale of the EORTC QLQ-PR25 at 24 weeks compared to baseline in the ODM-201 study arm. A 10-point difference is regarded as a clinically meaningful benefit. Objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline PSA response at 24 weeks defined as a ≥90% decline in PSA compared to baseline Safety according to National Cancer Institute - Common terminology for adverse events (NCI-CTC) version 4.0

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
Hormone Naive Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ADT
Arm Type
Active Comparator
Arm Description
The standard treatment for this stage of the disease is ADT by means of LHRH antagonist for 24 weeks or by LHRH agonist therapy for 24 weeks with 4 weeks of anti-androgen to prevent flare. This includes leuprolide, goserelin, triptorelin, and degarelix. Beyond week 24, the treatment will be left to the discretion of the treating physician.
Arm Title
ODM 201
Arm Type
Experimental
Arm Description
ODM 201 will be administered as oral 300-mg tablets. The dose of study drug to be administered is 600 mg (2 x 300-mg tablets) bid for a daily dose of 1200 mg. It is recommended that ODM-201 be taken with food. Subjects who have clinical benefit at week 24 may continue to receive ODM-201 at the discretion of the investigator until disease progression, objective or clinical, or occurrence of an unacceptable toxicity. This includes those that will receive external beam radiation therapy. Any anti-cancer therapy other than the study drug given as single agent will not be considered part of the protocol treatment.
Intervention Type
Drug
Intervention Name(s)
ODM-201
Intervention Description
ODM-201 is a novel, oral, potent nonsteroidal AR inhibitor. ODM 201 will be administered as oral 300-mg tablets. The dose of study drug to be administered is 600 mg (2 x 300-mg tablets) b.i.d. to a daily dose of 1200 mg. It is recommended that ODM-201 be taken with food. Treatment should be initiated within 28 days from randomization.
Intervention Type
Drug
Intervention Name(s)
ADT
Intervention Description
ADT by means of LHRH antagonist for 24 weeks or by LHRH agonist therapy for 24 weeks with 4 weeks of anti-androgen to prevent flare. This includes leuprolide, goserelin, triptorelin, and degarelix. Beyond week 24, the treatment will be left to the discretion of the treating physician.
Primary Outcome Measure Information:
Title
PSA response
Description
PSA response is defined as a ≥ 80% decline in PSA measurement taken at week 24 relative to the measurement taken at baseline, in the ODM-201 study arm. The ADT arm is used as an internal control.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
EORTC QLQ-PR25
Description
Change in hormone-treatment related symptoms scale of the EORTC QLQ-PR25 at 24 weeks compared to baseline in the ODM-201 study arm. A 10-point difference is regarded as a clinically meaningful benefit.
Time Frame
24 weeks
Title
Objective tumor response
Description
Objective response rate at 24 weeks in patients with RECIST 1.1 measurable disease at baseline
Time Frame
24 weeks
Title
90% PSA response rate
Description
PSA response at 24 weeks defined as a ≥90% decline in PSA compared to baseline
Time Frame
24 weeks
Title
evaluation of safety
Description
All adverse events will be recorded; the investigator will assess whether those events are drug related (reasonable possibility, no reasonable possibility) and this assessment will be recorded in the database for all adverse events.
Time Frame
The collection period will start from randomization until 30 days after last protocol treatment administration.

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed prostate cancer (all stages) for whom continuous androgen-deprivation therapy (ADT) is indicated for a minimum period of 24 weeks Patient presenting with a maximum of 4 confirmed metastatic lesions, including bone, extra-pelvic lymph nodes, and pelvic lymph nodes > 2 cm on baseline Computed tomography(CT) or Magnetic resonance imaging (MRI) and/or Tc bone scintigraphy. Visceral metastases are excluded Asymptomatic for metastatic prostate cancer; urinary symptoms are allowed Baseline testosterone ≥ 8 nmol/L or 230 ng/dL Two subsequent PSA values ≥ 2 ng/ml, taken at minimum 2-week interval, with the second being equal to or higher than the first one WHO performance status (PS) of 0-1 G8 score ≥ 14 for patients aged ≥ 70 years old A life expectancy of at least 12 months Able to swallow the study drug and comply with the study requirements Adequate bone marrow function (absolute neutrophil count (ANC) ≥ 1.5 10exp9/L; hemoglobin ≥ 10.0 g/dl, platelets ≥ 100 10exp9/L) Adequate renal function: creatinine clearance/eGFR within normal limits to baseline assessed as per local standard method Albumin > 25 g/L Adequate hepatic function: Bilirubin: total bilirubin ≤ to 1.5 X upper limit of normal (ULN) Aspartate aminotransferase (AST) and/or Alanine aminotransferase(ALT) ≤ 2.5 X ULN Normal cardiac function according to local standard by 12-lead Electrocardiogram (ECG) (complete, standardized 12-lead recording) Before patient registration/randomization, written informed consent must be given according to International Conference on Harmonization on Good Clinical Practices (ICH/GCP), and national/local regulations. Exclusion Criteria: any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule Previously or currently receiving hormonal therapy with intent to treat prostate cancer disease (surgical castration or other hormonal manipulation, e.g. GnRH agonists, GnRH antagonists, anti-androgens, oestrogens, 5α-reductase inhibitor). For patients that have received (neo)adjuvant ADT before radiotherapy, it should have been stopped for more than 1 year Prior use of investigational agents that block androgen synthesis or block androgen receptor Use of herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (e.g. saw palmetto) Has received systemic glucocorticoids within 24 weeks prior to enrollment or is expected to require systemic glucocorticoids during the study period Radiation therapy for treatment of the primary tumor within 3 months prior to enrollment Use of an investigational agent within 4 weeks prior to enrollment is not allowed. The maximum allowed duration may be extended to comply with national regulations in the participating countries. Gastrointestinal disorder affecting absorption (e.g. gastrectomy, active peptic ulcer disease within 3 months prior to enrollment) Known hypersensitivity to the study treatment or any of its ingredients (refer to Investigator's brochure). Severe or uncontrolled concurrent disease, infection or co-morbidity including active viral hepatitis, known human immunodeficiency virus infection with detectable viral load (Human immunodeficiency virus (HIV)) or chronic liver disease History of prior malignancy. Adequately treated basal cell or squamous cell carcinoma of skin or superficial bladder cancer that has not spread behind the connective tissue layer (i.e. pTis, pTa, and pT1) is allowed, as well as any other cancer for which chemotherapy has been completed ≤ 5 years ago and from which the patient has been disease-free. Clinically significant cardiovascular disease including: Myocardial infarction within six months prior to randomization Uncontrolled angina within 3 months prior to randomization Coronary/peripheral artery bypass within 6 months prior to randomization Stroke within 6 months prior to randomization Congestive heart failure New York Heart Association (NYHA) class 3 or 4, or subjects with history of congestive heart failure NYHA class 3 or 4 in the past, unless a screening echocardiogram or multi-gated acquisition scan (MUGA) performed within 3 months results in a left ventricular ejection fraction that is ≥ 45% History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes) History of Mobitz II second degree or third degree heart block without a permanent pacemaker in place Uncontrolled hypertension as indicated by a resting systolic blood pressure >170 mm Hg or diastolic blood pressure > 105 mm Hg at the screening visit
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bertrand Tombal, Pr
Organizational Affiliation
Cliniques universitaires saint-Luc (Brussels)
Official's Role
Study Chair
Facility Information:
Facility Name
Hopitaux Universitaires Bordet-Erasme - Hopital Universitaire Erasme
City
Brussels
ZIP/Postal Code
1070
Country
Belgium
Facility Name
Cliniques Universitaires Saint-Luc
City
Brussels
ZIP/Postal Code
1200
Country
Belgium
Facility Name
Universitair Ziekenhuis Gent
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
CHU Dinant Godinne - UCL Namur
City
Yvoir
ZIP/Postal Code
5530
Country
Belgium
Facility Name
CHU de Dijon - Centre Georges-Francois-Leclerc
City
Dijon
ZIP/Postal Code
21079
Country
France
Facility Name
Gustave Roussy
City
Villejuif
ZIP/Postal Code
94805
Country
France
Facility Name
Azienda Ospedaliera Citta della Salute e della Scienza di Torino - Ospedale Molinette
City
Torino
ZIP/Postal Code
10126
Country
Italy
Facility Name
Institut Catala d'Oncologia - ICO Badalona - Hospital Germans Trias i Pujol
City
Badalona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Hospital Universitario Ramon y Cajal
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
Hospital Universitario Virgen De La Victoria
City
Malaga
ZIP/Postal Code
29010
Country
Spain
Facility Name
Hospital Universitario de Salamanca
City
Salamanca
ZIP/Postal Code
37007
Country
Spain
Facility Name
Fundacion Instituto Valenciano De Oncologia
City
Valencia
ZIP/Postal Code
46009
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

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ODM-201 vs Androgen Deprivation Therapy in Hormone naïve Prostate Cancer

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