Study of Pembrolizumab (MK-3475) Plus Olaparib Versus Abiraterone Acetate or Enzalutamide in Metastatic Castration-resistant Prostate Cancer (mCRPC) (MK-7339-010/KEYLYNK-010) (KEYLYNK-010)
Prostatic Neoplasms
About this trial
This is an interventional treatment trial for Prostatic Neoplasms focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Cell Death 1 Ligand 1 (PDL1, PD-L1), Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)
Eligibility Criteria
Inclusion Criteria:
- Has histologically- or cytologically-confirmed adenocarcinoma of the prostate without small cell histology
- Has prostate cancer progression while receiving androgen deprivation therapy (or post bilateral orchiectomy) within 6 months before screening
- Has current evidence of metastatic disease documented by bone lesions on bone scan and/or soft tissue disease shown by computed tomography/magnetic resonance imaging (CT/MRI)
Has received prior treatment with abiraterone acetate OR enzalutamide, but not both
- Have disease that progressed during or after treatment with abiraterone acetate for either metastatic hormone-sensitive prostate cancer (mHSPC) or mCRP or enzalutamide for mCRPC for at least 8 weeks (at least 14 weeks for participants with bone progression)
- Participants that received abiraterone acetate for mHSPC may not have received abiraterone acetate or enzalutamide for mCRPC
- Have received docetaxel chemotherapy regimen for mCRPC and have had progressive disease during or after treatment with docetaxel
- Has ongoing androgen deprivation with serum testosterone <50 ng/dL (<2.0 nM)
- If receiving bone resorptive therapy, including but not limited to bisphosphonates or denosumab, must have been receiving stable doses before randomization
- Must agree to refrain from donating sperm during the intervention period and for at least the time needed to eliminate each study intervention after the last dose of study intervention PLUS be abstinent from heterosexual intercourse OR must agree to use contraception unless confirmed to be azoospermic
- Contraception use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. If the contraception requirements in the local label for any of the study interventions is more stringent than the requirement above, the local label requirements are to be followed.
- Has provided tumor tissue from a fresh core or excisional biopsy (obtained within 12 months of screening) from soft tissue not previously irradiated. Samples from tumors progressing at a prior site of radiation are allowed. Participants with bone-only or bone-predominant disease may provide a bone biopsy sample
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 assessed within 7 days of randomization
Exclusion Criteria:
- Has a known additional malignancy that is progressing or has required active treatment in the last 3 years
- Has an active autoimmune disease that has required systemic treatment in the past 2 years
- Has a history of (noninfectious) pneumonitis requiring steroids, or has current pneumonitis
- Has known active human immunodeficiency virus (HIV), hepatitis B virus (e.g., hepatitis B surface antigen reactive) or hepatitis C virus (HCV) infection (e.g., HCV RNA [qualitative] is detected)
- Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Has a history of seizure or any condition that may predispose to seizure
- Has a history of loss of consciousness within 12 months of screening
- Has myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or has features suggestive of MDS/AML
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
- Has (≥Grade 3) hypersensitivity to pembrolizumab and/or any of its excipients
- Has known hypersensitivity to the components or excipients in olaparib, abiraterone acetate, prednisone or prednisolone, or enzalutamide
- Has symptomatic congestive heart failure (New York Heart Association Class III or IV heart disease)
- Has received an anticancer monoclonal antibody (mAb) before randomization
- Has received prior treatment with olaparib or any other PARP inhibitor
- Has received prior treatment with apalutamide or darolutamide
- Has received prior treatment with enzalutamide or apalutamide for metastatic hormone-sensitive prostate cancer
- Has used herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA (e.g., saw palmetto) before the date of randomization
- Has received prior treatment with radium or other therapeutic radiopharmaceuticals for prostate cancer
- Has received prior treatment with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent, or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX-40, or CD137)
- Is currently receiving either strong or moderate inhibitors of cytochrome P450 [CYP] (CYP3A4) that cannot be discontinued for the duration of the study
- Has received a previous allogenic bone marrow transplant or double umbilical cord transplantation (dUCBT) or a solid organ transplant
- Has received a live vaccine within 30 days prior to the date of randomization
- Is currently participating in or has participated in a study of an investigational agent, or has used an investigational device, within 4 weeks before the date of randomization
- Has a bone "superscan"
- Is expecting to father children within the projected duration of the study, starting with the screening visit through 90 days after the last dose of study intervention
Sites / Locations
- St. Joseph Heritage Healthcare ( Site 0069)
- UCLA Hematology/Oncology - Santa Monica ( Site 0081)
- Sibley Memorial Hospital ( Site 0096)
- Georgia Cancer Center at Augusta University ( Site 0026)
- Quincy Medical Group ( Site 0021)
- Tulane Cancer Center ( Site 0066)
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ( Site 0005)
- Chesapeake Urology Research Associates ( Site 0076)
- Beth Israel Deaconess Medical Ctr. ( Site 0093)
- Dana Farber Cancer Institute ( Site 0033)
- UMass Memorial Medical Center ( Site 0053)
- Barbara Ann Karmanos Cancer Institute ( Site 0077)
- Henry Ford Health System ( Site 0039)
- St. Vincent Frontier Cancer Center ( Site 0016)
- Nebraska Cancer Specialists ( Site 0034)
- Comprehensive Cancer Centers of Nevada ( Site 0092)
- University of New Mexico Cancer Center ( Site 0048)
- Memorial Medical Center ( Site 0095)
- Associated Medical Professionals of NY ( Site 0060)
- Duke Cancer Center Cary ( Site 0010)
- Gabrail Cancer Center-Research ( Site 0097)
- The Urology Group- Cincinnati ( Site 0094)
- University Hospitals of Cleveland Seidman Cancer Center ( Site 0036)
- Carolina Urologic Research Center ( Site 0070)
- Huntsman Cancer Institute ( Site 0002)
- Virginia Cancer Institute ( Site 0052)
- Blue Ridge Cancer Care ( Site 0086)
- Seattle Cancer Care Alliance ( Site 0079)
- Froedtert and Medical College of Wisconsin ( Site 0045)
- Centro de Oncologia e Investigacion Buenos Aires COIBA ( Site 1013)
- Centro de Diagnostico Urologico ( Site 1008)
- Hospital Britanico de Buenos Aires ( Site 1006)
- Sanatorio Parque ( Site 1002)
- Instituto de Investigaciones Metabolicas ( Site 1011)
- Hospital Aleman ( Site 1004)
- Instituto Medico Alexander Fleming ( Site 1010)
- CEMAIC ( Site 1014)
- St. Vincent's Hospital ( Site 0158)
- Macquarie University ( Site 0151)
- Port Macquarie Base Hospital ( Site 0153)
- Calvary Mater Newcastle ( Site 0148)
- Southern Medical Day Care Centre ( Site 0160)
- Royal Brisbane and Women s Hospital ( Site 0155)
- John Flynn Hospital & Medical Centre ( Site 0164)
- Box Hill Hospital ( Site 0146)
- Peter MacCallum Cancer Centre ( Site 0152)
- Fiona Stanley Hospital ( Site 0162)
- Ordensklinikum Linz GmbH Elisabethinen ( Site 0373)
- Medizinische Universitat Graz ( Site 0374)
- SCRI-CCCIT GesmbH ( Site 0371)
- Medizinische Universitaet Wien ( Site 0375)
- Hospital de Caridade de Ijui ( Site 1038)
- Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 1021)
- Centro de Novos Tratamentos Itajai - Clinica de Neoplasias Litoral ( Site 1035)
- Hospital de Base de Sao Jose de Rio Preto ( Site 1022)
- IBCC - Instituto Brasileiro de Controle do Câncer ( Site 1040)
- A.C. Camargo Cancer Center ( Site 1026)
- Cross Cancer Institute ( Site 0110)
- BC Cancer-Kelowna - Sindi Ahluwalia Hawkins Centre ( Site 0113)
- BC Cancer-Vancouver Center ( Site 0112)
- Nova Scotia Health Authority QEII-HSC ( Site 0114)
- William Osler Health System (Brampton Civic Hospital) ( Site 0121)
- Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0116)
- Princess Margaret Cancer Centre ( Site 0107)
- CIUSSS du Bas Saint Laurent - Hopital Regional de Rimouski ( Site 0102)
- CIUSSS de l Estrie - CHUS - Centre Hosp. Univ. Sherbrooke ( Site 0105)
- CHUQ-Univ Laval-Hotel Dieu de Quebec ( Site 0103)
- Centro Investigación del Cáncer James Lind ( Site 1041)
- Rey y Oreilly Limitada ( Site 1048)
- Fundacion Arturo Lopez Perez ( Site 1049)
- Pontificia Universidad Catolica de Chile ( Site 1047)
- Bradford Hill Centro de Investigaciones Clinicas ( Site 1044)
- C.H. de Saint Quentin ( Site 0481)
- Clinique Sainte Anne ( Site 0431)
- Centre Jean Perrin ( Site 0434)
- Institut Paoli Calmettes ( Site 0419)
- CHU de Brest -Site Hopital Morvan ( Site 0441)
- CHU Jean Minjoz ( Site 0423)
- Institut Bergonie ( Site 0421)
- Institut Claudius Regaud IUCT Oncopole ( Site 0418)
- Hopital Foch ( Site 0428)
- Institut Regional du Cancer de Montpellier - ICM ( Site 0443)
- Institut De Cancerologie De L Ouest ( Site 0448)
- Centre Hospitalier Regional du Orleans ( Site 0430)
- Centre D Oncologie de Gentilly ( Site 0432)
- Centre Leon Berard ( Site 0422)
- C.H.U. Lyon Sud ( Site 0436)
- CHU Amiens Picardie Site Sud Amiens ( Site 0438)
- Institut Gustave Roussy ( Site 0416)
- Institut Sainte Catherine ( Site 0447)
- Institut Mutualiste Montsouris ( Site 0446)
- Universitaetsklinikum Freiburg - Medizinische Klinik ( Site 0304)
- Universitaetsklinikum in Mannheim ( Site 0314)
- Studienpraxis Urologie ( Site 0309)
- Universitaetsklinik fuer Urologie ( Site 0307)
- Universitaetsklinikum Erlangen ( Site 0303)
- Klinikum Rechts der Isar ( Site 0300)
- Universitaetsklinik der Paracelsus Medizinischen Privatuniversitaet ( Site 0318)
- Universitaetsklinikum Duesseldorf ( Site 0306)
- Krankenhaus der Barmherzigen Brueder Trier ( Site 0310)
- Universitaetsklinikum Jena ( Site 0305)
- Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0301)
- Tallaght University Hospital ( Site 0730)
- Mid Western Cancer Centre ( Site 0728)
- Ha Emek Medical Center ( Site 0548)
- Assaf Harofe ( Site 0547)
- Soroka Medical Center ( Site 0549)
- Rambam Medical Center ( Site 0543)
- Hadassah Ein Kerem Medical Center ( Site 0546)
- Meir Medical Center ( Site 0544)
- Rabin Medical Center ( Site 0545)
- Chaim Sheba Medical Center ( Site 0541)
- Sourasky Medical Center ( Site 0542)
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori ( Site 0462)
- Istituto Clinico Humanitas Research Hospital ( Site 0452)
- Medical Oncology Ospedale San Donato ( Site 0461)
- Policlinico S.Orsola-Malpighi ( Site 0453)
- Azienda Ospedaliera Cannizzaro ( Site 0458)
- Azienda Ospedaliera San Camillo Forlanini ( Site 0455)
- Fondazione Policlinico Universitario A. Gemelli ( Site 0463)
- Azienda Ospedaliera Santa Maria Terni ( Site 0456)
- Presidio Ospedaliero Santa Chiara ( Site 0451)
- Fujita Health University Hospital ( Site 0724)
- National Cancer Center Hospital East ( Site 0702)
- Toho University Sakura Medical Center ( Site 0703)
- National Hospital Organization Shikoku Cancer Center ( Site 0716)
- Kobe City Medical Center General Hospital ( Site 0726)
- Kanazawa University Hospital ( Site 0701)
- Kitasato University Hospital ( Site 0705)
- Yokohama City University Medical Center ( Site 0706)
- Nara Medical University Hospital ( Site 0715)
- Kindai University Hospital ( Site 0714)
- Osaka University Hospital ( Site 0713)
- Saitama Medical University International Medical Center ( Site 0708)
- Dokkyo Medical University Saitama Medical Center ( Site 0707)
- Fuji City General Hospital ( Site 0725)
- Hamamatsu University Hospital ( Site 0720)
- Yamaguchi University Hospital ( Site 0717)
- Chiba Cancer Center ( Site 0704)
- Kyushu University Hospital ( Site 0718)
- University of Miyazaki Hospital ( Site 0721)
- Nagano Municipal Hospital ( Site 0723)
- Nagasaki University Hospital ( Site 0719)
- Osaka International Cancer Institute ( Site 0722)
- Toranomon Hospital ( Site 0711)
- Nippon Medical School Hospital ( Site 0709)
- Keio University Hospital ( Site 0710)
- Chonnam National University Hwasun Hospital ( Site 0174)
- National Cancer Center ( Site 0176)
- Asan Medical Center ( Site 0171)
- Severance Hospital Yonsei University Health System ( Site 0173)
- Samsung Medical Center ( Site 0172)
- Medisch Centrum Leeuwarden ( Site 0477)
- Radboud University Medical Center ( Site 0470)
- Antoni van Leeuwenhoek Ziekenhuis ( Site 0480)
- Vrije Universiteit Medisch Centrum ( Site 0479)
- Spaarne Ziekenhuis ( Site 0473)
- Ziekenhuisgroep Twente ( Site 0469)
- Haaglanden MC - locatie Antoniushove ( Site 0471)
- Erasmus MC ( Site 0475)
- Franciscus Gasthuis en Vlietland ( Site 0489)
- Auckland City Hospital ( Site 0193)
- Chelyabinsk Regional Clinical Oncological Dispensary ( Site 0565)
- Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 0585)
- Russian Scientific Center of Roentgenoradiology ( Site 0559)
- Central Clinical Hospital with Polyclinic ( Site 0562)
- Omsk Clinical Oncology Dispensary ( Site 0568)
- SBHI Samara Regional Clinical Oncology Dispensary ( Site 0576)
- SBHI Leningrad Regional Oncology Dispensary ( Site 0588)
- Clinical Research Center of specialized types medical care-Oncology ( Site 0570)
- Russian Scientific Center of Radiology and Surgical Technologies ( Site 0567)
- Tomsk National Scientific Medical Center of Russian Academy of Science ( Site 0579)
- Instituto Catalan de Oncologia - ICO ( Site 0330)
- Hospital Parc Tauli ( Site 0335)
- Hospital San Pedro de Alcantara ( Site 0326)
- Hospital Josep Trueta ( Site 0321)
- Hospital Quiron Madrid ( Site 0325)
- Hospital del Mar ( Site 0333)
- Hospital General Universitari Vall d Hebron ( Site 0334)
- Hospital Clinic ( Site 0323)
- Hospital Universitario Virgen de la Victoria ( Site 0337)
- National Cheng Kung University Hospital ( Site 0134)
- China Medical University Hospital ( Site 0132)
- Taichung Veterans General Hospital ( Site 0133)
- National Taiwan University Hospital ( Site 0131)
- Taipei Veterans General Hospital ( Site 0135)
- University Hospitals Bristol NHS Foundation Trust ( Site 0530)
- Cambridge University Hospitals NHS Trust ( Site 0540)
- Torbay Hospital ( Site 0532)
- Royal Marsden Hospital ( Site 0526)
- Musgrove Park Hospital ( Site 0537)
- University of North Midlands NHS Foundation Trust ( Site 0527)
- Mount Vernon Cancer Centre ( Site 0536)
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pembrolizumab + Olaparib
Next-generation Hormonal Agent Monotherapy (NHA)
Participants will receive olaparib 600 mg as two 150 mg oral tablets twice daily (BID) continuously until progression PLUS on Day 1 of each 21-day cycle, pembrolizumab 200 mg by intravenous (IV) infusion for up to 35 cycles (approximately 2 years).
Participants will receive a single NHA, which will be either abiraterone acetate (participants previously treated with enzalutamide) 1000 mg as two 500 mg or four 250 mg oral tablets once daily (QD) PLUS prednisone or prednisolone 10 mg as one 5 mg tablet BID until progression OR enzalutamide (participants previously treated with abiraterone acetate) 160 mg as four 40 mg oral tablets or capsules OR two 80 mg tablets QD until progression.