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A Study of Apalutamide in Chinese Participants With Non Metastatic Castration Resistant Prostate Cancer (NM-CRPC)

Primary Purpose

Prostatic Neoplasms

Status
Active
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Apalutamide
Placebo
Androgen-deprivation Therapy (ADT)
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostatic Neoplasms

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation or small cell features, with high risk for development of metastases, defined as prostate-specific antigen doubling time (PSADT) less than or equals to (<=) 10 months. PSADT is calculated using at least 3 prostate-specific antigen (PSA) values obtained during continuous androgen deprivation therapy (ADT)
  • Castration-resistant prostate cancer (PC) demonstrated during continuous ADT, defined as 3 PSA rises at least 1 week apart, with the last PSA greater than (>) 2 nanogram per milliliter (ng/mL)
  • Surgically or medically castrated, with testosterone levels of less than (<) 50 nanogram per deciliter (ng/dL). If the participant is medically castrated, continuous dosing with gonadotropin releasing hormone analog (GnRHa) must have been initiated at least 4 weeks prior to randomization and must be continued throughout the study to maintain castrate levels of testosterone
  • Participants who received a first-generation anti-androgen (example: bicalutamide, flutamide, nilutamide) must have at least a 4-week washout prior to randomization and must show continuing disease progression (an increase in PSA) after washout
  • At least 4 weeks must have elapsed from major surgery or radiation therapy prior to randomization

Exclusion Criteria:

  • Presence of distant metastases, including central nervous system (CNS) and vertebral or meningeal involvement, or history of distant metastases. Exception: Pelvic lymph nodes <2 centimeter in short axis (N1) located below the iliac bifurcation are allowed
  • Symptomatic loco-regional disease requiring medical intervention, such as moderate or severe urinary obstruction or hydronephrosis, due to primary tumor (example, tumor obstruction of bladder trigone)
  • Prior treatment with cytochrome P450 17 alpha-hydroxylase/17,20-lyase (CYP17) inhibitors (example: abiraterone acetate, orteronel, galerterone, ketoconazole, aminoglutethimide) for PC
  • Prior chemotherapy for PC, except if administered in the adjuvant/neoadjuvant setting
  • Prior treatment with second generation anti-androgens (example, enzalutamide)
  • History of seizure or condition that may pre-dispose to seizure (example: prior stroke within 1 year prior to randomization, brain arteriovenous malformation, schwannoma, meningioma, or other benign CNS or meningeal disease which may require treatment with surgery or radiation therapy)

Sites / Locations

  • Cancer Hospital Chinese Academy of Medical Sciences
  • Peking University First Hospital
  • Peking University People's Hospital
  • Beijing Friendship Hospital
  • Peking University Third Hospital
  • Beijing Hospital
  • Hunan Cancer hospital
  • Sichuan Provincial People's Hospital
  • Chongqing University Cancer Hospital
  • Fujian Medical University Union Hospital
  • Sun Yat-Sen Memorial Hospital Sun Yat-sen University
  • Guangzhou First Municipal People's Hospital
  • Zhejiang Cancer Hospital
  • Zhejiang Provincial People's Hospital
  • The First Affiliated Hospital, Zhejiang University College of Medicine
  • Nanjing Drum Tower Hospital
  • The First Affiliated Hospital of Ningbo University
  • Cancer Hospital, FuDan University
  • Shanghai Zhongshan Hospital
  • Huashan Hospital Fudan University
  • Renji Hospital, Shanghai Jiaotong University School of Medicine
  • The Fifth People's Hospital of Shanghai, Fudan University
  • Huadong Hospital Affiliated to Fudan University
  • First Affiliated Hospital, SooChow University
  • TongJi Hospital of TongJi Medical College of Huazhong University of Science & Technology
  • Wuxi People's Hospital
  • The First Affiliated Hospital of Xi'an Jiaotong University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Apalutamide 240 milligram (mg) plus ADT

Placebo plus ADT

Arm Description

Participants will receive apalutamide 240 mg orally daily from Day 1 of Cycle 1 until disease progression, unacceptable toxicity, withdrawal of consent, death or termination of the study along with androgen-deprivation therapy (ADT). Each treatment cycle will consist of 28 days.

Participants will receive matching placebo daily along with ADT from Cycle 1 Day 1 until disease progression, unacceptable toxicity, withdrawal of consent, death or termination of the study. Participants who do not have distant metastasis will switch to treatment with apalutamide after completion of 5 cycles of placebo treatment. Participants who have prostate-specific antigen (PSA) progression prior to completion of 5 cycles of study treatment, will cross over to apalutamide at the time of PSA progression. Each treatment cycle will consist of 28 days.

Outcomes

Primary Outcome Measures

Time to Prostate Specific Antigen (PSA) Progression (TTPP)
TTPP is defined as the time from randomization to the first date of documented PSA progression based on Prostate Cancer Working Group 2 (PCWG2) criteria.

Secondary Outcome Measures

Number of Participants with Adverse Event (AEs) as a Measure of Safety and Tolerability
An AE is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Number of Participants with Clinical Laboratory Abnormalities
Number of participants with clinical laboratory abnormalities will be reported.
Prostate Specific Antigen (PSA) Response Rate
PSA response rate is defined as the percentage of participants who achieved at least a 50 percent (%) decline in PSA value from baseline assessed by a central laboratory according to PCWG2 criteria.
Plasma Concentrations of Apalutamide and its Metabolite (N-desmethyl apalutamide)
Plasma concentrations of apalutamide and its metabolite (N-desmethyl apalutamide) will be assessed after single dose and at steady-state.

Full Information

First Posted
September 26, 2019
Last Updated
October 10, 2023
Sponsor
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04108208
Brief Title
A Study of Apalutamide in Chinese Participants With Non Metastatic Castration Resistant Prostate Cancer (NM-CRPC)
Official Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase IV Study of Apalutamide in Chinese Participants With Non-Metastatic Castration-Resistant Prostate Cancer (NM-CRPC)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 17, 2019 (Actual)
Primary Completion Date
September 5, 2024 (Anticipated)
Study Completion Date
June 5, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC

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
The purpose of this study is to compare the improvement in time to prostate specific antigen (PSA) progression (TTPP, as defined by Prostate Cancer Working Group 2 [PCWG2]) of apalutamide versus placebo in Chinese participants with high-risk non-metastatic castration resistant prostate cancer (NM-CRPC).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostatic Neoplasms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Apalutamide 240 milligram (mg) plus ADT
Arm Type
Experimental
Arm Description
Participants will receive apalutamide 240 mg orally daily from Day 1 of Cycle 1 until disease progression, unacceptable toxicity, withdrawal of consent, death or termination of the study along with androgen-deprivation therapy (ADT). Each treatment cycle will consist of 28 days.
Arm Title
Placebo plus ADT
Arm Type
Placebo Comparator
Arm Description
Participants will receive matching placebo daily along with ADT from Cycle 1 Day 1 until disease progression, unacceptable toxicity, withdrawal of consent, death or termination of the study. Participants who do not have distant metastasis will switch to treatment with apalutamide after completion of 5 cycles of placebo treatment. Participants who have prostate-specific antigen (PSA) progression prior to completion of 5 cycles of study treatment, will cross over to apalutamide at the time of PSA progression. Each treatment cycle will consist of 28 days.
Intervention Type
Drug
Intervention Name(s)
Apalutamide
Other Intervention Name(s)
JNJ-56021927, ARN-509
Intervention Description
Apalutamide 240 mg (4*60 mg tablets) will be administrated orally once daily.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo will be administered orally.
Intervention Type
Drug
Intervention Name(s)
Androgen-deprivation Therapy (ADT)
Intervention Description
Participants will continue to receive ADT with gonadotrophin-releasing hormone agonists (GnRHa) who have not been surgically castrated.
Primary Outcome Measure Information:
Title
Time to Prostate Specific Antigen (PSA) Progression (TTPP)
Description
TTPP is defined as the time from randomization to the first date of documented PSA progression based on Prostate Cancer Working Group 2 (PCWG2) criteria.
Time Frame
Up to 4.9 years
Secondary Outcome Measure Information:
Title
Number of Participants with Adverse Event (AEs) as a Measure of Safety and Tolerability
Description
An AE is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Time Frame
Up to 6.6 years
Title
Number of Participants with Clinical Laboratory Abnormalities
Description
Number of participants with clinical laboratory abnormalities will be reported.
Time Frame
Up to 6.6 years
Title
Prostate Specific Antigen (PSA) Response Rate
Description
PSA response rate is defined as the percentage of participants who achieved at least a 50 percent (%) decline in PSA value from baseline assessed by a central laboratory according to PCWG2 criteria.
Time Frame
Up to 6.6 years
Title
Plasma Concentrations of Apalutamide and its Metabolite (N-desmethyl apalutamide)
Description
Plasma concentrations of apalutamide and its metabolite (N-desmethyl apalutamide) will be assessed after single dose and at steady-state.
Time Frame
Presdose (Day 1 of Cycles 1, 2, 3, 6); 2 hours postdose (Day 1 of Cycles 1 and 3) (each cycle is of 28 days)

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation or small cell features, with high risk for development of metastases, defined as prostate-specific antigen doubling time (PSADT) less than or equals to (<=) 10 months. PSADT is calculated using at least 3 prostate-specific antigen (PSA) values obtained during continuous androgen deprivation therapy (ADT) Castration-resistant prostate cancer (PC) demonstrated during continuous ADT, defined as 3 PSA rises at least 1 week apart, with the last PSA greater than (>) 2 nanogram per milliliter (ng/mL) Surgically or medically castrated, with testosterone levels of less than (<) 50 nanogram per deciliter (ng/dL). If the participant is medically castrated, continuous dosing with gonadotropin releasing hormone analog (GnRHa) must have been initiated at least 4 weeks prior to randomization and must be continued throughout the study to maintain castrate levels of testosterone Participants who received a first-generation anti-androgen (example: bicalutamide, flutamide, nilutamide) must have at least a 4-week washout prior to randomization and must show continuing disease progression (an increase in PSA) after washout At least 4 weeks must have elapsed from major surgery or radiation therapy prior to randomization Exclusion Criteria: Presence of distant metastases, including central nervous system (CNS) and vertebral or meningeal involvement, or history of distant metastases. Exception: Pelvic lymph nodes <2 centimeter in short axis (N1) located below the iliac bifurcation are allowed Symptomatic loco-regional disease requiring medical intervention, such as moderate or severe urinary obstruction or hydronephrosis, due to primary tumor (example, tumor obstruction of bladder trigone) Prior treatment with cytochrome P450 17 alpha-hydroxylase/17,20-lyase (CYP17) inhibitors (example: abiraterone acetate, orteronel, galerterone, ketoconazole, aminoglutethimide) for PC Prior chemotherapy for PC, except if administered in the adjuvant/neoadjuvant setting Prior treatment with second generation anti-androgens (example, enzalutamide) History of seizure or condition that may pre-dispose to seizure (example: prior stroke within 1 year prior to randomization, brain arteriovenous malformation, schwannoma, meningioma, or other benign CNS or meningeal disease which may require treatment with surgery or radiation therapy)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Cancer Hospital Chinese Academy of Medical Sciences
City
Beijing
ZIP/Postal Code
100021
Country
China
Facility Name
Peking University First Hospital
City
Beijing
ZIP/Postal Code
100034
Country
China
Facility Name
Peking University People's Hospital
City
Beijing
ZIP/Postal Code
100044
Country
China
Facility Name
Beijing Friendship Hospital
City
Beijing
ZIP/Postal Code
100050
Country
China
Facility Name
Peking University Third Hospital
City
Beijing
ZIP/Postal Code
100191
Country
China
Facility Name
Beijing Hospital
City
Beijing
ZIP/Postal Code
100730
Country
China
Facility Name
Hunan Cancer hospital
City
Changsha
ZIP/Postal Code
410013
Country
China
Facility Name
Sichuan Provincial People's Hospital
City
Chengdu
ZIP/Postal Code
610072
Country
China
Facility Name
Chongqing University Cancer Hospital
City
Chongqing
ZIP/Postal Code
400030
Country
China
Facility Name
Fujian Medical University Union Hospital
City
Fuzhou
ZIP/Postal Code
350001
Country
China
Facility Name
Sun Yat-Sen Memorial Hospital Sun Yat-sen University
City
Guangzhou
ZIP/Postal Code
510120
Country
China
Facility Name
Guangzhou First Municipal People's Hospital
City
Guangzhou
ZIP/Postal Code
510180
Country
China
Facility Name
Zhejiang Cancer Hospital
City
Hang Zhou
ZIP/Postal Code
310022
Country
China
Facility Name
Zhejiang Provincial People's Hospital
City
Hangzhou
ZIP/Postal Code
310000
Country
China
Facility Name
The First Affiliated Hospital, Zhejiang University College of Medicine
City
Hangzhou
ZIP/Postal Code
310003
Country
China
Facility Name
Nanjing Drum Tower Hospital
City
Nanjing
ZIP/Postal Code
210008
Country
China
Facility Name
The First Affiliated Hospital of Ningbo University
City
Ningbo
ZIP/Postal Code
315010
Country
China
Facility Name
Cancer Hospital, FuDan University
City
Shanghai
ZIP/Postal Code
200032
Country
China
Facility Name
Shanghai Zhongshan Hospital
City
ShangHai
ZIP/Postal Code
200032
Country
China
Facility Name
Huashan Hospital Fudan University
City
Shanghai
ZIP/Postal Code
200040
Country
China
Facility Name
Renji Hospital, Shanghai Jiaotong University School of Medicine
City
Shanghai
ZIP/Postal Code
200240
Country
China
Facility Name
The Fifth People's Hospital of Shanghai, Fudan University
City
Shanghai
ZIP/Postal Code
200240
Country
China
Facility Name
Huadong Hospital Affiliated to Fudan University
City
Shanghai
ZIP/Postal Code
200400
Country
China
Facility Name
First Affiliated Hospital, SooChow University
City
Suzhou
ZIP/Postal Code
215006
Country
China
Facility Name
TongJi Hospital of TongJi Medical College of Huazhong University of Science & Technology
City
Wuhan
ZIP/Postal Code
430030
Country
China
Facility Name
Wuxi People's Hospital
City
Wuxi
ZIP/Postal Code
214023
Country
China
Facility Name
The First Affiliated Hospital of Xi'an Jiaotong University
City
Xi'an
ZIP/Postal Code
710061
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The data sharing policy of the Janssen Pharmaceutical Companies of Johnson & Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu
IPD Sharing URL
https://www.janssen.com/clinical-trials/transparency

Learn more about this trial

A Study of Apalutamide in Chinese Participants With Non Metastatic Castration Resistant Prostate Cancer (NM-CRPC)

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