A Study of Apalutamide in Chinese Participants With Non Metastatic Castration Resistant Prostate Cancer (NM-CRPC)
Prostatic Neoplasms
About this trial
This is an interventional treatment trial for Prostatic Neoplasms
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)
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
Experimental
Placebo Comparator
Apalutamide 240 milligram (mg) plus ADT
Placebo plus ADT
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.