ZEN003694 and Enzalutamide Versus Enzalutamide Monotherapy in Metastatic Castration-Resistant Prostate Cancer
Metastatic Castration-Resistant Prostate Cancer
About this trial
This is an interventional treatment trial for Metastatic Castration-Resistant Prostate Cancer focused on measuring mCRPC, ZEN003694, ZEN-3694, Bromodomain, BETi, Enzalutamide, Xtandi®
Eligibility Criteria
Inclusion Criteria:
- Males age ≥ 18 years
- Metastatic, castration-resistant, histologically confirmed prostate cancer
- Surgical castration or continuous medical castration for ≥ 8 weeks prior to screening; serum testosterone < 50 ng/dL confirmed within 4 weeks of first administration of study drug
- Have progressed on prior abiraterone treatment by PCWG3 criteria
- Patients who are not candidates for chemotherapy in the opinion of the investigator or patients who decline chemotherapy
Cohort A only - Patient must meet definition of poor responder to abiraterone by one of the following:
- Abiraterone started in hormone-sensitive prostate cancer (HSPC) disease setting: < 12 months duration on abiraterone or failure to achieve PSA nadir of 0.2 ng/mL while taking abiraterone
- Abiraterone started in castrate-resistant prostate cancer (CRPC) disease setting: < 6 months duration on abiraterone or failure to achieve a PSA50 response
Cohort B only - Patient must meet definition of responder to abiraterone by one of the following:
- Abiraterone started in hormone-sensitive prostate cancer (HSPC) disease setting: ≥ 12 months duration on abiraterone and nadir PSA < 0.2 ng/mL
- Abiraterone started in castrate-resistant prostate cancer (CRPC) disease setting: ≥ 6 months duration on abiraterone and PSA50 response
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
Exclusion Criteria:
- Any history of brain metastases, prior seizure, conditions predisposing to seizure activity
- Have previously received an investigational BET inhibitor (including previous participation in this study or a study of ZEN003694)
- Receipt of prior second-generation androgen receptor inhibitors (e.g. enzalutamide, apalutamide, darolutamide, proxalutamide). Receipt of first-generation AR antagonists (e.g. bicalutamide, nilutamide, flutamide) does not count towards this limit.
- Have received prior chemotherapy in the metastatic castration-resistant setting (prior chemotherapy in the hormone-sensitive setting is allowed provided last dose was at least 6 months prior to first dose of study drug)
- Have received prior systemic anti-cancer therapy within 2 weeks or five half-lives, whichever is shorter, prior to the first administration of study drug
- Have received exogenous administration of testosterone therapy since discontinuation of abiraterone.
- Failure to recover to Grade 1 or lower toxicity related to prior systemic therapy (excluding alopecia and neuropathy) prior to study entry
- Radiation therapy within 2 weeks of the first administration of study drug
Sites / Locations
- University of California, San FranciscoRecruiting
- Innovative Clinical Research InstituteRecruiting
- Colorado UrologyRecruiting
- BRCR GlobalRecruiting
- Hematology Oncology Clinic
- University of Michigan Rogel Cancer CenterRecruiting
- Weill Cornell Medical College - New York Presbyterian Hospital
- Messino Cancer CenterRecruiting
- Seattle Cancer Care AllianceRecruiting
- Anhui Provincial HospitalRecruiting
- Chongqing Cancer HospitalRecruiting
- The First Affiliated Hospital of Xiamen UniversityRecruiting
- Henan Cancer HospitalRecruiting
- Tongji Hospital of Tongji Medical College, Huazhong University of Science & TechnologyRecruiting
- Hubei Cancer HospitalRecruiting
- Hunan Cancer HospitalRecruiting
- Nanjing Drum Tower HospitalRecruiting
- Liaoning Cancer Hospital
- The First Affiliated Hospital of Xi'an Jiaotang UniversityRecruiting
- Fudan University Shanghai Cancer CenterRecruiting
- Shanghai Tenth People's HospitalRecruiting
- First Hospital of Shanxi Medical UniversityRecruiting
- Sichuan Provincial People's HospitalRecruiting
- Zhejiang Provincial People's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Experimental
Active Comparator
Cohort A - ZEN003694 + Enzalutamide
Cohort A - Enzalutamide
Cohort B - ZEN003694 + Enzalutamide
Cohort B - Enzalutamide
Patients will be administered enzalutamide (160 mg) orally once daily for 21 days prior to the initiation of the combination therapy (Lead-in) to reach steady state concentration (Css) prior to Cycle 1. After the Lead-in, ZEN003694 (72 mg) will be administered orally one daily in combination with daily enzalutamide for 28-day cycles.
Patients will be administered enzalutamide (160 mg) orally once daily for 21 days prior to Cycle 1 Day 1 (Lead-in). After the Lead-in, patients will be administered enzalutamide 160 mg orally once daily for 28-day cycles. Active control patients will have the option to cross-over to treatment with ZEN003694 in combination with enzalutamide upon confirmed radiographic progression by PCWG3 criteria by independent central review.
Patients will be administered enzalutamide (160 mg) orally once daily for 21 days prior to the initiation of the combination therapy (Lead-in) to reach steady state concentration (Css) prior to Cycle 1. After the Lead-in, ZEN003694 (72 mg) will be administered orally one daily in combination with daily enzalutamide for 28-day cycles.
Patients will be administered enzalutamide (160 mg) orally once daily for 21 days prior to Cycle 1 Day 1 (Lead-in). After the Lead-in, patients will be administered enzalutamide 160 mg orally once daily for 28-day cycles. Active control patients will have the option to cross-over to treatment with ZEN003694 in combination with enzalutamide upon confirmed radiographic progression by PCWG3 criteria by independent central review.