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Efficacy and Safety of Darolutamide Combined With ADT in High-risk/Very High-risk Localized Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Darolutamide 300 mg
Androgen deprivation therapy
Sponsored by
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients must be ≥ 18 and ≤75 years of age;
  2. All patients must have a histologically or cytologically diagnosis of prostate cancer,without distant metastasis, and suitable for radical prostatectomy;
  3. All patients meet at least one of the following criteria:

    1. multi-parameter MRI or PSMA PET / CT shows clinical staging of primary tumor ≥ T3;
    2. Gleason score of primary tumor ≥ 8;
    3. prostate specific antigen (PSA) ≥20 ng/ml; d) Radiographic assessment of regional lymph node metastases (N1);
  4. Eastern Cooperative Oncology Group (ECOG) physical condition score 0- 1;
  5. Patients must have adequate organ function: hematologic function:within 28 days prior to registration as evidenced by: white blood cell (WBC) ≥ 4.0 × 109 / L, platelets≥ 100 × 109 / L, hemoglobin ≥ 9 g / dL and international normalized ratio (INR) < 1.5; renal function:within 28 days prior to registration, as evidenced by serum creatinine ≤2×ULN; hepatic function: within 28 days prior to registration, as evidenced by: total bilirubin (TBIL)≤1.5 x upper limit of normal (ULN),and SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN;
  6. Patients must participate voluntarily and sign an informed consent form (ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must be willing to obey the prohibitions and restrictions specified in the research protocol.
  7. Patients of childbearing potential must be willing to take high-efficiency contraceptive measures during the study period and within 120 days after the last dose of treatment.

Exclusion Criteria:

  1. Patients with prostate having neuroendocrine, small cell, or sarcoma-like features are not eligible.
  2. Patients with low-risk and medium-risk, localized prostate cancer (the following conditions are met at the same time) are not eligible: multiparameter MRI or PSMA PET / CT shows clinical staging of primary tumor < T3, Gleason score of primary tumor < 8, and prostate specific antigen (PSA)。
  3. Patients with clinical or radiological evidence of regional or extra-regional lymph node metastases or bone metastases or visceral metastases are not eligible.(any M1)。
  4. Patients who have previously received androgen deprivation therapy (medical or surgical) more than 3 months or focal treatment of prostate cancer or prostate cancer radiotherapy or prostate cancer chemotherapy are not eligible
  5. Patients with severe or uncontrolled concurrent infections are not eligible。
  6. Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration.
  7. Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection.
  8. Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled.
  9. The patient is mentally ill, mentally disabled or incapable of giving informed consent

Sites / Locations

  • Hongqian GuoRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ADT with Darolutamide

Arm Description

Pathological response rate after radical prostatectomy with dalotamide combined with androgen deprivation therapy (ADT) in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer. Duration of treatment: 28-day cycle of darotamide treatment and 6 cycles of neoadjuvant therapy. ADT treatment continued during neoadjuvant therapy and was discontinued after surgery. Adjusted dosing: When the serum testosterone concentration cannot be maintained at <50 ng/dL, the dose and type of ADT can be adjusted. Investigators can adjust the dose of darostatide according to the situation.

Outcomes

Primary Outcome Measures

Pathological Response Rate (pCR or MRD)
Pathological Response Rate is defined as the pCR(Pathologic Complete Response Rate) or MRD (Proportion of Subjects With Minimal Residual Disease) Pathologic Complete Response Rate is defined as the proportion of subjects with no morphologically recognizable cancer cell in tumor specimens after radical prostatectomy. Proportion of Subjects With Minimal Residual Disease is defined as the proportion of subjects that have residual tumors with maximum diameter of 5 mm or less after radical prostatectomy or residual cancer burden <0.25cm3.

Secondary Outcome Measures

AEs/SAEs
The level of AEs defined by NCI-CTCAE v5.0. Safety assessments will be assessed and documented after initiation of study drug, regardless of relationship to study drug. The level of complications defined by Clavien-Dindo classification.
PSA biochemical progression-free survival rate
Defined as the proportion of patients who did not experience biochemical progression or death within 3 years of initiation of darotamide treatment; biochemical progression was defined as an increase in serum PSA level to >0.2 ng/ml with 2 consecutive increases at least 3 months apart
Rate of Positive Surgical Margins
The proportion of subjects with positive surgical margins after radical prostatectomy
Rate of Stage Degradation
The proportion of subjects whose tumor clinical or pathological stage degradation after neoadjuvant therapy.
PSA response rate
The proportion of subjects with a ≥98% reduction in nadir PSA from baseline PSA during neoadjuvant therapy

Full Information

First Posted
February 10, 2022
Last Updated
December 29, 2022
Sponsor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Collaborators
First Affiliated Hospital of Zhejiang University, The First Affiliated Hospital of Soochow University
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1. Study Identification

Unique Protocol Identification Number
NCT05249712
Brief Title
Efficacy and Safety of Darolutamide Combined With ADT in High-risk/Very High-risk Localized Prostate Cancer
Official Title
Medical Ethics Committee of Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2022 (Actual)
Primary Completion Date
January 1, 2023 (Anticipated)
Study Completion Date
December 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Collaborators
First Affiliated Hospital of Zhejiang University, The First Affiliated Hospital of Soochow University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This trial aims to evaluate the efficacy and safety of neoadjuvant therapy with Darolutamide combined with Androgen-Deprivation Therapy in High-risk/Very high-risk localized prostate cancer. This trial is A prospective, single-arm, multicenter clinical trial. Treatment cycle is 24 weeks,
Detailed Description
High risk prostate cancer (PCa) had worse outcomes on radical treatment results, short-time oncological results, even cancer-specific survival, than those low or mediate risk PCa. Neoadjuvant treatment before radical prostatectomy had been proven to get some benefits on peri-operation results, especially on reduction of tumor volume and minimization of biochemical recurrence. This study will evaluate the efficacy and safety of androgen deprivation therapy (ADT) with Darolutamide in neoadjuvant therapy for surgically resectable high-risk or very high-risk PCa.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ADT with Darolutamide
Arm Type
Experimental
Arm Description
Pathological response rate after radical prostatectomy with dalotamide combined with androgen deprivation therapy (ADT) in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer. Duration of treatment: 28-day cycle of darotamide treatment and 6 cycles of neoadjuvant therapy. ADT treatment continued during neoadjuvant therapy and was discontinued after surgery. Adjusted dosing: When the serum testosterone concentration cannot be maintained at <50 ng/dL, the dose and type of ADT can be adjusted. Investigators can adjust the dose of darostatide according to the situation.
Intervention Type
Drug
Intervention Name(s)
Darolutamide 300 mg
Other Intervention Name(s)
Nubeqa, BAY1841788
Intervention Description
600 mg (300 mg × 2 tablets) twice daily with meals, equivalent to a total daily dose of 1200 mg.
Intervention Type
Other
Intervention Name(s)
Androgen deprivation therapy
Other Intervention Name(s)
ADT
Intervention Description
The ADT regimen used by each patient will be determined by the investigator, and the dose and frequency of administration will be consistent with the prescribing information.
Primary Outcome Measure Information:
Title
Pathological Response Rate (pCR or MRD)
Description
Pathological Response Rate is defined as the pCR(Pathologic Complete Response Rate) or MRD (Proportion of Subjects With Minimal Residual Disease) Pathologic Complete Response Rate is defined as the proportion of subjects with no morphologically recognizable cancer cell in tumor specimens after radical prostatectomy. Proportion of Subjects With Minimal Residual Disease is defined as the proportion of subjects that have residual tumors with maximum diameter of 5 mm or less after radical prostatectomy or residual cancer burden <0.25cm3.
Time Frame
up to 8months
Secondary Outcome Measure Information:
Title
AEs/SAEs
Description
The level of AEs defined by NCI-CTCAE v5.0. Safety assessments will be assessed and documented after initiation of study drug, regardless of relationship to study drug. The level of complications defined by Clavien-Dindo classification.
Time Frame
Baseline up to 30 days after the last dose of study drug or before initiation of a new antitumor treatment, whichever occurred first
Title
PSA biochemical progression-free survival rate
Description
Defined as the proportion of patients who did not experience biochemical progression or death within 3 years of initiation of darotamide treatment; biochemical progression was defined as an increase in serum PSA level to >0.2 ng/ml with 2 consecutive increases at least 3 months apart
Time Frame
3 years
Title
Rate of Positive Surgical Margins
Description
The proportion of subjects with positive surgical margins after radical prostatectomy
Time Frame
up to 8 months
Title
Rate of Stage Degradation
Description
The proportion of subjects whose tumor clinical or pathological stage degradation after neoadjuvant therapy.
Time Frame
up to 8 months
Title
PSA response rate
Description
The proportion of subjects with a ≥98% reduction in nadir PSA from baseline PSA during neoadjuvant therapy
Time Frame
up to 2 years
Other Pre-specified Outcome Measures:
Title
Change From Baseline in Quality of Life as assessed by FACT-P
Description
Defined by Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire
Time Frame
up to 2 years
Title
Change From Baseline in Quality of life as assessed by BPI-SF
Description
Defined by worst pain item based on BPI-SF questionnaire.
Time Frame
up to 2 years
Title
Change From Baseline in Quality of life as assessed by EPIC-26
Description
Defined by EPIC-26 questionnaire.
Time Frame
up to 2 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must be ≥ 18 and ≤75 years of age; All patients must have a histologically or cytologically diagnosis of prostate cancer,without distant metastasis, and suitable for radical prostatectomy; All patients meet at least one of the following criteria: multi-parameter MRI or PSMA PET / CT shows clinical staging of primary tumor ≥ T3; Gleason score of primary tumor ≥ 8; prostate specific antigen (PSA) ≥20 ng/ml; d) Radiographic assessment of regional lymph node metastases (N1); Eastern Cooperative Oncology Group (ECOG) physical condition score 0- 1; Patients must have adequate organ function: hematologic function:within 28 days prior to registration as evidenced by: white blood cell (WBC) ≥ 4.0 × 109 / L, platelets≥ 100 × 109 / L, hemoglobin ≥ 9 g / dL and international normalized ratio (INR) < 1.5; renal function:within 28 days prior to registration, as evidenced by serum creatinine ≤2×ULN; hepatic function: within 28 days prior to registration, as evidenced by: total bilirubin (TBIL)≤1.5 x upper limit of normal (ULN),and SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN; Patients must participate voluntarily and sign an informed consent form (ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must be willing to obey the prohibitions and restrictions specified in the research protocol. Patients of childbearing potential must be willing to take high-efficiency contraceptive measures during the study period and within 120 days after the last dose of treatment. Exclusion Criteria: Patients with prostate having neuroendocrine, small cell, or sarcoma-like features are not eligible. Patients with low-risk and medium-risk, localized prostate cancer (the following conditions are met at the same time) are not eligible: multiparameter MRI or PSMA PET / CT shows clinical staging of primary tumor < T3, Gleason score of primary tumor < 8, and prostate specific antigen (PSA)。 Patients with clinical or radiological evidence of regional or extra-regional lymph node metastases or bone metastases or visceral metastases are not eligible.(any M1)。 Patients who have previously received androgen deprivation therapy (medical or surgical) more than 3 months or focal treatment of prostate cancer or prostate cancer radiotherapy or prostate cancer chemotherapy are not eligible Patients with severe or uncontrolled concurrent infections are not eligible。 Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration. Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection. Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled. The patient is mentally ill, mentally disabled or incapable of giving informed consent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hongqian Guo, Phd
Phone
+86-13605171690
Email
dr.ghq@nju.edu.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Shun Zhang, Phd
Phone
+86-15050589789
Email
explorershun@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hongqian Guo, Phd
Organizational Affiliation
Nanjing Drum Tower Hospital, affiliated to medical school of Nanjing University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hongqian Guo
City
Nanning
State/Province
Jiangsu
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongqian Guo, PhD

12. IPD Sharing Statement

Learn more about this trial

Efficacy and Safety of Darolutamide Combined With ADT in High-risk/Very High-risk Localized Prostate Cancer

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