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A Phase II Neoadjuvant Study of Darolutamide Plus ADT in Men With Localized Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Darolutamide+ADT
Sponsored by
Peking University First Hospital
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: Male ≥18 years of age. Able to Sign informed consent form independently. Non-metastatic adenocarcinoma of the prostate. Subjects must have as least one of the following features according to NCCN definition of high-risk: Gleason score ≥8, or PSA >20ng/ml,or≥clinical T3a. Subjects with pelvic lymph node involvement(N1) can be included. Candidate for radical prostatectomy with or without pelvic lymph node dissection as per the investigator. Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1. Subjects must have normal organ and marrow function as defined below: Hemoglobin ≥ 9.0 g/dL;Absolute neutrophil count (ANC) ≥ 1,500/mcL; Platelets ≥ 100,000/mcL, independent of transfusions/growth factors within 3 months of treatment start; Serum potassium ≥ 3.5 mmol/L; Serum total bilirubin ≤ 2.0 x upper limit of normal (ULN) (except in subjects with Gilbert's syndrome who have a total bilirubin > 1.5 x ULN, measure direct and indirect bilirubin and if direct bilirubin is ≤ 1.5 x ULN, subject may be eligible);Aspartate aminotransferase (AST), alanine aminotransferase (ALT) ≤ 2.5 x ULN;Serum albumin ≥ 3.0 g/dL;Serum creatinine < 2.0 x ULN. Exclusion Criteria: Prostate cancer with neuroendocrine differentiation or small cell features Distant metastasis based on conventional imaging (clinical stage M1). Nodal disease below the iliac bifurcation (clinical stage N1) is not an exclusion. History of prior systemic or local therapy for prostate cancer, including pelvic radiation for prostate cancer. Subjects who are planning bilateral orchidectomy during the treatment period of the study. Intolerable with darolutamide or ADT treatment. Candidates of other clinical trials. Any prior malignancy within 5 years. Complications include significant cardiovascular disease, active infection, astrointestinal disorders, or any other complications that in the opinion of the investigator. Any condition that in the opinion of the investigator would preclude participation in this study.

Sites / Locations

  • Peking University First Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Darolutamide + ADT

Arm Description

Duration of treatment: 28-day cycle of darolutamide treatment and 6 cycles of neoadjuvant therapy.

Outcomes

Primary Outcome Measures

Rate of pathological downstaging
Percentage of patients with tumor downstaging

Secondary Outcome Measures

pCR or MRD
Pathologic complete response or Minimal Residual Disease(defined as overall diameter <5 mm)
PSM
Percentage of patients with positive surgical margins
Rate of peri-operative complications
including delay in surgery, intra-operative complications, and postoperative complications
Biochemical complete response
PSA <0.1ng/ml prior to RP
PSA undetectable rate
PSA<0.02 ng/ml
2-year biochemical progression-free survival, bPFS
PSA>0.2 ng/ml
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.

Full Information

First Posted
September 1, 2023
Last Updated
September 1, 2023
Sponsor
Peking University First Hospital
Collaborators
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Xijing Hospital of Air Force Military Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT06029036
Brief Title
A Phase II Neoadjuvant Study of Darolutamide Plus ADT in Men With Localized Prostate Cancer
Official Title
A Phase II, Multi-center, Single-arm, Prospective Study of Darolutamide + ADT Prior to Radical Prostatectomy (RP) in High-risk/Very High-risk Localized Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 1, 2023 (Anticipated)
Primary Completion Date
July 31, 2025 (Anticipated)
Study Completion Date
July 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peking University First Hospital
Collaborators
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Xijing Hospital of Air Force Military Medical University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Scientific Rationale: High risk localized prostate cancer (PCa) is associated with higher rates of biochemical recurrence, clinical recurrence, metastasis and PCa-specific death. Novel hormone therapies(NHT) have shown a significant survival advantage with respect to classical ADT in later stages of PCa and have already been investigated in neoadjuvant setting. PURPOSE: To assess antitumor effect by measuring pathological tumor volume with pathological downstaging following radical prostatectomy + pelvic lymph-node dissection (RP + PLND) for high-risk localized prostate cancer patients.

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
53 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Darolutamide + ADT
Arm Type
Experimental
Arm Description
Duration of treatment: 28-day cycle of darolutamide treatment and 6 cycles of neoadjuvant therapy.
Intervention Type
Drug
Intervention Name(s)
Darolutamide+ADT
Intervention Description
Drug: Darolutamide Darolutamide 600 mg, (two 300 mg tablets) administered orally twice daily. Swallow tablets whole. Take Darolutamide with food. Drug: ADT GnRH agonist per physicians' choice, orchiectomy is excluded
Primary Outcome Measure Information:
Title
Rate of pathological downstaging
Description
Percentage of patients with tumor downstaging
Time Frame
6 months
Secondary Outcome Measure Information:
Title
pCR or MRD
Description
Pathologic complete response or Minimal Residual Disease(defined as overall diameter <5 mm)
Time Frame
6 months
Title
PSM
Description
Percentage of patients with positive surgical margins
Time Frame
6 months
Title
Rate of peri-operative complications
Description
including delay in surgery, intra-operative complications, and postoperative complications
Time Frame
within 30 days of surgery
Title
Biochemical complete response
Description
PSA <0.1ng/ml prior to RP
Time Frame
6 months
Title
PSA undetectable rate
Description
PSA<0.02 ng/ml
Time Frame
12 months post-RP
Title
2-year biochemical progression-free survival, bPFS
Description
PSA>0.2 ng/ml
Time Frame
24 months post-RP
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.
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

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: Male ≥18 years of age. Able to Sign informed consent form independently. Non-metastatic adenocarcinoma of the prostate. Subjects must have as least one of the following features according to NCCN definition of high-risk: Gleason score ≥8, or PSA >20ng/ml,or≥clinical T3a. Subjects with pelvic lymph node involvement(N1) can be included. Candidate for radical prostatectomy with or without pelvic lymph node dissection as per the investigator. Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1. Subjects must have normal organ and marrow function as defined below: Hemoglobin ≥ 9.0 g/dL;Absolute neutrophil count (ANC) ≥ 1,500/mcL; Platelets ≥ 100,000/mcL, independent of transfusions/growth factors within 3 months of treatment start; Serum potassium ≥ 3.5 mmol/L; Serum total bilirubin ≤ 2.0 x upper limit of normal (ULN) (except in subjects with Gilbert's syndrome who have a total bilirubin > 1.5 x ULN, measure direct and indirect bilirubin and if direct bilirubin is ≤ 1.5 x ULN, subject may be eligible);Aspartate aminotransferase (AST), alanine aminotransferase (ALT) ≤ 2.5 x ULN;Serum albumin ≥ 3.0 g/dL;Serum creatinine < 2.0 x ULN. Exclusion Criteria: Prostate cancer with neuroendocrine differentiation or small cell features Distant metastasis based on conventional imaging (clinical stage M1). Nodal disease below the iliac bifurcation (clinical stage N1) is not an exclusion. History of prior systemic or local therapy for prostate cancer, including pelvic radiation for prostate cancer. Subjects who are planning bilateral orchidectomy during the treatment period of the study. Intolerable with darolutamide or ADT treatment. Candidates of other clinical trials. Any prior malignancy within 5 years. Complications include significant cardiovascular disease, active infection, astrointestinal disorders, or any other complications that in the opinion of the investigator. Any condition that in the opinion of the investigator would preclude participation in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhisong He, MD
Phone
+8610-83572418
Email
wyj7074@sohu.com
First Name & Middle Initial & Last Name or Official Title & Degree
Kaiwei Yang, MD
Phone
13811501435
Email
13811501435@163.com
Facility Information:
Facility Name
Peking University First Hospital
City
Beijing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhisong He, MD
Phone
+8610-83572418
Email
wyj7074@sohu.com
First Name & Middle Initial & Last Name & Degree
Kaiwei Yang, MD
Phone
13811501435
Email
13811501435@163.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase II Neoadjuvant Study of Darolutamide Plus ADT in Men With Localized Prostate Cancer

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