A Study of Niraparib Combination Therapies for the Treatment of Metastatic Castration-Resistant Prostate Cancer (QUEST)
Prostatic Neoplasms, Castration-Resistant
About this trial
This is an interventional treatment trial for Prostatic Neoplasms, Castration-Resistant
Eligibility Criteria
Inclusion Criteria for Combination 3:
- Diagnosed with mCRPC, who in the opinion of the investigator may benefit from treatment in Combination 3 of this study
- Able to continue gonadotropin releasing hormone analogue (GnRHa) therapy during the study if not surgically castrate (that is, subjects who has not undergone bilateral orchiectomy).
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of less than or equal to (<=) 1
- Toxicity associated with prior chemotherapy or radiotherapy has resolved to Grade <= 1 (except alopecia or Grade <= 2 neuropathy) at screening
- Participant must agree not to donate sperm while on study treatment, and for 3 months following the last dose of study treatment
Exclusion Criteria:
- History or current diagnosis of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML)
- Active malignancies (that is, progressing or requiring treatment change in the last 24 months) other than the disease being treated under study. The only allowed exceptions are: non-muscle invasive bladder cancer; skin cancer (non-melanoma or melanoma); breast cancer; malignancy that is considered cured with minimal risk of recurrence
- Active infection requiring systemic therapy
- Allergies, hypersensitivity, or intolerance to niraparib or the corresponding excipients
Combination 3:
- Symptomatic brain metastases
- Prior disease progression during combination treatment with AA and poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitor (PARPi). Prior discontinuation of treatment with AA or PARPi due to AA- or PARPi-related toxicity
Sites / Locations
- Urological Associates of Southern Arizona, P.C.
- The Urology Center of Colorado
- Mayo Clinic - Division Of Hematology/oncology
- First Urology, PSC
- Chesapeake Urology Research Associates
- Michigan Institute of Urology
- New York Oncology Hematology
- Memorial Sloan Kettering Cancer Center
- Memorial Sloan Kettering Cancer Center
- Thomas Jefferson University
- University of Pittsburgh Medical Center (UPMC)
- MUSC-Hollings Cancer Center
- Carolina Urologic Research Center
- Urology Associates
- Houston Metro Urology
- The University of Texas MD Anderson Cancer Center
- Utah Cancer Specialists
- Urology of Virginia, PLCC
- University of Wisconsin Carbone Cancer Center
- OLV Ziekenhuis Aalst
- ZNA Middelheim
- ULB Hôpital Erasme
- Universitair Ziekenhuis Gent
- Az Groeninge
- Centre Hospitalier Universitaire de Liege Domaine Universitaire du Sart Tilman
- Southern Alberta Institute of Urology / Prostate Cancer Centre
- British Columbia Cancer Agency
- University Health Network (UHN) Princess Margaret Cancer Centre
- Centre de Recherche du CHUM
- Asaf Harofe Medical Center
- Soroka Hospital
- Rambam Medical Center
- Rabin Medical Center
- Sheba Medical Center Tel Hashomer
- Azienda Ospedaliera Universitaria Careggi di Firenze
- Azienda Ospedaliera ''Vito Fazzi''
- UOC Oncologia Ospedale Provinciale di Macerata
- ASST Grande Ospedale Metropolitano Niguarda
- IRCCS-Fondazione Pascale
- Hosp. de La Santa Creu I Sant Pau
- Hospital Vall D'Hebron
- Hosp. Univ. de La Princesa
- Hosp. Univ. Fund. Jimenez Diaz
- Hosp. Univ. Hm Sanchinarro
- Hosp. Virgen de La Victoria
- Royal United Hospital
- University College London Hospitals
- Southampton General Hospital
- The Royal Marsden NHS Trust Sutton
- Royal Cornwall Hospitals NHS Trust - Royal Cornwall Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Combination 1:Dose Selection: Niraparib + cetrelimab (Part 1)
Combination 1:Dose Expansion: Niraparib + cetrelimab (Part 2)
Combination 2: Dose Expansion: Niraparib + AA-P (Part 2)
Combination 3: Niraparib + AA-P
Dose regimen 1: The participants will receive niraparib 200 milligram (mg) orally once daily in combination with cetrelimab 240 mg intravenously (IV) once every 2 weeks. Dose regimen 2: The participants will receive niraparib 200 mg orally once daily in combination with cetrelimab 480 mg IV once every 4 weeks in 28-day treatment cycles until disease progression, unacceptable toxicity, death, or the sponsor terminates the study. The safety evaluation team (SET) will determine if an additional cohort is necessary, based on the data from dose regimens 1 and 2. Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
Participants will be assigned to either Cohort 1A (Biomarker [BM] positive [+]) or Cohort 1B (BM negative [-]) and will receive established RP2D of cetrelimab and niraparib, in Part 2 until disease progression, unacceptable toxicity, death, or the sponsor terminates the study. A futility analysis will be performed for the Cohort 1B after 10 BM- participants are enrolled in Part 2. This cohort will be closed if the response is less than predetermined response rate as outlined in the protocol. Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
Participants will be assigned to one of 4 cohorts based on biomarker status - Cohort 2A (BRCA biallelic loss), 2B (other DRD biallelic loss), 2C (BRCA monoallelic loss), or 2D (other DRD monoallelic loss), and will receive niraparib 200 mg once daily in combination with abiraterone acetate 1000 mg (4*250 mg) plus 10 mg prednisone (5 mg twice daily) throughout treatment phase. Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
Participants will be assigned to one of three cohorts to receive AA-P with or without niraparib. Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.