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A Study of Pamiparib Combined With Abiraterone Acetate in Neoadjuvant Treatment of Prostate Cancer

Primary Purpose

Neoadjuvant Therapy

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
pamiparib
abiraterone
prednisone
Sponsored by
Hongqian Guo
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neoadjuvant Therapy focused on measuring pamiparib, abiraterone acetate, high-risk prostate cancer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Inclusion Criteria:

    1. Men aged ≥18 years and ≤80 years old.
    2. Patients with prostate cancer diagnosed by histology or cytology who are suitable for radical prostatectomy.
    3. All patients meet at least one of the following criteria:

      1. Multiparametric MRI and PSMA PET/CT scan or CT scan showing primary tumor stage ≥ T3;
      2. Primary tumor Gleason score ≥ 8;
      3. Serum PSA concentration ≥ 20 ng/ml;
      4. Imaging assessment has regional lymph node metastasis (N1);
    4. Eastern Cooperative Oncology Group (ECOG) performance status score≤1
    5. Laboratory inspections meet the following requirements:

      Blood routine: white blood cell count (WBC) ≥3.0×109/L, platelet count ≥100×109/L, hemoglobin ≥9g/dl; renal function: serum creatinine ≤2×ULN; liver function: alanine aminotransferase (ALT) and Aspartate aminotransferase (AST)≤2.5×ULN, total bilirubin TBIL≤1.5×ULN; coagulation function: international normalized ratio (INR)<1.5.

    6. The subjects participate voluntarily, and the subjects themselves must sign the Informed Consent Form (ICF), indicating that they understand the purpose and required procedures of this research, and are willing to participate in the research. Subjects must be willing and comply with the prohibitions and restrictions set forth in the study protocol.
    7. During the treatment, the testosterone level in the blood is reduced to the "castration" level, and the testosterone level is less than 50ng/dL;
    8. The subjects can understand and are willing to sign the informed consent

Exclusion Criteria:

  • Exclusion Criteria:

    1. Patients with neuroendocrine, small cell, or sarcomatoid features on prostate histopathology.
    2. Low- and intermediate-risk localized prostate cancer (all the following conditions are met) (PSA<20 ng/mL; Gleason score<8; clinical stage<T3).
    3. Patients with clinical or radiological evidence suggestive of extraregional lymph node metastasis or bone or visceral metastasis (any M1).
    4. Received androgen deprivation therapy (including drug or surgical castration) for more than 3 months or focal prostate cancer treatment or prostate cancer radiotherapy and chemotherapy in the past.
    5. Patients with severe or uncontrolled concurrent infections.
    6. Suffering from New York Heart Association (NYHA) class III/IV congestive heart failure, unstable angina or a history of myocardial infarction within the past 6 months.
    7. Uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection.
    8. In the past 5 years, other malignancies other than prostate cancer, but cured basal or squamous cell skin cancer can be enrolled.
    9. Suffering from mental illness, mental disability or inability to give informed consent.

Sites / Locations

  • Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing UniversityRecruiting
  • Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing UniversityRecruiting
  • The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical SchoolRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

pamiparib

Arm Description

Subjects received pamiparib 40 mg orally, twice a day; abiraterone acetate 1000 mg orally, once a day; prednisone acetate tablets (prednisone) 5 mg, once a day; every 30 days Treatment cycle, treatment for 4-6 cycles, that is, 4-6 months. Robot-assisted laparoscopic radical prostatectomy and extended lymph node dissection within 30 days of the end of 4 months of neoadjuvant therapy. If the subjects have intolerable toxic reactions during the treatment period, the dose adjustment can be carried out. Day 1 of cycle 1, day 15 and day 1±3 days of each cycle thereafter, and 1 follow-up within 30 days after the end of treatment and before surgery; 1 prostate MRI during the screening period and within 30 days after the end of treatment and before surgery Scan, PSMA PET/CT scan or CT scan

Outcomes

Primary Outcome Measures

the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy
To evaluate the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy

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.
the 1-year PSA biochemical recurrence-free survival (bPFS) rate after radical prostatectomy in neoadjuvant therapy of paamiparib combined with abiraterone acetate in high- or very-high-risk prostate cancer
Defined as the proportion of patients who did not experience biochemical progression or death within 3 years of initiation of pamiparib 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
Downstaging rate of radical prostatectomy
Downstaging rate of radical prostatectomy
Pathological response rate of neoadjuvant patients with HRR gene mutation
Pathological response rate of neoadjuvant patients with HRR gene mutation
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 23, 2022
Last Updated
January 3, 2023
Sponsor
Hongqian Guo
Collaborators
First Affiliated Hospital of Zhejiang University, The First Affiliated Hospital of Soochow University, Nanjing First Hospital, Nanjing Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT05376722
Brief Title
A Study of Pamiparib Combined With Abiraterone Acetate in Neoadjuvant Treatment of Prostate Cancer
Official Title
A Prospective Clinical Study of the Safety and Efficacy of Pamiparib Combined With Abiraterone Acetate in Neoadjuvant Treatment of High-risk or Very High-risk Localized Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 22, 2022 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
September 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Hongqian Guo
Collaborators
First Affiliated Hospital of Zhejiang University, The First Affiliated Hospital of Soochow University, Nanjing First Hospital, Nanjing Medical University

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy
Detailed Description
the main purpose: To evaluate the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant treatment of surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy; Note: pathological response rate = pathological complete response rate (pCR) + minimal residual disease (MRD)(defined as residual tumor with the largest crosssection dimension ≤5 mm OR RCB≤0.25CM³) Secondary purpose: To evaluate the safety of pamiparib combined with abiraterone acetate as neoadjuvant therapy for high-risk or very high-risk prostate cancer; To evaluate the rate of PSA biochemical recurrence-free survival (bPFS) at 1 year after radical prostatectomy in neoadjuvant treatment of high-risk or very-high-risk prostate cancer with pamiparib combined with abiraterone acetate; The positive rate of surgical margins in radical prostatectomy; Downstaging rate of radical prostatectomy; Pathological response rate of neoadjuvant patients with HRR gene mutation;

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neoadjuvant Therapy
Keywords
pamiparib, abiraterone acetate, high-risk 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
pamiparib
Arm Type
Experimental
Arm Description
Subjects received pamiparib 40 mg orally, twice a day; abiraterone acetate 1000 mg orally, once a day; prednisone acetate tablets (prednisone) 5 mg, once a day; every 30 days Treatment cycle, treatment for 4-6 cycles, that is, 4-6 months. Robot-assisted laparoscopic radical prostatectomy and extended lymph node dissection within 30 days of the end of 4 months of neoadjuvant therapy. If the subjects have intolerable toxic reactions during the treatment period, the dose adjustment can be carried out. Day 1 of cycle 1, day 15 and day 1±3 days of each cycle thereafter, and 1 follow-up within 30 days after the end of treatment and before surgery; 1 prostate MRI during the screening period and within 30 days after the end of treatment and before surgery Scan, PSMA PET/CT scan or CT scan
Intervention Type
Drug
Intervention Name(s)
pamiparib
Intervention Description
pamiparib 40 mg orally, twice a day
Intervention Type
Drug
Intervention Name(s)
abiraterone
Intervention Description
biraterone acetate 1000 mg orally, once a day
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Description
prednisone acetate tablets (prednisone) 5 mg, once a day
Primary Outcome Measure Information:
Title
the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy
Description
To evaluate the pathological response rate of pamiparib combined with abiraterone acetate in neoadjuvant therapy for surgically resectable high-risk or very high-risk prostate cancer after radical prostatectomy
Time Frame
up to 6months
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
the 1-year PSA biochemical recurrence-free survival (bPFS) rate after radical prostatectomy in neoadjuvant therapy of paamiparib combined with abiraterone acetate in high- or very-high-risk prostate cancer
Description
Defined as the proportion of patients who did not experience biochemical progression or death within 3 years of initiation of pamiparib 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
Downstaging rate of radical prostatectomy
Description
Downstaging rate of radical prostatectomy
Time Frame
four months to 2 years after surgery
Title
Pathological response rate of neoadjuvant patients with HRR gene mutation
Description
Pathological response rate of neoadjuvant patients with HRR gene mutation
Time Frame
four months to 2 years after surgery
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

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inclusion Criteria: Men aged ≥18 years and ≤80 years old. Patients with prostate cancer diagnosed by histology or cytology who are suitable for radical prostatectomy. All patients meet at least one of the following criteria: Multiparametric MRI and PSMA PET/CT scan or CT scan showing primary tumor stage ≥ T3; Primary tumor Gleason score ≥ 8; Serum PSA concentration ≥ 20 ng/ml; Imaging assessment has regional lymph node metastasis (N1); Eastern Cooperative Oncology Group (ECOG) performance status score≤1 Laboratory inspections meet the following requirements: Blood routine: white blood cell count (WBC) ≥3.0×109/L, platelet count ≥100×109/L, hemoglobin ≥9g/dl; renal function: serum creatinine ≤2×ULN; liver function: alanine aminotransferase (ALT) and Aspartate aminotransferase (AST)≤2.5×ULN, total bilirubin TBIL≤1.5×ULN; coagulation function: international normalized ratio (INR)<1.5. The subjects participate voluntarily, and the subjects themselves must sign the Informed Consent Form (ICF), indicating that they understand the purpose and required procedures of this research, and are willing to participate in the research. Subjects must be willing and comply with the prohibitions and restrictions set forth in the study protocol. During the treatment, the testosterone level in the blood is reduced to the "castration" level, and the testosterone level is less than 50ng/dL; The subjects can understand and are willing to sign the informed consent Exclusion Criteria: Exclusion Criteria: Patients with neuroendocrine, small cell, or sarcomatoid features on prostate histopathology. Low- and intermediate-risk localized prostate cancer (all the following conditions are met) (PSA<20 ng/mL; Gleason score<8; clinical stage<T3). Patients with clinical or radiological evidence suggestive of extraregional lymph node metastasis or bone or visceral metastasis (any M1). Received androgen deprivation therapy (including drug or surgical castration) for more than 3 months or focal prostate cancer treatment or prostate cancer radiotherapy and chemotherapy in the past. Patients with severe or uncontrolled concurrent infections. Suffering from New York Heart Association (NYHA) class III/IV congestive heart failure, unstable angina or a history of myocardial infarction within the past 6 months. Uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection. In the past 5 years, other malignancies other than prostate cancer, but cured basal or squamous cell skin cancer can be enrolled. Suffering from mental illness, mental disability or inability to give informed consent.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
hongqian guo, Dr.
Phone
13605171690
Email
dr.ghq@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
shun zhang, Dr.
Phone
15050589789
Email
explorershun@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
shun zhang, Dr.
Organizational Affiliation
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shun Zhang
Phone
15050589789
Ext
15050589789
Email
explorershun@126.com
Facility Name
Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Junlong Zhuang, MD
Phone
8615950451917
Email
zhuangjl-2008@163.com
Facility Name
The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongqian Guo, Phd
Phone
8613605171690
Email
dr.ghq@nju.edu.cn
First Name & Middle Initial & Last Name & Degree
Shun Zhang, MD
Phone
8615050589789
Email
explorershun@126.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of Pamiparib Combined With Abiraterone Acetate in Neoadjuvant Treatment of Prostate Cancer

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