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Recruiting

Abiraterone, Enzalutamide, or Apalutamide in Castrate-sensitive Prostate Cancer.

NCT05422911 · Sun Pharmaceutical Industries Limited
In plain English

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Official title
A Phase 2 Randomized Study of Abiraterone Acetate, Enzalutamide or Apalutamide as First Line Therapy in Veterans With Castrate-sensitive Prostate Cancer
About this study
The investigators have used national VHA data to demonstrate real-world efficacy of abiraterone and enzalutamide in Veterans with mCRPC. In the real-world that is the VHA, the investigators have successfully estimated g values that accurately predict OS and the use of this metric in other settings should now be explored. In the egalitarian system that is the VHA the treatment of prostate cancer is excellent and uniform across the US. The choices made are clearly personalized, given not all men received all therapies and that younger Veterans were treated more aggressively. But with survivals that rival those in registration trials that enroll optimally fit individuals usually not encumbered by the co-morbidities that afflict many Veterans, the outcomes are testimony to the fact that for this common malady of older Veterans with whom VA physicians have broad experience the care administered is unsurpassed. Importantly this care at least as regards Veterans with mCRPC demonstrates that given equal access to health care, all men with prostate cancer fare comparably well. As our sophistication in categorizing cancers molecularly has increased this study will look to better examine any emerging differences across study participants.
Eligibility criteria
Inclusion Criteria: * Veterans must meet the following to be eligible to participate: * Be willing and able to provide written informed consent for the trial. * Age ≥18 years of age on day of signing informed consent. * Eastern Cooperative Oncology Group (ECOG) performance status of 2 or less (on a scale from 0 to 5, with higher scores indicating greater disability and a score of 5 indicating death). * Histologically or cytologically confirmed adenocarcinoma of the prostate without morphologic evidence of small-cell features in either a recently obtained sample or in the archival sample at the time of diagnosis. * Have previously begun within 120 days of randomization or will receive androgen-deprivation therapy with a gonadotropin releasing hormone agonist or antagonist or have undergone bilateral orchiectomy (i.e., medical, or surgical castration). * Laboratory tests meet minimum safety requirements: * Hepatic: AST ≤2.5 X institutional ULN, ALT ≤2.5 X institutional ULN, Total bilirubin ≤1.5X upper limit of normal (ULN) \[except for subjects with documented Gilbert's disease in which case total bilirubin not to exceed 10X ULN\]. * Renal: Creatinine clearance ≥30 ml/min or serum creatinine ≤1.8 mg/dl * Hematological: Platelet count ≥100,000/mm\^3; Hemoglobin \>9 g/dL; ANC \>1 X10\^9/L * Serum potassium \>3 mEq/L Exclusion Criteria: Subjects with any of the following will not be enrolled: * Prior cytotoxic chemotherapy, aminoglutethimide, ketoconazole, abiraterone acetate, apalutamide or enzalutamide or darolutamide for the treatment of prostate cancer or participation in a clinical trial of an investigational agent that inhibits the androgen receptor or androgen synthesis (unless treatment was placebo). * Treatment with hormonal therapy (e.g., androgen receptor inhibitors other than bicalutamide, estrogens, 5-alpha reductase inhibitors) or biologic therapy for prostate cancer (other than approved bone-targeting agents and GnRH agonist/antagonist therapy) within 4 weeks of randomization. * History of seizure or any condition that may predispose to seizure (e.g., prior cortical stroke or significant brain trauma). * Patients who are receiving any other investigational agents concurrently. * Clinically significant heart disease as evidenced by New York Heart Association (NYHA) Class III-IV heart disease. * Child-Pugh Class B and C
Study design
Enrollment target: 192 participants
Allocation: randomized
Masking: none
Age groups: adult, older_adult
Timeline
Starts: 2022-08-31
Estimated completion: 2027-12-31
Last updated: 2026-06-15
Interventions
Drug: Abiraterone acetateDrug: ApalutamideDrug: Enzalutamide
Primary outcomes
  • Tumor growth rate (g) (2 years)
  • Testosterone levels (2 years)
Sponsor
Sun Pharmaceutical Industries Limited · industry
With: VA Puget Sound Health Care System, VA Greater Los Angeles Healthcare System, James A. Haley Veterans Administration Hospital, VA New York Harbor Healthcare System, VA Ann Arbor Healthcare System, Corporal Michael J. Crescenz VA Medical Center, W.G. Bill Hefner Medical Center, Portland VA Medical Center, Michael E. DeBakey VA Medical Center, VA St. Louis Health Care System, VA Hudson Valley HealthCare System
Contacts & investigators
ContactTito Fojo, MD, PhD · contact · antonio.fojo@va.gov · 718-584-9000
ContactAdrienne A Perea, MPH · contact · adrienne.perea@va.gov · 718-584-9000
All locations (12)
VA Greater Los Angeles Healthcare SystemRecruiting
Los Angeles, California, United States
James A. Haley Veterans Administration HospitalRecruiting
Tampa, Florida, United States
VA Ann Arbor Healthcare SystemRecruiting
Ann Arbor, Michigan, United States
VA St. Louis Health Care SystemRecruiting
St Louis, Missouri, United States
VA New York Harbor Healthcare SystemRecruiting
New York, New York, United States
James J. Peters VA Medical CenterRecruiting
The Bronx, New York, United States
VA Hudson Valley Health Care SystemRecruiting
Wappingers Falls, New York, United States
W.G. Bill Hefner Medical CenterRecruiting
Salisbury, North Carolina, United States
VA Portland Health Care SystemRecruiting
Portland, Oregon, United States
Corporal Michael J. Crescenz VA Medical CenterRecruiting
Philadelphia, Pennsylvania, United States
Michael E. DeBakey VA Medical CenterRecruiting
Houston, Texas, United States
VA Puget Sound Health Care SystemRecruiting
Seattle, Washington, United States