This study is comparing the effectiveness of enzalutamide with or without abiraterone acetate for men with high-risk, localized prostate cancer.
In this research study, the investigators are comparing the effectiveness of enzalutamide with or without abiraterone acetate for men with high-risk, localized prostate cancer. Abiraterone acetate with prednisone and enzalutamide are currently FDA-approved for use in the treatment of patients with metastatic castration-resistant prostate cancer, however they are investigational for the treatment of localized prostate cancer. Abiraterone acetate works by decreasing the production of male sex hormones, which cause prostate cancer growth. Enzalutamide works by blocking the effects of male sex hormones, which cause prostate cancer growth. The FDA (the U.S. Food and Drug Administration) has not approved the combination of enzalutamide and abiraterone acetate as neoadjuvant therapy for high risk prostate cancer undergoing prostatectomy but each drug has been approved for the treatment of more advanced prostate cancer. Participants will be randomized to one of two study arms. Randomization means that the participant is put into a group by chance. It is like flipping a coin. Neither participant nor the research doctor will choose what group participants are randomized to. The names of the study medications involved in this study are: * Enzalutamide * Abiraterone Acetate * Prednisone * Leuprolide Acetate
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
75
160 mg (four 40 mg capsules), oral, once daily, 28 days (4 weeks) 6 cycles maximum. Can be taken with or without food.
1000 mg (four 250 mg tablets), oral, once daily, 28 days (4 weeks) 6 cycles maximum. No food should be consumed for at least two hours before the dose and for at least one hour after the dose.
5 mg, oral, once daily, 28 days (4 weeks) 6 cycles maximum.Take with food, preferred to be taken in the morning .
Johns Hopkins University
Baltimore, Maryland, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
University of Washington
Seattle, Washington, United States
Percentage of Participants With Pathologic Complete Response (pCR) or Minimal Residual Disease (MRD)
pCR is defined as the absence of morphologically identifiable carcinoma in the radical prostatectomy (RP) specimen. MRD is defined as the largest cross-sectional dimension of residual tumor measuring \</= 0.5 cm. If the tumor is multifocal, the size of the largest focus will be used to determine the size of the residual tumor.
Time frame: after RP approximately 24 weeks from study entry
Participants With Pathologic Complete Response (pCR)
pCR is defined as the absence of morphologically identifiable carcinoma in the radical prostatectomy (RP) specimen.
Time frame: after RP approximately 24 weeks from study entry
Residual Cancer Burden (RCB)
RCB was analyzed using radical prostatectomy (RP) tissue. The largest area of tumor was measured by ruler and the longest tumor dimension in this area was used as the dimension for calculation.
Time frame: after RP approximately 24 weeks from study entry
Positive Surgical Margin Status
Participants were classified by presence or absence of positive surgical margins defined as margins, which are the edges of the removed tumor, that show some cancer cells.
Time frame: after RP approximately 24 weeks from study entry
Median Prostate Specific Antigen (PSA) Nadir
PSA nadir is the lowest PSA level recorded during neoadjuvant therapy.
Time frame: PSA was assessed at baseline and every cycle during neoadjuvant therapy (up to 24 weeks).
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Either 7.5 mg monthly or 22.5 mg every three months, Intramuscular, monthly or every three months.