This study is being conducted to characterize the safety and recommended phase 2 dose (RP2D) of combining afuresertib, independently with 2 approved drugs: enzalutamide (Xtandi®, "Xtandi is a trademark of Astellas Pharma, Inc." ) and abiraterone (Zygita®, "Zytiga is a trademark of Janssen Biotech, Inc."). The study will be conducted in two parts. Part 1, a dose escalation phase, will establish RP2D of afuresertib when administered with enzalutamide or abiraterone. Part 2, a dose expansion phase, will further evaluate long-term safety of the combinations at the RP2Ds in additional subjects. Dose-finding cohorts will be studied in parallel and will evaluate safety and pharmacokinetic to guide selection of the dose regimens for further evaluation. Part 2 will begin once the RP2Ds have been established in Part 1. Additional doses and/or schedules may be explored if warranted, based upon the pharmacokinetic (PK) and pharmacodynamic (PD) assessments or emerging preclinical evidence. Overall, approximately 60 chemotherapy-naïve subjects with mCRPC and who are receiving either enzalutamide or abiraterone will be enrolled into the study.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
White of off-white round immediate release tablet for oral administration with unit dose strength of 50 mg and 75 mg to achieve the dosage level of 100 mg, 125 mg, 150 mg or 200 mg once daily.
Opaque white to off-white capsule for oral administration with unit dose strength of 40mg to achieve dose level of 160 mg once daily.
White to off-white tablet for oral administration with unit dose strength 250 mg to achieve dose level of 1000 mg once daily.
Continuous twice daily co administration of prednisone 5 mg as per labelled recommendation from United State Prescribing Information.
Number of participants with adverse events (AEs), serious adverse events (SAEs) and dose limiting toxicities as a safety measure.
All AEs and SAEs will be collected and recorded from receipt of first dose of study drug until 30 days after the last dose of study drug, or until the start of subsequent therapy.
Time frame: From first dose of study drug until 30 days after last dose of study drug (assessed up to average of 6 months).
Change from baseline in composite of laboratory parameters as a safety measure: hematology, clinical chemistry and urinalysis.
Changes in the laboratory parameter including hematology, clinical chemistry and urinalysis will be assessed as a measure of safety tolerability and to establish RP2D.
Time frame: From baseline up to end of treatment (assessed up to average of 6 months).
Change from baseline in electrocardiogram values as a safety measure.
Changes in electrocardiograms (ECGs) values will be assessed as a measure of safety, tolerability and to establish RP2D.
Time frame: From baseline up to average of 6 months.
Change from baseline in composite of vital signs as a safety measure: blood pressure, temperature and pulse rate.
Changes in vital sign values of blood pressure, temperature and pulse rate will be assessed as a measure of safety, tolerability and to establish RP2D.
Time frame: From baseline up to end of treatment (assessed up to average of 6 months).
Composite of PK parameters as a measure of RP2D following administration of afuresertib plus enzalutamide or afuresertib plus abiraterone: AUC and Cmax.
PK parameters of area under time concentration curve (AUC) and maximum plasma concentration (Cmax) will be evaluated to determine RP2D of afuresertib.
Time frame: Pre-dose Sample on Day 1 of Cycle 1, 2, 3, 4, and then every 12 weeks and again on Day 1 of Cycle 7 (assessed up to 169 days).
Composite of PK parameters as a measure of RP2D following administration of afuresertib plus abiraterone: AUC and Cmax.
PK parameters of area under time concentration curve (AUC) and maximum plasma concentration (Cmax) will be evaluated.
Time frame: Pre-dose and 2 hours post dose sample will be collected on Day 8 of Cycle 1.
Number of participants with adverse events, serious adverse events and dose limiting toxicities to establish RP2D of afuresertib.
All AEs and SAEs will be collected and recorded from receipt of first dose of study drug until 30 days after the last dose of study drug, or until the start of subsequent therapy.
Time frame: Cycle 1 (28 days).
Change from baseline in composite of laboratory parameters to establish RP2D of afuresertib: hematology, clinical chemistry and urinalysis.
Changes in the laboratory parameter including hematology, clinical chemistry and urinalysis will be assessed as a measure of safety tolerability and to establish RP2D.
Time frame: From baseline up to 28 days (Cycle 1).
Change from baseline in electrocardiogram values to establish RP2D of afuresertib.
Changes in electrocardiograms (ECGs) will be assessed as a measure of safety, tolerability and to establish RP2D.
Time frame: From baseline up to 28 days (Cycle 1).
Change from baseline composite of vital sign values to establish RP2D of afuresertib: blood pressure, temperature and pulse rate.
Changes in vital sign values of blood pressure, temperature and pulse rate will be assessed as a measure of safety, tolerability and to establish RP2D.
Time frame: From baseline up to 28 days (Cycle 1).
Composite of afuresertib PK parameters following administration with enzalutamide: AUC and Cmax.
PK profile of afuresertib will be established following administration with enzalutamide by assessing AUC and Cmax.
Time frame: Blood samples will be collected at pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 24 hours post dose on Day 1of Cycle 1.
Composite of enzalutamide PK parameters following administration alone and in combination with afuresertib: AUC and Cmax.
PK profile of enzalutamide will be establish by assessing AUC and Cmax when administered alone and in combination with afuresertib.
Time frame: Blood samples will be collected at pre-dose, 0.5, 1, 2, 3, 4, 6 and 24 hours post dose on Day-1 and Day 1 in Cycle 2.
Composite of PK parameters following administration afuresertib and abiraterone alone and in combination with each other: AUC and Cmax.
PK profile of afuresertib and abiraterone will be establish by assessing AUC and Cmax when administered alone and in combination with each other.
Time frame: Blood samples will be collected at pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 24 hours post dose on Day 15 of Cycle 1 and Day 1 of Cycle 2 for afuresertib and on Day-1 and Day 1 in Cycle 2 for abiraterone.
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