This is an investigator-initiated phase II single arm trial, combining neoadjuvant apalutamide (ARN509) with radical prostatectomy, in the treatment of D'Amico intermediate to high risk organ-confined prostate cancer. Apalutamide has shown efficacy in castrate resistant prostate cancer in phase II studies and are now in phase III trials combined with radiation in organ confined disease. The primary study objectives include assessment of (i) oncological efficacy as determined by tumour downstaging and achievement of nadir PSA The secondary study objectives include(i) determination of adverse effects related to apalutamide and surgical complication rates (ii) human prostate tissue effect of apalutamide The study will recruit thirty eligible participants who will receive 12 weeks of oral apalutamide 240mg daily. This will be followed by standard-of-care radical prostatectomy. The total trial duration is 26 weeks.
This is a phase II single arm study looking at the efficacy of 12 weeks of neoadjuvant apalutamide (ARN 509), combined with standard-of-care radical prostatectomy, for D'Amico intermediate to high risk prostate cancer patients. The phases of the study will include: screening, treatment and follow-up phases. Safety will be monitored throughout the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Participants will receive oral apalutamide 240mg daily for 12 weeks
Department of Urology
Singapore, Singapore
Proportion of patients with pathological downstaging after neodjuvant apalutamide followed by radical prostatectomy
This is described as residual cancer burden and treatment response group on histopathology after neoadjuvant apalutamide and radical prostatectomy
Time frame: 24 weeks
Proportion of patients with biochemical treatment response following neoadjuvant apalutamide and radical prostatectomy
Patients who attain serum PSA levels below 0.03microg/L
Time frame: 24 weeks
Proportion of patients who report significant adverse effects after 12 weeks of neoadjuvant apalutamide
Adverse effects as defined by CTCAE criteria grade 3 and above
Time frame: 12 weeks
The proportion of patients with peri-operative complications following neoadjuvant apalutamide and radical prostatectomy
The level of complications defined by Clavien-Dindo classification
Time frame: 24 weeks
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