The purpose of this study is to assess the efficacy and safety of the combination of pembrolizumab (MK-3475) and enzalutamide in the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) who have not received chemotherapy for mCRPC, are abiraterone-naïve, or are intolerant to or progressed on abiraterone acetate. There are two primary study hypotheses. Hypothesis 1: The combination of pembrolizumab plus enzalutamide is superior to placebo plus enzalutamide with respect to Overall Survival (OS). Hypothesis 2: The combination of pembrolizumab plus enzalutamide is superior to placebo plus enzalutamide with respect to Radiographic Progression-free Survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by blinded independent central review.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
1,244
IV infusion
Capsules/Tablets
IV infusion
University of South Alabama, Mitchell Cancer Institute ( Site 0065)
Mobile, Alabama, United States
Providence Medical Foundation-Oncology ( Site 0069)
Fullerton, California, United States
UCLA Hematology/Oncology - Santa Monica ( Site 0081)
Los Angeles, California, United States
University of Colorado Cancer Center ( Site 0022)
Aurora, Colorado, United States
Smilow Cancer Hospital at Yale New Haven ( Site 0038)
New Haven, Connecticut, United States
Overall Survival (OS)
OS was defined as the time from randomization to death due to any cause. The OS for all participants is presented.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Radiographic Progression-free Survival (rPFS) Per Prostate Cancer Working Group (PCWG)-Modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
rPFS was defined as the time from randomization to the first documented progressive disease (PD) per PCWG-modified RECIST 1.1 based on blinded independent central review or death due to any cause, whichever occurred first. The rPFS per PCWG-modified RECIST for all participants is presented.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Time to Initiation of the First Subsequent Anti-cancer Therapy or Death (TFST)
TFST was defined as time from randomization to initiation of the first subsequent anti-cancer therapy or death, whichever occurs first. The TFST for all participants is presented.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Prostate-specific Antigen (PSA) Response Rate
PSA response rate was defined as percentage of participants in the analysis population who have a negative change (decrease) in PSA level of ≥50% measured twice ≥3 weeks apart. The analysis was performed on participants who had baseline PSA measurements.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Prostate-specific Antigen (PSA) Undetectable Rate
PSA undetectable rate was defined as percentage of participants in the analysis population with PSA \<0.2 ng/mL during study treatment. The analysis was performed on participants who had baseline PSA measurements.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Objective Response (OR) Per Prostate Cancer Working Group (PCWG)-Modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by as Assessed by Blinded Independent Central Review
OR was defined as the percentage of participants with complete response (CR: disappearance of all target lesions per RECIST 1.1; and no evidence of disease (NED) on bone scan per PCWG) or partial response (PR: at least a 30% decrease in the sum of diameters of target lesions per RECIST 1.1; and non-progressive disease, non-evaluable \[NE\], or NED on bone scan or CR with non-progressive disease or NE bone scan per PCWG).
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Duration of Response (DOR) Per Prostate Cancer Working Group (PCWG)-Modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by as Assessed by Blinded Independent Central Review
DOR was defined as the time from first documented evidence of complete response (CR) or partial response (PR) per PCWG and RECIST 1.1 criteria until progressive disease (PD) or death. PD per RECIST 1.1 was defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PD per PCWG was the appearance of ≥2 new bone lesions on bone scan, that have been confirmed to not represent tumor flare, and were persistent for ≥6 weeks. The DOR was calculated using the product-limit (Kaplan-Meier) method for censored data. If a participant had not progressed, the participant was censored at the date of last disease assessment.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Time to Prostate-specific Antigen (PSA) Progression
Time from randomization to PSA progression. PSA progression date is defined as the date of 1) ≥25% increase and ≥2 ng/mL above the nadir, confirmed by a second value ≥3 weeks later if there is PSA decline from baseline, or 2) ≥25% increase and ≥2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Time to Radiographic Soft Tissue Progression Per Soft Tissue Rules of Prostate Cancer Working Group (PCWG)-Modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by as Assessed by Blinded Independent Central Review
Time from randomization to radiographic soft tissue progression per PCWG-modified RECIST 1.1
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Time to Pain Progression (TTPP) as Assessed by Brief Pain Inventory-Short Form (BPI-SF) Item 3 ("Worst Pain in 24 Hours") and Opiate Analgesic Use (Analgesic Quantification Algorithm [AQA] Score)
Time from randomization to pain progression. In this study, pain progression was assessed by participant responses to Item 3 of the BPI-SF and participant AQA Scores which are both assessed by participants daily for 7 consecutive days.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Time to First Symptomatic Skeletal-related Event (SSRE)
Time from randomization to the first SSRE. SSRE is defined as radiation to prevent or relieve skeletal symptoms, occurrence of new symptomatic pathological fracture, spinal cord compression, or surgery to bone.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Number of Participants Who Experience an Adverse Event (AE)
An AE is defined as any untoward medical occurrence associated with the use of a drug in a participant, whether or not considered drug related. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product and does not imply any judgment about causality. The number of participants who experienced an AE is presented.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)
An AE is defined as any untoward medical occurrence associated with the use of a drug in a participant, whether or not considered drug related. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product and does not imply any judgment about causality. The number of participants who discontinued study treatment due to an AE is presented.
Time frame: Up to 40 months (through database cut-off date of 12-Dec-2022)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Moffitt Cancer Center ( Site 0080)
Tampa, Florida, United States
Georgia Cancer Center at Augusta University ( Site 0026)
Augusta, Georgia, United States
Mount Sinai Hospital ( Site 0042)
Chicago, Illinois, United States
Methodist Hospitals. ( Site 0008)
Merrillville, Indiana, United States
Tulane Cancer Center ( Site 0066)
New Orleans, Louisiana, United States
...and 249 more locations