This study is a multicenter phase I/II study of the treatment of patients with metastatic prostate cancer. The objective of Phase I part is to study the safety and tolerability of LAE001 monotherapy in patients with metastatic castration-resistant prostate cancer, and determine the maximum tolerated dose (MTD) as well as the recommended phase II dose (RP2D) of the drug, the Phase II part is to assess the efficacy of LAE001 based on PSA in the treatment of patients with metastatic castration-resistant prostate cancer.
Phase I study of this study is a dose-escalating study with enrollment of patients with metastatic castration-resistant prostate cancer who have never received chemotherapy or who have received chemotherapy (chemotherapy failure or intolerance), and preferential enrollment of patients who had failed chemotherapy. The phase II study is a single arm, multicenter study based on ADT, and only patients with metastatic castration-resistant prostate cancer will be enrolled. According to the results of a completed phase I dose-escalation trial and preclinical data on the drug, the initial dose proposed for this study is 50 mg BID, and one cycle will be 28 days. The escalated doses are 100 mg BID and 125 mg BID, two dose groups. If two or more cases of DLT occur for 100 mg BID, the dose may be reduced to 75 mg BID for investigation. If DLT occurs in two or more out of six patients for a certain dose group, the group with the dose preceding the testing dose will be determined to be the MTD dose group. RP2D will be determined based on a comprehensive analysis of the safety, pharmacokinetic, pharmacodynamic and efficacy data of dose escalation. Where the MTD is determined, MTD is usually taken as the RP2D, or a dose lower than MTD is selected as the RP2D based on the combined data. If it is determined from the safety data that the dose can still be further increased, but the pharmacokinetic data indicate that the plasma concentration of LAE001 has reached steady-state saturation, the lowest dose that reaches steady-state saturation will be taken as the RP2D. According to the above principles, if the overall incidence of DLT at the dose is \< 1/3, this testing dose will be determined as the RP2D. Six patients will be further enrolled and treated at the RP2D dose for sufficient pharmacokinetic data. Phase II study is designed as a signle arm, multicenter trial on top of ADT therapy. Its primary objective is to assess the efficacy and safety of LAE001 in patients with metastatic castration-resistant prostate cancer. About 40 patients will be enrolled and assigned to the LAE001 treatment group on top of basic ADT therapy. Participant will be treated until the occurrence of disease progression (clinical evidence required), intolerance, judgement by the investigator that the patient is unsuitable to continue receiving treatment, death, or withdrawal of informed consent.
LAE001 BID will be orally administered until the subjects develop disease progression, intolerable adverse events, or trial withdrawal decided by the investigator/subject. The LAE001 dose adopted for the phase II study will be based on the RP2D determined in the phase I study.
Fudan Cancer Hospital
Shanghai, Shanghai Municipality, China
ZheJiang Cancer Hospital
Hangzhou, Zhejiang, China
Incidence of DLT (Phase I)
To study the incidence of DLT in the first cycle of administration
Time frame: up to 28 days
Number of Participants With Adverse Events as a Measure of Safety and Tolerability
To describe the incidence and severity of adverse events as assessed by CTCAE Version 5.0
Time frame: through phase I part of study completion, an approximate average of 7 months
12-week PSA response rate
12-week PSA response rate Two consecutive measurements taken three to four weeks apart)
Time frame: 12 weeks after randomization
Overall response rate (ORR)
Overall response rate (ORR) based on RECIST v1.1
Time frame: through study completion, an approximate average of 7 months
Pharmacokinetic: Cmax
Collect plasma concentration of LAE001 at various time points and calculate Peak Plasma Concentration (Cmax)
Time frame: through phase I part of study completion, an approximate average of 7 months
Changes in Testosterone Levels
Observe changes in testosterone levels
Time frame: through phase I part of study completion, an approximate average of 7 months
Radiographic progression-free survival (rPFS) (Phase II)
Time from randomization to radiographic (as defined by Recist 1.1) progression or disease-induced death
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, approximately up to 35 months
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Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
33
PSA progression-free survival (Phase II)
Time from start of treatment to PSA progression
Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, approximately up to 35 months
Overall response rate (ORR) (Phase II)
Overall response rate (ORR) based on RECIST v1.1
Time frame: through phase II part of study completion, approximately up to 35 months
12-month FFS rate (Phase II)
The rate of radiographic, clinical or PSA (as defined by PCWG3) progression or disease-induced death after 12 months treatment
Time frame: 12 months after randomization
Time to symptomatic skeletal event (SSE) (Phase II)
Time to symptomatic skeletal event
Time frame: Time from the date of randomization to the date of documented symptomatic skeletal event,approximately up to 35 months
Number of participants with adverse events as assessed by CTCAE v5.0
To describe the incidence and severity of adverse events as assessed by CTCAE Version 5.0
Time frame: through phase II part of study completion, approximately up to 35 months
Pharmacokinetic: Tmax
Collect plasma concentration of LAE001 at various time points and calculate Time to Peak Plasma Concentration (Tmax)
Time frame: through Phase I part of study completion, an approximate average of 7 months
Pharmacokinetic: T 1/2
Collect plasma concentration of LAE001 at various time points and calculate half life
Time frame: through Phase I part of study completion, an approximate average of 7 months
Pharmacokinetic: AUC0 - ∞
Collect plasma concentration of LAE001 at various time points and calculate Area under the plasma concentration versus time curve (AUC)
Time frame: through Phase I part of study completion, an approximate average of 7 months
Pharmacokinetic: CL
Collect plasma concentration of LAE001 at various time points and calculate plasma clearance (CL)
Time frame: through Phase I part of study completion, an approximate average of 7 months
Pharmacokinetic: Vd
Collect plasma concentration of LAE001 at various time points and calculate volume of distribution
Time frame: through Phase I part of study completion, an approximate average of 7 months
Changes in aldosterone levels
Observe changes in aldosterone levels
Time frame: through phase I part of study completion, an approximate average of 7 months
Changes in cortisol levels
Observe changes in cortisol levels
Time frame: through phase I part of study completion, an approximate average of 7 months
Changes in ACTH levels
Observe changes in ACTH levels
Time frame: through phase I part of study completion, an approximate average of 7 months