This is a multicenter, open-label, randomized, two-arm, phase II clinical trial to evaluate the efficacy and safety of talazoparib (PF-06944076) in combination with enzalutamide in patients with metastatic hormone-naïve prostate cancer (mHNPC)
Men age ≥ 18 years with high-volume mHNPC that are not candidates for curative intent and have not received previous systemic treatment with any other agent for unresectable locally advanced or mHNPC. After signing ICF and confirm eligibility, patients will start treatment with enzalutamide in addition to standard ADT. After 2 cycles of enzalutamide-containing regimen, patients will be randomized in a 1:2 ratio to: Cohort A - Enzalutamide 160 mg orally daily continuously; Cohort B - Enzalutamide 160 mg in combination with talazoparib (PF-06944076) 0.5 mg, both orally daily and continuously in 28-day cycles. In either arm, patients will be requested to continue ADT throughout trial participation (unless surgical castration). Randomization will be stratified based on HR gene alterations (presence versus absence/unknown) detected in the baseline biopsy. Patients will receive treatment until disease progression, unacceptable toxicity, death, or discontinuation from the study treatment for any other reason. Patients discontinuing the study treatment period will enter a post-treatment follow-up period during which survival and at least the first two new anti-cancer therapies will be collected every six months (± 14 days) from the last dose of investigational product until the end of study (EoS).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
54
Enzalutamide capsules orally once daily and continuously (160 mg) in 28-day cycles (every four weeks)
Talazoparib capsules orally once daily and continuously (0.5 mg) in 28-day cycles (every four weeks)
Institut Català d'Oncologia Badalona
Badalona, Spain
Hospital Clínic i Provicial de Barcelona
Barcelona, Spain
Hospital del Mar
Barcelona, Spain
Hospital Vall d'Hebrón
Barcelona, Spain
Prostate specific antigen complete response (PSA-CR)
The primary efficacy endpoint for the study is the PSA-CR. The PSA-CR is defined as the percentage of patients with PSA \< 0.2 ng/mL divided by the number of patients in the analysis set.
Time frame: Baseline up to 12 months
Efficacy determined by Prostate specific antigen complete response (PSA-CR)
PSA-CR is defined as the number of patients with PSA \<0.2 ng/mL from randomization to Cycle 7 Day 1 therapy divided by the number of patients in the analysis set.
Time frame: Baseline up to 7 months
Efficacy determined by PSA response
PSA response is defined as the number of patients with PSA \<0.4 ng/mL from randomization to 7- or 12-months therapy divided by the number of patients in the analysis set
Time frame: Baseline up to 7 and 12 months
Efficacy determined by Time to Clinical Progression (TCP)
TCP is defined as the time from randomization to clinical progression, based on progression in bone as per 2+2 rule, progression per RECIST criteria v1.1. or clinical deterioration due to cancer per investigator's opinion.
Time frame: Baseline up to 12 months
Efficacy determined by Prostate-Specific Antigen progression of disease (PSA-PD)
PSA-PD in accordance with PCWG3 criteria, is defined as the time from randomization to PSA progression.
Time frame: Baseline up to 12 months
Efficacy determined by Prostate-Specific Antigen progression-free survival (PSA-PFS)
PSA-PFS in accordance with based on Prostate Cancer Working Group 3 (PCWG3) criteria (PSA ≥ 25% and ≥ 2 ng/mL from nadir confirmed by a second value obtained 3 or more weeks later).
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Hospital Universitario 12 de Octubre
Madrid, Spain
Hospital Universitario Virgen de la Victoria
Málaga, Spain
Instituto Valenciano de Oncología (IVO)
Valencia, Spain
Hospital Universitario Miguel Sevet
Zaragoza, Spain
Time frame: Baseline up to 12 months
Efficacy determined by Radiological progression-free survival (rPFS)
PFS is defined as the time from randomization to radiological progression based on progression in bone as per 2+2 rule or progression per RECIST criteria v1.1.
Time frame: Baseline up to 12 months
Efficacy determined by Time to development of castration resistant (TTCR) prostate cancer
TTCR prostate cancer is defined as the time from randomization to PSA progression in accordance with PCWG3 criteria or clinical progression, whichever occurred first.
Time frame: Baseline up to 12 months
Efficacy determined by Overall survival (OS)
OS is defined as the time from randomizatiom date to date of death due to any cause or the last date the patient was known to be alive.
Time frame: Baseline up to 12 months
Incidence of adverse events (AEs)
Incidence of prespecified AEs as per National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) v.5.0, change from baseline in targeted vital signs, and change from baseline in targeted clinical laboratory test results.
Time frame: Up to 53 months after study start