This study will evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics, and preliminary efficacy of AZD5305 when given in combination with new hormonal agents (NHAs) in patients with Metastatic Prostate Cancer.
The study consists of 2 parts, Part A and Part B. Part A consists of the dose escalation cohorts and will include patients with metastatic castration resistant prostate cancer (mCRPC) or metastatic castration-sensitive prostate cancer (mCSPC); Part B consists of dose expansion cohorts and will include patients with mCSPC only. Part A comprises 4 individual arms each evaluating the safety, tolerability, and preliminary efficacy of AZD5305 in combination with a specific new hormonal agent (NHA). Part B comprises up to 4 individual arms (arms to be opened at Sponsor's discretion) each investigating the preliminary efficacy and aims to further build on the safety data for the combination of AZD5305 with a specific NHA. Approximately 783 patients will be enrolled and screened to ensure the required number of evaluable patients in each part and arm are enrolled. For Part A, 356 patients may be screened to obtain up to approximately 308 patients that can be assigned to study treatments across all study arms (1 to 4). For Part B dose expansion cohorts, up to 427 patients may be screened to obtain up to approximately 360 patients that can be assigned to study treatments across all study arms (1 to 4). Study treatment administration will continue until disease progression, initiation of alternative anticancer therapy, unacceptable toxicity, withdrawal of consent, or other reasons to discontinue study treatment occur.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
174
Patients will receive an oral dose of AZD5305 once daily
Patients will receive an oral dose of Enzalutamide once daily
Patients will receive an oral dose of Abiraterone Acetate once daily
Research Site
Detroit, Michigan, United States
Research Site
Detroit, Michigan, United States
Number of patients with Adverse Events and Serious Adverse Events
Number of patients with adverse events and with serious adverse events including abnormal clinical observations, abnormal ECG parameters, abnormal laboratory assessments and abnormal vital signs that changed from baseline will be assessed.
Time frame: Up to post treatment follow-up (28 days after last dose) [assessed up to 2.3 years]
Part A: Number of patients with Dose Limiting Toxicities (DLTs)
To assess the safety and tolerability of AZD5305 when given in combination with NHA.
Time frame: For Arm 1: 35 days, For Arm 2 and 3: 28 days
Area Under the concentration Curve (AUC) of AZD5305
To characterise the PK (AUC) of AZD5305 at steady state after multiple dosing of AZD5305 monotherapy.
Time frame: At the end of Cycle 0 (Cycle 0 is of 7 days)
Maximum plasma concentration (Cmax) of AZD5305
To characterise the PK (Cmax) of AZD5305 at steady state after multiple dosing of AZD5305 monotherapy.
Time frame: At the end of Cycle 0 (Cycle 0 is of 7 days)
Time to maximum concentration (tmax) of AZD5305
To characterise the PK (tmax) of AZD5305 at steady state after multiple dosing of AZD5305 monotherapy.
Time frame: At the end of Cycle 0 (Cycle 0 is of 7 days)
AUC of AZD5305
To characterise the PK (AUC) of AZD5305 following oral dose administration of AZD5305 in combination with NHA.
Time frame: Arm 1: At Cycle 1 Day 1, Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8, and Cycle 3 Day 1; Arm 2 and 3: At Cycle 1 Day 1, Cycle 1 Day 15 and Cycle 2 Day 1 (Each Cycle is of 28 days)
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Patients will receive an oral dose of Darolutamide twice daily
Patients will receive an oral dose of Apalutamide once daily
Research Site
Syracuse, New York, United States
Research Site
Myrtle Beach, South Carolina, United States
Research Site
Houston, Texas, United States
Research Site
Houston, Texas, United States
Research Site
Camperdown, Australia
Research Site
Darlinghurst, Australia
Research Site
East Melbourne, Australia
Research Site
Heidelberg, Australia
...and 10 more locations
Cmax of AZD5305
To characterise the PK (Cmax) of AZD5305 following oral dose administration of AZD5305 in combination with NHA.
Time frame: Arm 1: At Cycle 1 Day 1, Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8, and Cycle 3 Day 1; Arm 2 and 3: At Cycle 1 Day 1, Cycle 1 Day 15 and Cycle 2 Day 1 (Each Cycle is of 28 days)
tmax of AZD5305
To characterise the PK (tmax) of AZD5305 following oral dose administration of AZD5305 in combination with NHA.
Time frame: Arm 1: At Cycle 1 Day 1, Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8, and Cycle 3 Day 1; Arm 2 and 3: At Cycle 1 Day 1, Cycle 1 Day 15 and Cycle 2 Day 1 (Each Cycle is of 28 days)
Objective response rate (ORR)
To assess the preliminary antitumour activity of AZD5305 in combination with NHA. ORR will be assessed as per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (soft tissue) and Prostate Cancer Clinical Trials Working Group 3 (PCWG3) and is defined as the percentage of patients who have a confirmed visit response of complete response (CR) or partial response (PR) in their soft tissue disease and no disease progression in their bone scan.
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Duration of response (DoR)
To assess the preliminary antitumour activity of AZD5305 in combination with NHA. DoR is defined as the time from the date of first documented response (which is subsequently confirmed) until date of documented progression or death in the absence of progressive disease (PD).
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Time to response (TTR)
To assess the preliminary antitumour activity of AZD5305 in combination with NHA. TTR is defined as the time from first dose until the first documentation of a subsequently confirmed objective response.
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Radiographic progression-free survival (rPFS)
To assess the preliminary antitumour activity of AZD5305 in combination with NHA. rPFS is defined as the time from start of first treatment until progression as per RECIST v1.1 (soft tissue) and PCWG3 criteria (bone) or death from any cause.
Time frame: From Screening (Day -28), 12 months, 24 months and up to confirmed disease progression [assessed up to 2.3 years]
Percentage change in tumour size
To assess the preliminary antitumour activity of AZD5305 in combination with NHA. Percentage change in tumour size will be determined for patients with measurable disease at baseline.
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Number of patients with ≥ 50% prostate-specific antigen (PSA) decrease from baseline
To assess the preliminary antitumour activity of AZD5305 in combination with NHA.
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Number of patients with ≥ 90% prostate-specific antigen (PSA) decrease from baseline
To assess the preliminary antitumour activity of AZD5305 in combination with NHA.
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]
Part B: Number of patients with undetectable PSA (< 0.2 ng/mL)
To assess the preliminary antitumour activity of AZD5305 in combination with NHA.
Time frame: 3, 6, 9 and 12 months
PSA Progression-free survival
To assess the preliminary antitumour activity of AZD5305 in combination with NHA.
Time frame: 6, 12, 18, 24 and 30 months
AUC of Enzalutamide
To characterize the PK (AUC) of Enzalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
Cmax of Enzalutamide
To characterize the PK (Cmax) of Enzalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
tmax of Enzalutamide
To characterize the PK (tmax) of Enzalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
AUC of Apalutamide
To characterize the PK (AUC) of Apalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
Cmax of Apalutamide
To characterize the PK (Cmax) of Apalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
tmax of Apalutamide
To characterize the PK (tmax) of Apalutamide in plasma at steady state when given orally in combination with AZD5305
Time frame: At Cycle 1 Day 22, Cycle 2 Day 1, Cycle 2 Day 2, Cycle 2 Day 8 and Cycle 3 Day 1 (Each Cycle is of 28 days)
Part B: Homologous recombination repair gene mutation (HRRRm)
To investigate HRRm (including BRCA1/2) and their relationship with clinical response
Time frame: From Screening (Day -28) to confirmed disease progression [assessed up to 2.3 years]