The purpose of this clinical phase 3 randomized trial is to compare two different dosing schedules of Docetaxel in combination with ADT and Darolutamide in subjects with mHSPC. The main question aims to compare grade 3-5 adverse events (AEs) in patients with mHSPC treated with 6 cycles of either Docetaxel 75 mg/m2 every 3 weeks in a 3 week cycle or 6 cycles of Docetaxel 50 mg/m2 every 2 weeks in a 4 week cycle in combination with Darolutamide + ADT. The primary endpoint are Grade 3-5 AEs, followed by neutropenia grade 3/4 + grade 5 AEs to be analysed 28 weeks after last patient first Docetaxel dose (LPFD).
This is a randomized, open, controlled, multicenter phase III clinical trial. Approximately 250 patients with mHSPC who are candidates for docetaxel, darolutamide and ADT will be randomized (1:1 ratio) to one of the following study arms: * Arm 1: 6 x Docetaxel 75 mg/m2 every 3 weeks of a 3 week cycle * Arm 2: 6 x Docetaxel 50 mg/ m2 every 2 weeks of a 4 week cycle Subjects will be stratified at randomization for the extent of disease and for Alkaline Phosphatase levels. All subjects must receive ADT of Investigator's choice (LHRH agonist/antagonists or orchiectomy) and darolutamide as standard therapy. Six cycles of docetaxel are be administered after randomization according to either Arm 1 or Arm 2. After completion of study drug treatment, subjects will continue with the observation period. During the observation period all subjects will continue with Darolutamide+ADT until occurrence of metastatic castration-resistant prostate cancer (mCRPC).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
250
as prescribed by the treating physician.
2x600 mg/d as prescribed by the treating physician
Docetaxel
Ordensklinikum Linz GmbH, Elisabethinen
Linz, Austria, Austria
Krankenhaus der Barmherzigen Brüder
Vienna, Austria, Austria
Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg
Heidelberg, Baden-Wurttemberg, Germany
Klinikum Wetzlar
Wetzlar, Hesse, Germany
Med. Hochschule Hannover
Hanover, Lower Saxony, Germany
Rate of grade 3-5 AEs
Rate of grade 3-5 AEs, followed by rate of neutropenia grade 3/4 + grade 5 AEs t
Time frame: 28 weeks after last patient first Docetaxel dose (LPFD)
PSA-response
PSA-response (PSA \<=0.2, \>0.2-4.0 und \>4.0 ng/ml) determined at week 28 after LPFD
Time frame: 28 after LPFD
Time to castration-resistant prostate cancer
approx. every 90 days, defined as the time to PSA progression with serum testosterone being at castrate level \<0.50 ng/mL, or the time to progression by soft tissue/visceral lesions or time to progression by bone lesions whatever comes first;
Time frame: approximately 42 months
Overall survival
defined as the time (in days) from date of randomization until death from any cause
Time frame: approximately 42 months
Time to initiation of subsequent antineoplastic therapy
approx. every 90 days up to the date of first subsequent antineoplastic therapy for prostate cancer
Time frame: approximately 42 months
Symptomatic skeletal event free survival (SSE)
approx. every 90 days up to the first occurence of SSE, symptomatic skeletal event free survival, defined as the time from randomization to the first occurrence of SSE or death from any cause, whichever comes first. An SSE is defined as EBRT to relieve skeletal symptoms, or new symptomatic pathologic bone fracture, or occurrence of spinal cord compression or tumor-related orthopedic surgical intervention, whichever comes first.
Time frame: approximately 42 months
Time to first symptomatic skeletal event (SSE)
approx. every 90 days up to the first occurence of SSE, defined as the time from randomization to the first occurrence of SSE. An SSE is defined as EBRT to relieve skeletal symptoms, or new symptomatic pathologic bone fracture, or occurrence of spinal cord compression or tumor-related orthopedic surgical intervention, whichever comes first.
Time frame: approximately 42 months
Time to pain progression
approx. every 90 days up to the first date a subject experiences a pain progression. Pain to be assessed with a patient reported questionaire
Time frame: approximately 42 months
Time to worsening of physical symptoms of disease
approx. every 90 days up to the first date a subject experiences an increase in physical symptoms based on the NCCN-FACT-FPSI-17 questionnaire
Time frame: approximately 42 months
Treatment emergent adverse events
all grade AEs until the end-of-study treatment visit (to be analysed 26 weeks after last patient first Docetaxel, all grade AEs until the discontinuation visit, all and Study drug-related SAEs until the end of Survival Follow-up
Time frame: approximately 42 months
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Urologische Klinik München Planegg
Planegg, München, Germany
Urologicum Duisburg
Duisburg, North Rhine-Westphalia, Germany
Brüderkrankenhaus St- Josef Paderborn
Paderborn, North Rhine-Westphalia, Germany
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Würselen, North Rhine-Westphalia, Germany
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Halle, Saxony-Anhalt, Germany
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