This Phase II study aims to evaluate efficacy and safety of the combination of JSB462 (also known as luxdegalutamide) at 100 mg and 300 mg once a day (QD) doses + abiraterone compared with an androgen receptor pathway inhibitor (ARPI, abiraterone or enzalutamide) in participants with metastatic Hormone Sensitive Prostate Cancer (mHSPC) and to select the recommended dose of the combination for phase III. Towards that end, the totality of the efficacy, safety, tolerability and PK data from participants randomized in the study will be evaluated
The study for each participant consists of a Screening period (28 days), a treatment period, a post-treatment safety follow-up (30 days) followed by a long-term follow-up period. During the treatment period: * JSB462 is administered from randomization, orally, daily and continuously (100 mg or 300 mg QD) until disease progression per PCWG3-modified RECIST 1.1 as assessed by the investigator, the occurrence of unacceptable toxicities, death, participant decision or investigator decision. * Abiraterone 1000 mg or enzalutamide 160 mg are administered from randomization, orally, daily, and continuously until disease progression per PCWG3-modified RECIST 1.1 as assessed by the investigator, the occurrence of unacceptable toxicities, death, participant decision or investigator decision. During the post-treatment follow up period: * Safety follow-Up: After discontinuation of study treatment, all participants will be followed for at least 1 safety follow-up visit (30 days \[+/- 7 days\] after treatment discontinuation). Subsequent lines of therapy may be administered according to investigator's discretion after treatment discontinuation. * Long-term follow-up: Starts after the Safety follow-up period and lasts until the end of study. Safety, efficacy and survival information may be collected from participants during this period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
168
JSB462 is administered orally, daily and continuously (100 mg or 300 mg QD) until disease progression per PCWG3-modified RECIST 1.1 as assessed by the investigator, the occurrence of unacceptable toxicities, death, participant decision or investigator decision.
Abiraterone 1000 mg is administered orally, daily and continuously until disease progression per PCWG3-modified RECIST 1.1 as assessed by the investigator, the occurrence of unacceptable toxicities, death, participant decision or investigator decision.
Enzalutamide 160 mg is administered orally, daily and continuously until disease progression per PCWG3-modified RECIST 1.1 as assessed by the investigator, the occurrence of unacceptable toxicities, death, participant decision or investigator decision.
University of California San Diego - Moores Cancer Center
La Jolla, California, United States
Saint Johns Cancer Institute
Santa Monica, California, United States
Rocky Mountain Cancer Centers
Denver, Colorado, United States
Yale Cancer Center
New Haven, Connecticut, United States
Advanced Urology Ins Daytona Beach
Daytona Beach, Florida, United States
Prostate Specific Antigen 90 (PSA90) Rate
Prostate Specific Antigen 90 (PSA90) Rate is defined as the proportion of participants who achieve a ≥90% decrease in PSA from baseline at any timepoint, confirmed by a second PSA measurement ≥3 weeks without any PSA progression in between.
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Incidence rate of adverse events (AEs)
The analysis of adverse events will include categorization by type, frequency, and severity, as graded by the NCI CTCAE version 5.0.
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Number of participants with dose adjustments
The number of participants with dose adjustments (reductions, interruption, or permanent discontinuation) will be summarized by treatment arm.
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Duration of exposure to study treatment
The duration of exposure in weeks to study treatment and for each study treatment component (JSB462, abiraterone and enzalutamide) will be summarized for each study treatment component by means of descriptive statistics using the SAS.
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Radiographic Progression Free Survival (rPFS)
Radiographic Progression Free Survival (rPFS) is defined as the time between randomization and the first occurrence of disease progression (per PCWG3-modified RECIST 1.1 as assessed by the investigator) or death due to any cause
Time frame: From date of randomization until date of radiographic progression or date of death from any cause, whichever comes first, assessed up to approximately 83 months
Overall Survival (OS)
Overall Survival (OS) is defined as the time between randomization and death due to any cause
Time frame: From date of randomization until date of death from any cause, assessed up to approximately 83 months
Incidence rate of adverse events (AEs)
The analysis of adverse events and laboratory abnormalities will include categorization by type, frequency, and severity, as graded by the NCI CTCAE version 5.0.
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 83 months
Overall Response Rate (ORR)
Overall Response Rate (ORR) is defined as the proportion of participants achieving a confirmed complete response (CR) or partial response (PR) per PCWG3-modified RECIST 1.1 as assessed by the investigator
Time frame: From date of randomization until date of progression or date of death from any cause, whichever come first, assessed up to approximately 83 months
Disease Control Rate (DCR)
Disease Control Rate (DCR) is defined as the proportion of participants achieving a CR, PR or stable disease (SD) per PCWG3-modified RECIST 1.1 as assessed by the investigator
Time frame: From date of randomization until date of progression or date of death from any cause, whichever come first, assessed up to approximately 83 months
Duration of Response (DOR)
Duration of Response (DOR) is defined as the time between first documented CR/PR and disease progression or death due to any cause per PCWG3-modified RECIST 1.1 as assessed by the investigator
Time frame: From date of randomization until date of progression or date of death from any cause, whichever come first, assessed up to approximately 83 months
Time to Response (TTR)
Time to response (TTR) is defined as the time from randomization to the date of first documented CR or PR per PCWG3-modified RECIST 1.1 as assessed by the investigator
Time frame: From date of randomization until date of first documented Complete Response (CR) or Partial Response (PR), assessed up to approximately 83 months
Time to soft tissue progression (TTSTP)
Time to soft tissue progression (TTSTP) is defined as the time from randomization to the date of first documented radiographic soft tissue progression per PCWG3-modified RECIST 1.1 as assessed by the investigator
Time frame: From date of randomization until date of soft tissue radiographic progression or date of death from any cause, whichever comes first, assessed up to approximately 83 months
Prostate Specific Antigen 30 (PSA30) Rate
Prostate Specific Antigen 30 (PSA30) Rate is defined as the proportion of participants who achieve a ≥30% decrease from baseline at any timepoint, confirmed by a second PSA measurement ≥3 weeks without any PSA progression in between
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Prostate Specific Antigen 50 (PSA50) Rate
Prostate Specific Antigen 50 (PSA50) Rate is defined as the proportion of participants who achieve a ≥50% decrease from baseline at any timepoint, confirmed by a second PSA measurement ≥3 weeks without any PSA progression in between
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Prostate Specific Antigen 0 (PSA0) Rate
Prostate Specific Antigen 0 (PSA0) Rate is defined as the proportion of participants who achieve a PSA level \<0.2 ng/ml at any timepoint after start of treatment, confirmed by a second PSA measurement ≥3 weeks without any PSA progression in between
Time frame: From date of randomization till 30 days safety fup, assessed up to approximately 75 months
Duration of biochemical response (DBR)
Duration of biochemical response (DBR) is defined as the time between PSA90 and/or PSA0 and PSA progression (increase ≥25% in PSA and an absolute increase of ≥2 ng/mL from NADIR) or death due to any cause
Time frame: From date of date of first PSA50 response until date of PSA progression or death from any cause, assessed up to approximately 83 months
Time to first symptomatic skeletal event (TTSSE)
Time to first symptomatic skeletal event (TTSSE) is defined as the date of randomization to the date of first new symptomatic pathological bone fracture, spinal cord compression, tumor-related orthopedic surgical intervention, requirement for radiation therapy to relieve bone pain or death from any cause, whichever occurs first
Time frame: From date of randomization till EOT or death, whichever happens first, assessed up to approximately 83 months
Plasma concentrations of JSB462 and plasma concentrations of its metabolite ARV-767
JSB462 pharmacokinetic (PK) samples will be obtained and evaluated in all participants at all dose levels in JSB462 treatment arms.
Time frame: Day 1 of Cycles 1 and 2: Pre-dose/0h and Post-dose 4h +/- 1h. Day 1 of Cycles 3 to 8: Pre-dose/0h. End of Treatment Visit (EOT): Anytime. 1 cycle = 28 days.
Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)
The PRO-CTCAE is a patient-reported outcomes measurement system developed by the National Cancer Institute as a companion to the CTCAE. It includes items covering participant-reported symptomatic adverse events (AEs) from the CTCAE. Each symptomatic AE concept has up to three items evaluating frequency, severity, or interference, focused on the study population and treatment regimens. Participants respond on a 5-point scale for each item: * Frequency: Never, Rarely, Occasionally, Frequently, Almost constantly * Severity: None, Mild, Moderate, Severe, Very severe * Interference: Not at all, A little bit, Somewhat, Quite a bit, Very much The past 7-day recall version is used, focusing on relevant symptoms like fatigue, diarrhea, and hot flashes.
Time frame: From randomization up till 30 day safety Follow-up, assessed up to approximately 83 months
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Emory University School of Medicine-Winship Cancer Institute
Atlanta, Georgia, United States
Associated Urological Specialists
Chicago Ridge, Illinois, United States
Mass General Hospital
Boston, Massachusetts, United States
Michigan Institute of Urology
West Bloomfield, Michigan, United States
XCancer Omaha LLC
Omaha, Nebraska, United States
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