Trial Outcomes & Findings for Apalutamide in Treating Patients With Prostate Cancer Who Are in Active Surveillance (NCT NCT02721979)

NCT ID: NCT02721979

Last Updated: 2023-02-09

Results Overview

Negative rate will be presented as the percent of subjects with a negative repeat biopsy, and will be calculated as: (number of patients with a negative biopsy following 90-days of apalutamide) / (total number of patients enrolled on the study) x 100. A 1-sample chi-square test will be used to compare the proportion with a negative repeat biopsy to the null hypothesis value of 20% (above). The 95% confidence interval will be computed.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

24 participants

Primary outcome timeframe

At 90 days

Results posted on

2023-02-09

Participant Flow

The screening study procedures are conducted within 30 days prior to enrollment. The only exception to this would be the surveillance prostate biopsy.

24 subjects signed consent for this study, but only 23 were eligible to enter into the treatment phase.

Participant milestones

Participant milestones
Measure
Apalutamide
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Overall Study
STARTED
23
Overall Study
COMPLETED
22
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Only patients that did not screen fail are included in this analysis.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Apalutamide)
n=24 Participants
Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Age, Categorical
<=18 years
0 Participants
n=24 Participants
Age, Categorical
Between 18 and 65 years
10 Participants
n=24 Participants
Age, Categorical
>=65 years
14 Participants
n=24 Participants
Sex: Female, Male
Female
0 Participants
n=24 Participants
Sex: Female, Male
Male
24 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
24 Participants
n=24 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=24 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=24 Participants
Race (NIH/OMB)
Asian
0 Participants
n=24 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=24 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=24 Participants
Race (NIH/OMB)
White
23 Participants
n=24 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=24 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=24 Participants
Region of Enrollment
United States
24 Participants
n=24 Participants
Patients with very low risk disease at baseline
9 Participants
n=23 Participants • Only patients that did not screen fail are included in this analysis.

PRIMARY outcome

Timeframe: At 90 days

Population: These are patients that had 90 days of treatment and had post-treatment biopsies.

Negative rate will be presented as the percent of subjects with a negative repeat biopsy, and will be calculated as: (number of patients with a negative biopsy following 90-days of apalutamide) / (total number of patients enrolled on the study) x 100. A 1-sample chi-square test will be used to compare the proportion with a negative repeat biopsy to the null hypothesis value of 20% (above). The 95% confidence interval will be computed.

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Negative (i.e. no Residual Carcinoma) Site Directed and Systematic Prostate Biopsy Rate
59 percentage of subjects
Interval 37.0 to 78.0

SECONDARY outcome

Timeframe: At 2 years

The percentage of patients who exited active surveillance due to pathologic reclassification (e.g. increasing tumor volume or gleason score) will be computed along with its 95% confidence interval.

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Percentage of Patients Exiting Active Surveillance Due to Pathologic Reclassification
18.2 Percentage of participants
Interval 6.6 to 41.2

SECONDARY outcome

Timeframe: At 2 years

Percentage of patients exiting active surveillance for any reason will be computed along with its 95% confidence interval.

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Percentage of Patients Exiting Active Surveillance for Any Reason
22.7 Percentage of participants
Interval 9.3 to 45.9

SECONDARY outcome

Timeframe: At 2 years

Computed along with its 95% confidence interval.

Outcome measures

Outcome measures
Measure
Apalutamide
n=19 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Percent of Men Undergoing Local Treatment
5 Participants

SECONDARY outcome

Timeframe: Up to 730 days

Median treatment free survival will be estimated using Kaplan-Meier methods and 95% confidence interval will be calculated

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Local Treatment Free Survival
874 days
Interval 805.0 to 9999.0

SECONDARY outcome

Timeframe: At 2 years

Prostate-specific antigen progression rate is the proportion of patients that had PSA progression following treatment. PSA progression is as a confirmed rising prostate-specific antigen \>= 2 ng/mL, with subsequent PSA values obtained at least one week apart.

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Prostate-specific Antigen Progression Rate
100 Percentage of participants

SECONDARY outcome

Timeframe: At 2 years

Prostate-specific antigen progression free survival will be estimated using Kaplan-Meier methods and 95% confidence interval will be estimated using Greenwood's formula.

Outcome measures

Outcome measures
Measure
Apalutamide
n=22 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Prostate-specific Antigen Progression Free Survival as Defined by the Prostate Cancer Working Group 2 Criteria
365 days
Interval 204.0 to 401.0

SECONDARY outcome

Timeframe: Baseline to up to 90 days

Population: Only 1 patient had paired MRI at baseline and again at post-treatment.

This calculates the percentage of participants with radiographic disappearance of magnetic resonance imaging detectable prostate cancer. This is only in patients with a baseline nodule that is Prostate Imaging Reporting and Data System 3 or more and \> 5 mm.

Outcome measures

Outcome measures
Measure
Apalutamide
n=1 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Change in Radiographic Disappearance of Magnetic Resonance Imaging Detectable Prostate Cancer
0 percentage of participants

SECONDARY outcome

Timeframe: Baseline compared to 730 days

Population: Only 14 subjects completed Day 730 survey.

As assessed using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) surveys. Functional Assessment of Cancer Therapy-Prostate is a validated quality of life survey specific for patients with prostate cancer. The total FACT-P score ranges from 0 to 156, with higher scores indicating better quality of life. The change in FACT-P score between baseline and day 730 is reported.

Outcome measures

Outcome measures
Measure
Apalutamide
n=14 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Change in Quality of Life: FACT-P Assessment
3.17 Change in median FACT-P score
Interval -3.0 to 9.0

SECONDARY outcome

Timeframe: Baseline compared to 730 days

Population: Only 14 subjects completed Day 730 survey.

As assessed using the Short Form-36 (SF-36) survey physical functioning subscale. Short Form-36 is a validated quality of life survey. This is a generic survey to assess an individual's overall well-being, and is not specific to one disease. The SF-36 physical functioning subscale score ranges from 0 to 100, with higher scores indicating better quality of life. The change in SF-36 energy/fatigue subscale score between baseline and day 730 is reported.

Outcome measures

Outcome measures
Measure
Apalutamide
n=14 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Change in Quality of Life: SF-36 Physical Functioning
-17.65 Change in median SF-36 subscale score
Interval 0.5 to 50.0

SECONDARY outcome

Timeframe: Baseline compared to 730 days

Population: Only 14 subjects completed Day 730 survey.

As assessed using the Short Form-36 (SF-36) survey energy/fatigue subscale. Short Form-36 is a validated quality of life survey. This is a generic survey to assess an individual's overall well-being, and is not specific to one disease. The SF-36 energy/fatigue subscale score ranges from 0 to 100, with higher scores indicating better quality of life. The change in SF-36 energy/fatigue subscale score between baseline and day 730 is reported.

Outcome measures

Outcome measures
Measure
Apalutamide
n=14 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Change in Quality of Life: SF-36 Energy/Fatigue
12.5 Change in median SF-36 subscale score
Interval -5.0 to 20.0

SECONDARY outcome

Timeframe: Baseline compared to 730 days

Population: Only 14 subjects completed Day 730 survey.

As assessed using the Short Form-36 (SF-36) survey emotional well being subscale. Short Form-36 is a validated quality of life survey. This is a generic survey to assess an individual's overall well-being, and is not specific to one disease. The SF-36 emotional well being subscale score ranges from 0 to 100, with higher scores indicating better quality of life. The change in SF-36 emotional well being subscale score between baseline and day 730 is reported.

Outcome measures

Outcome measures
Measure
Apalutamide
n=14 Participants
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Change in Quality of Life: SF-36 Emotional Well Being
6 Change in median SF-36 subscale score
Interval -4.0 to 24.0

Adverse Events

Apalutamide

Serious events: 0 serious events
Other events: 23 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Apalutamide
n=23 participants at risk
Day 1 until Day 90. Patients receive apalutamide PO QD for 90 days in the absence of disease progression or unacceptable toxicity. Apalutamide: Given PO Laboratory Biomarker Analysis: Correlative studies Quality-of-Life Assessment: Ancillary studies Questionnaire Administration: Ancillary studies
Gastrointestinal disorders
Nausea
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Vascular disorders
Hot Flashes
21.7%
5/23 • Number of events 5 • Through study completion, which corresponded to a median time of 753 days.
Endocrine disorders
Hypothyroidism
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Nervous system disorders
Dysgeusia
30.4%
7/23 • Number of events 7 • Through study completion, which corresponded to a median time of 753 days.
General disorders
Fatigue/Decreased Energy
78.3%
18/23 • Number of events 18 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Insomnia
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Libido Decreased
21.7%
5/23 • Number of events 5 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Labile Mood
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Cognitive Disturbance
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Erythema
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Rectal Hemorrhage
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Gynecomastia
26.1%
6/23 • Number of events 6 • Through study completion, which corresponded to a median time of 753 days.
Musculoskeletal and connective tissue disorders
Arthralgia
26.1%
6/23 • Number of events 6 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Nipple Sensitivity/Tenderness
47.8%
11/23 • Number of events 11 • Through study completion, which corresponded to a median time of 753 days.
General disorders
Flu Like Symptoms
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Metabolism and nutrition disorders
Weight Loss/Anorexia
21.7%
5/23 • Number of events 7 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Mastodynia
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Pruritis
13.0%
3/23 • Number of events 3 • Through study completion, which corresponded to a median time of 753 days.
Infections and infestations
Rhinorrhea
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Investigations
Increased/Elevated TSH
17.4%
4/23 • Number of events 4 • Through study completion, which corresponded to a median time of 753 days.
Investigations
Alanine Aminotransferase Increased
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Investigations
Aspartate Aminotransferase Increased
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Injury, poisoning and procedural complications
Fall
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Memory Impairment/Forgetfulness/Amnesia
13.0%
3/23 • Number of events 3 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Erectile Dysfunction
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Rash
30.4%
7/23 • Number of events 7 • Through study completion, which corresponded to a median time of 753 days.
Infections and infestations
Shingles
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Respiratory, thoracic and mediastinal disorders
Cough
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Constipation
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Musculoskeletal and connective tissue disorders
Edema
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Increased Bowel Movement Frequency
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Renal and urinary disorders
Lower Urinary Tract Symptoms
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Immune system disorders
Sinusitis
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Nervous system disorders
Tingling
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Brain Fog
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Nervous system disorders
Postural Dizziness/Balance Changes
17.4%
4/23 • Number of events 4 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Concentration Impairment
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Anxiety
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Dry Skin
13.0%
3/23 • Number of events 3 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Muscositis Oral
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Stomach Pain
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Dyspepsia
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Cellulitis
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Renal and urinary disorders
Dribbling
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Blood and lymphatic system disorders
Anemia
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Musculoskeletal and connective tissue disorders
Myalgia
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Breast Tenderness
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Nervous system disorders
Lightheadedness
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Lack of Body Odor
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Ejaculation Disorder
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Burning Sensation
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Psychiatric disorders
Decreased Mental Acuity
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Musculoskeletal and connective tissue disorders
Cramp
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Nipple Itchiness
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Vascular disorders
Warmer Body
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Musculoskeletal and connective tissue disorders
Akathisia
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Blood and lymphatic system disorders
Hypocalcemia
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Immune system disorders
Sore Throat
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Skin and subcutaneous tissue disorders
Painful Callus Bumps
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Respiratory, thoracic and mediastinal disorders
Upper Respiratory Infection Symptoms
8.7%
2/23 • Number of events 2 • Through study completion, which corresponded to a median time of 753 days.
Eye disorders
Impaired Vision
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Nervous system disorders
Headache
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Perceived Shrinking of Genitals
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Testicle Pain
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Renal and urinary disorders
Hematuria
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Blood and lymphatic system disorders
Hypertension
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Cardiac disorders
Tachycardia
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Reproductive system and breast disorders
Bronchitis
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Respiratory, thoracic and mediastinal disorders
Chest Tightness
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Gastrointestinal disorders
Clostridium Difficile Enteritis
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.
Cardiac disorders
Atrial Flutter
4.3%
1/23 • Number of events 1 • Through study completion, which corresponded to a median time of 753 days.

Additional Information

Dr. Michael Schweizer

University of Washington

Phone: (206) 606-6252

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place