EPI-7386 in Combination with Enzalutamide Compared with Enzalutamide Alone in Subjects with MCRPC

NCT ID: NCT05075577

Last Updated: 2025-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

77 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-21

Study Completion Date

2025-01-14

Brief Summary

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This is a Phase 1/2 study of EPI-7386 orally administered in combination with enzalutamide in subjects with mCRPC.

Phase 1 of the study will be a single-arm dose escalation study of EPI-7386 in combination with a fixed dose of enzalutamide. This portion of the study will primarily evaluate the safety and tolerability of the drug combination and establish the RP2CDs for EPI-7386 and enzalutamide when dosed in combination. In addition, blood sampling will be conducted for PK evaluation to assess the potential DDI between the two drugs.

Once the RP2CD for each drug has been established, Phase 2 of the study will commence. Phase 2 is a two-arm, randomized (2:1), open-label study. Approximately 120 subjects will be randomized 2:1 to:

* Group 1: EPI-7386 at the RP2CD + enzalutamide(depending on the results of the Phase 1) (n=80)
* Group 2: Enzalutamide single agent (n=40) The planned dose of enzalutamide and EPI-7386 for the combination arm will be those determined in the Phase 1 of this study based on safety and exposure data. Subjects may remain on study treatment as long as they are tolerating treatment without disease progression based on RECIST v1.1 and/or PCWG3.

Detailed Description

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Conditions

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Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase 1 Cohort 1

600 mg QD EPI-7386 in combination of Enzalutamide120 mg

Group Type EXPERIMENTAL

EPI-7386 with Enzalutamide

Intervention Type DRUG

Daily oral dose of EPI-7386 in combination of enzalutamide

Phase 1 Cohort 2

800 mg QD EPI-7386 in combination of Enzalutamide120 mg

Group Type EXPERIMENTAL

EPI-7386 with Enzalutamide

Intervention Type DRUG

Daily oral dose of EPI-7386 in combination of enzalutamide

Phase 1 Cohort 3

600 mg BID EPI-7386 in combination of Enzalutamide120 mg

Group Type EXPERIMENTAL

EPI-7386 with Enzalutamide

Intervention Type DRUG

Daily oral dose of EPI-7386 in combination of enzalutamide

Phase 1 Cohort 4

RP2D mg EPI-7386 in combination of Enzalutamide160 mg

Group Type EXPERIMENTAL

EPI-7386 with Enzalutamide

Intervention Type DRUG

Daily oral dose of EPI-7386 in combination of enzalutamide

Phase 2 Enzalutamide + EPI-7386 (Randomized 2:1)

RP2D mg EPI-7386 in combination of Enzalutamide RP2D mg

Group Type EXPERIMENTAL

EPI-7386 with Enzalutamide

Intervention Type DRUG

Daily oral dose of EPI-7386 in combination of enzalutamide

Phase 2 Enzalutamide single agent

Enzalutamide 160 mg

Group Type ACTIVE_COMPARATOR

Enzalutamide

Intervention Type DRUG

Daily oral dose of enzalutamide

Interventions

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Enzalutamide

Daily oral dose of enzalutamide

Intervention Type DRUG

EPI-7386 with Enzalutamide

Daily oral dose of EPI-7386 in combination of enzalutamide

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Males ≥18 years.
* Histologically, pathologically, or cytologically confirmed prostate adenocarcinoma.
* Evidence of castration-resistant prostate cancer (CRPC).
* Presence of metastatic disease at study entry documented by 1 or more bone lesions on bone scan or by soft tissue disease observed by CT/MRI.
* Naïve to second generation anti-androgens.
* Evidence of progressive disease defined as 1 or more Prostate Cancer Working Group 3 (PCWG3) criteria.
* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
* Ongoing ADT with luteinizing hormone-releasing hormone (LHRH) agonist/antagonist therapy or history of bilateral orchiectomy, with castrate level testosterone.
* Serum testosterone ≤1.73 nmol/L (50 ng/dL).
* Subjects receiving bisphosphonates or other approved bone-targeting therapy (e.g., denosumab) must be on a stable dose for at least 28 days prior to the start of study treatment.
* Demonstrate adequate organ function.

Exclusion Criteria

* Biologic anti-cancer therapy within 28 days prior to the start of study treatment.
* Use of hormonal agents with anti-tumor activity against prostate cancer within 28 days prior to the start of study treatment.
* Use of herbal products or alternative therapies that may decrease PSA levels or that may have hormonal anti-prostate cancer activity within 28 days prior to the start of study treatment or plans to initiate during the study.
* Intervention with any chemotherapy, investigational agents, or other anti-cancer drugs within 28 days of the first dose of study treatment.
* Use of radium-223 dichloride or other radioligand/radiopharmaceutical within 28 days prior to the start of study treatment.
* Received limited-field palliative bone radiotherapy \>5 fractions and/or any radiotherapy within 2 weeks prior to the start of study treatment.
* Received a blood transfusion within 28 days of hematologic screening labs.
* Known intra-cerebral disease or brain metastasis unless adequately treated and stable for the last 28 days before signing of informed consent.
* Spinal cord compression.
* Diagnosis of another clinically significant malignancy within the previous 3 years other than curatively treated non-melanomatous skin cancer or superficial urothelial carcinoma and other in situ or non-invasive malignancies.
* Gastrointestinal issues affecting absorption.
* Significant cardiovascular disease.
* Known history of seizure or conditions that may pre-dispose them to seizure, including brain injury with loss of consciousness, transient ischemic attack within the past 12 months, cerebral vascular accident, brain metastases, and brain arteriovenous malformation.
* Concurrent disease or any clinically significant abnormality.
* Known or suspected hypersensitivity to any components of the formulation used for EPI-7386 or enzalutamide.
* Use of strong inhibitors of CYP2C8.
* Use of strong inducers of CYP3A.
* Use of narrow therapeutic index sensitive CYP2C8 or sensitive substrates for CYP3A and CYP2B6.
* Use of granulocyte colony stimulating factor within 7 days prior to screening laboratories.
* Not a candidate for enzalutamide treatment.
* Patients with rare hereditary problems of fructose intolerance.
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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ESSA Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Arizona Urology

Tucson, Arizona, United States

Site Status

Hematology Oncology Associates of the Treasure Coast

Port Saint Lucie, Florida, United States

Site Status

Moffitt Cancer Center

Tampa, Florida, United States

Site Status

Chesapeake Urology Associates

Baltimore, Maryland, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Washington University Siteman Cancer Center

St Louis, Missouri, United States

Site Status

Urology Cancer Center

Omaha, Nebraska, United States

Site Status

Great Lakes Cancer Center

Buffalo, New York, United States

Site Status

Roswell Park Comprehensive Cancer Center

Buffalo, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

OHSU Knight Cancer Instititue

Portland, Oregon, United States

Site Status

Carolina Urologic Research Center

Myrtle Beach, South Carolina, United States

Site Status

University of Wisconsin

Madison, Wisconsin, United States

Site Status

The Canberra Hospital

Garran, Australian Capital Territory, Australia

Site Status

Chris O'Brien Lifehouse

Camperdown, New South Wales, Australia

Site Status

St. Vincent's Hospital Sydney

Darlinghurst, New South Wales, Australia

Site Status

Eastern Health

Box Hill, Victoria, Australia

Site Status

Tom Baker Cancer Centre

Calgary, Alberta, Canada

Site Status

Prostate Cancer Centre

Calgary, Alberta, Canada

Site Status

Cross Cancer Institute

Edmonton, Alberta, Canada

Site Status

Juravinski Cancer Centre, Hamilton, ON L8V 5C2

Hamilton, Ontario, Canada

Site Status

Princess Margaret Cancer Center

Toronto, Ontario, Canada

Site Status

Centre Hospitalier de l'Universite de Montreal

Montreal, Quebec, Canada

Site Status

Jewish General Hospital

Montreal, Quebec, Canada

Site Status

Countries

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United States Australia Canada

Other Identifiers

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EPI-7386-CS-010

Identifier Type: -

Identifier Source: org_study_id

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