Neoadjuvant Intense Endocrine Therapy for High Risk and Locally Advanced Prostate Cancer

NCT ID: NCT05406999

Last Updated: 2022-08-16

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

900 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-01

Study Completion Date

2030-06-30

Brief Summary

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This is a prospective, multicenter, multi-arm, non-randomized, open-label clinical trial to evaluate the efficacy and safety of neoadjuvant intense endocrine therapy for high-risk or locally advanced prostate cancer.

Detailed Description

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The study was designed to evaluate the efficacy and safety of different forms of neoadjuvant intense androgen deprivation therapy (ADT) compared with ADT alone, followed by prostatectomy.

Conditions

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Neoadjuvant Therapy High Risk Prostate Cancer Locally Advanced Prostate Cancer Intense Endocrine Therapy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ADT alone + prostatectomy

A total of 100 subjects receive ADT for 6 cycles (28 days per cycle) before prostatectomy. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type ACTIVE_COMPARATOR

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

ADT plus Abiraterone

A total of 150 subjects in this group received abiraterone acetate + prednisolone acetate daily for 6 cycles along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Abiraterone Acetate

Intervention Type DRUG

1000 mg (250 mg×4 tablets) once daily, orally

Prednisolone tablets

Intervention Type DRUG

5 mg once daily, orally.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

ADT plus Enzalutamide

A total of 50 subjects in this group received enzalutamide daily for 6 cycles along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Enzalutamide

Intervention Type DRUG

160 mg (40 mg× 4 tablets) once daily, orally.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

ADT plus Apalutamide

A total of 150 subjects in this group received apalutamide daily for 6 cycles along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Apalutamide

Intervention Type DRUG

240 mg (60 mg×4 tablets) once daily, orally.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

ADT plus Darotamide

A total of 150 subjects in this group received darotamide daily for 6 cycles along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Darotamide

Intervention Type DRUG

600 mg (300 mg × 2 tablets) twice daily, orally.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

ADT plus Rizvilutamide

A total of 150 subjects in this group received rizvilutamide daily for 6 cycles along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Rezvilutamide

Intervention Type DRUG

240 mg (80 mg × 3 tablets) once daily orally

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

PARP inhibitor + abiraterone + ADT

A total of 100 subjects in this group received Poly ADP-ribose Polymerase (PARP) Inhibitor plus abiraterone along with ADT. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Abiraterone Acetate

Intervention Type DRUG

1000 mg (250 mg×4 tablets) once daily, orally

Prednisolone tablets

Intervention Type DRUG

5 mg once daily, orally.

PARP inhibitor

Intervention Type DRUG

The PARP inhibitors will be determined by the investigators at separate centers. The dosage and frequency of administration will be consistent with the prescribing information. Available drugs include olaparib, fluzoparib, pamiparib, talazoparib ect.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

PARP inhibitor + ADT

A total of 50 subjects in this group in this group received Poly ADP-ribose Polymerase (PARP) Inhibitor along with ADT mentioned above. Enrolled patients carry homologous recombination repair (HRR) gene mutation verified by molecular testing. Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Group Type EXPERIMENTAL

ADT

Intervention Type DRUG

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

PARP inhibitor

Intervention Type DRUG

The PARP inhibitors will be determined by the investigators at separate centers. The dosage and frequency of administration will be consistent with the prescribing information. Available drugs include olaparib, fluzoparib, pamiparib, talazoparib ect.

Robot-assisted radical prostatectomy

Intervention Type PROCEDURE

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Interventions

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ADT

The ADT regimen will be determined by the investigators at separate centers. The dose and frequency of administration will be consistent with the prescribing information. Available drugs include triptorelin, goserelin, leuprolide, digareke ect.

Intervention Type DRUG

Abiraterone Acetate

1000 mg (250 mg×4 tablets) once daily, orally

Intervention Type DRUG

Prednisolone tablets

5 mg once daily, orally.

Intervention Type DRUG

Enzalutamide

160 mg (40 mg× 4 tablets) once daily, orally.

Intervention Type DRUG

Apalutamide

240 mg (60 mg×4 tablets) once daily, orally.

Intervention Type DRUG

Darotamide

600 mg (300 mg × 2 tablets) twice daily, orally.

Intervention Type DRUG

Rezvilutamide

240 mg (80 mg × 3 tablets) once daily orally

Intervention Type DRUG

PARP inhibitor

The PARP inhibitors will be determined by the investigators at separate centers. The dosage and frequency of administration will be consistent with the prescribing information. Available drugs include olaparib, fluzoparib, pamiparib, talazoparib ect.

Intervention Type DRUG

Robot-assisted radical prostatectomy

Robot-assisted radical prostatectomy was performed within 2 weeks after the end of the therapy.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. All patients must have been histologically diagnosed of prostate cancer and must be eligible for radical prostatectomy.
2. All patients must undergo thorough tumor staging and meet one of the following criteria: a) multi-parameter MRI or PSMA PET/CT shows clinical staging of primary tumor ≥ T3; b) Gleason score of primary tumor ≥ 8; c)prostate specific antigen(PSA) ≥20 ng/ml; d) Imaging evaluation shows regional lymph node metastases (N1).
3. Eastern Cooperative Oncology Group (ECOG) physical condition score ≤ 1.
4. Patients must have adequate hematologic function, hepatic function, renal function and cardiac function.
5. Patients must participate voluntarily and sign an informed consent form(ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must bewilling to obey the prohibitions and restrictions specified in the research protocol.
6. Fertile patients must be willing to use highly effective contraception during the study period and within 120 days of the last dose of treatment.

Exclusion Criteria

1. Patients with neuroendocrine, small cell, or sarcoma-like pathologic features are not eligible.
2. Patients with low-risk or medium-risk, localized prostate cancer (the following conditions are met at the same time) are not eligible: a) multiparameter MRI or PSMA PET / CT shows clinical staging of primary tumor \< T3; b) Gleason score of primary tumor \< 8; c) prostate specific antigen (PSA) \<20 ng/ml.
3. Patients with clinical or radiological evidence of extra-regional lymph node metastases or bone metastases or visceral metastases (any M1) are not eligible.
4. Patients who have previously received androgen deprivation therapy (medical or surgical) or focal treatment, radiotherapy, chemotherapy for prostate cancer are not eligible.
5. Patients with severe or uncontrolled concurrent infections are not eligible.
6. Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration.
7. Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection.
8. Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled.
9. Patients with mental illness, mental disability or inability to give informed consent are not eligible.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

OTHER

Sponsor Role lead

Responsible Party

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Hongqian Guo

Chief Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Institute of Urology, Nanjing University

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Facility Contacts

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Junlong Zhuang, MD

Role: primary

8615950451917

Other Identifiers

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IUNU-PC-118

Identifier Type: -

Identifier Source: org_study_id

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