A Study of an Intermittent ADT Approach With Apalutamide Monotherapy in Participants With mCSPC

NCT ID: NCT05884398

Last Updated: 2025-11-10

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-31

Study Completion Date

2028-10-12

Brief Summary

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The purpose of the study is to determine if the intermittent use of androgen-deprivation therapy (ADT) in participants with metastatic castrate-sensitive prostate cancer (mCSPC) who reached a prostate-specific antigen (PSA) level \< 0.2 nanograms/millilitres (ng/mL) after 6 months of treatment with apalutamide and ADT combination therapy provides non-inferior radiographic progression-free survival (rPFS) and a reduced burden of hot flashes measured as 18-month percent change in severity adjusted hot flash score.

Detailed Description

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Conditions

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Metastatic Castrate-sensitive Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm A (Intermittent ADT Group)

Participants with PSA level \<0.2 ng/mL after 6 months of treatment with Apalutamide and ADT during initial treatment phase, will enter main treatment phase and treated with apalutamide with intermittent ADT per protocol or followed up for at least 18 months from Day 1 of Cycle 7 (each cycle 28 days) and followed up for up to a maximum of 2 years after the main treatment phase, or until death, withdrawal of consent, loss to follow-up, early termination of the study by the sponsor for any reason, whichever occurs first.

Group Type EXPERIMENTAL

Apalutamide

Intervention Type DRUG

Apalutamide will be administered orally from Day 1 of Cycle 1 till 6 months in initial treatment phase and then in main treatment phase from Day 1 of Cycle 7 up to at least 18 months.

Androgen-deprivation Therapy (ADT)

Intervention Type DRUG

The choice of ADT will be at discretion of the Investigator. Dosing (dose and frequency of administration) will be consistent with the prescribing information.

Arm B (Continuous ADT Group)

Participants with PSA level \<0.2 ng/mL after 6 months of treatment with Apalutamide and ADT during initial treatment phase, will enter main treatment phase and continue to receive apalutamide plus ADT or followed up for at least 18 months from Day 1 of Cycle 7 (each cycle 28 days) and followed up for up to a maximum of 2 years after the main treatment phase, or until death, withdrawal of consent, loss to follow-up, early termination of the study by the sponsor for any reason, whichever occurs first.

Group Type ACTIVE_COMPARATOR

Apalutamide

Intervention Type DRUG

Apalutamide will be administered orally from Day 1 of Cycle 1 till 6 months in initial treatment phase and then in main treatment phase from Day 1 of Cycle 7 up to at least 18 months.

Androgen-deprivation Therapy (ADT)

Intervention Type DRUG

The choice of ADT will be at discretion of the Investigator. Dosing (dose and frequency of administration) will be consistent with the prescribing information.

Interventions

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Apalutamide

Apalutamide will be administered orally from Day 1 of Cycle 1 till 6 months in initial treatment phase and then in main treatment phase from Day 1 of Cycle 7 up to at least 18 months.

Intervention Type DRUG

Androgen-deprivation Therapy (ADT)

The choice of ADT will be at discretion of the Investigator. Dosing (dose and frequency of administration) will be consistent with the prescribing information.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of prostate cancer prior to screening with histologically or cytologically confirmed adenocarcinoma of the prostate
* For participants not undergoing Gender-affirming care: Metastatic prostate cancer disease documented by conventional imaging (example, computed tomography \[CT\], magnetic resonance imaging \[MRI\], or bone scan) and/or next-generation imaging \[NGI\] demonstrating greater than or equal (\>=) 2 distinct extraprostatic sites of metastasis
* For participants undergoing Gender-affirming care: No evidence of metastasis by either conventional imaging (example, CT, MRI, or bone scan) and/or NGI is also acceptable
* For participants not undergoing gender-affirming care: testosterone levels \> 50 (ng/dL) nanograms per deciliter at screening, except for those who may have received ADT prior to screening. Participants are allowed to have received up to 3 months of (ADT) androgen-deprivation therapy prior to enrollment
* For participants undergoing Gender-affirming care: There is no testosterone level requirement for inclusion
* Have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1. Participants with ECOG PS 2 or 3 are eligible for the study if the ECOG PS score is related to stable physical limitations (example, wheelchair-bound due to prior spinal cord injury) and not related to prostate cancer or associated therapy
* A participant must agree not to plan to conceive a child while enrolled in this study or within 3 months after the last dose of study treatment
* Must be able to take whole apalutamide tablets by swallowing alone or with another vehicle (example, applesauce)
* Assigned male at birth, inclusive of all gender identities

Exclusion Criteria

* History of seizure or known condition that has been determined to significantly predispose to seizure per investigator
* Pelvic lymph nodes as only site of metastasis
* Known allergies, hypersensitivity, or intolerance to excipients of apalutamide
* Any of the following within 6 months prior to screening: severe or unstable angina, myocardial infarction, symptomatic congestive heart failure, uncontrolled hypertension, clinically significant arterial or venous thromboembolic events
* Gastrointestinal disorder affecting absorption
* Participants who have undergone a bilateral orchiectomy with the exception of participants who completed this as part of their gender-affirming care or a result of a variation in physical sex development
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Janssen Research & Development, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janssen Research & Development, LLC Clinical Trial

Role: STUDY_DIRECTOR

Janssen Research & Development, LLC

Locations

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Urology Centers Of Alabama

Homewood, Alabama, United States

Site Status

Arizona Urology Specialists

Tucson, Arizona, United States

Site Status

Arkansas Urology

Little Rock, Arkansas, United States

Site Status

Urology Associates of Central California

Fresno, California, United States

Site Status

VA Medical Center

San Francisco, California, United States

Site Status

Sansum Clinic Pharm

Santa Barbara, California, United States

Site Status

Colorado Clinical Research

Lakewood, Colorado, United States

Site Status

Advanced Urology Institute

Daytona Beach, Florida, United States

Site Status

Associated Urological Specialists LLC

Chicago Ridge, Illinois, United States

Site Status

Advanced Urology Associates

Joliet, Illinois, United States

Site Status

Urology of Indiana

Greenwood, Indiana, United States

Site Status

First Urology, PSC

Jeffersonville, Indiana, United States

Site Status

Maryland Oncology Hematology P A

Silver Spring, Maryland, United States

Site Status

Chesapeake Urology Research Associates

Towson, Maryland, United States

Site Status

Michigan Institute of Urology

Troy, Michigan, United States

Site Status

MSKCC Basking Ridge

Basking Ridge, New Jersey, United States

Site Status

MSKCC Monmouth

Middletown, New Jersey, United States

Site Status

MSKCC Bergen

Montvale, New Jersey, United States

Site Status

MSKCC Commack

Commack, New York, United States

Site Status

MSKCC Westchester

Harrison, New York, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

Associated Medical Professionals

Syracuse, New York, United States

Site Status

MSKCC Nassau Regional Cancer Center

Uniondale, New York, United States

Site Status

TriState Urologic Services PSC Inc. DBA The Urology Group

Cincinnati, Ohio, United States

Site Status

Central Ohio Urology Group

Gahanna, Ohio, United States

Site Status

Helios Clinical Research, LLC

Middleburg Heights, Ohio, United States

Site Status

Northwest Cancer Specialists PC

Tigard, Oregon, United States

Site Status

Centers for Advanced Urology LLC d b a MidLantic Urology

Bala-Cynwyd, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

VA Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

The Conrad Pearson Clinic

Germantown, Tennessee, United States

Site Status

Urology Associates

Nashville, Tennessee, United States

Site Status

Texas Oncology P A

Austin, Texas, United States

Site Status

Parkland Health and Hospital System

Dallas, Texas, United States

Site Status

Texas Oncology P A

Dallas, Texas, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

Texas Oncology P A

Houston, Texas, United States

Site Status

Houston Metro Urology

Houston, Texas, United States

Site Status

Texas Oncology San Antonio Northeast

San Antonio, Texas, United States

Site Status

Texas Oncology P A

Wichita Falls, Texas, United States

Site Status

University of Utah Huntsman Cancer Institute

Salt Lake City, Utah, United States

Site Status

Virginia Oncology Associates

Norfolk, Virginia, United States

Site Status

Oncology and Hematology Associates of Southwest Virginia, Inc.

Roanoke, Virginia, United States

Site Status

Urology Of Virginia, Pllc

Virginia Beach, Virginia, United States

Site Status

Macquarie University Hospital

Macquarie University, , Australia

Site Status

Peter MacCallum Cancer Centre

Melbourne, , Australia

Site Status

Mater Misericordiae Hospital

South Brisbane, , Australia

Site Status

Fundacao Pio XII

Barretos, , Brazil

Site Status

Hospital das Clínicas - Universidade Federal de Minas Gerais

Belo Horizonte, , Brazil

Site Status

Liga Norte Riograndense Contra O Cancer

Natal, , Brazil

Site Status

Ministerio da Saude Instituto Nacional do Cancer

Rio de Janeiro, , Brazil

Site Status

Instituto D Or de Pesquisa e Ensino

Salvador, , Brazil

Site Status

CEPHO Centro de Estudos e Pesquisa de Hematologia e Oncologia

Santo André, , Brazil

Site Status

Fundacao Faculdade de Medicina Instituto do Cancer do Estado de Sao Paulo

São Paulo, , Brazil

Site Status

Southern Alberta Institute of Urology / Prostate Cancer Centre

Calgary, Alberta, Canada

Site Status

Nova Scotia Health Authority

Halifax, Nova Scotia, Canada

Site Status

Sunnybrook Health Sciences Center

Toronto, Ontario, Canada

Site Status

Princess Margaret Hospital

Toronto, Ontario, Canada

Site Status

CHU de Quebec Universite Laval Hopital de l Enfant Jesus

Québec, Quebec, Canada

Site Status

Peking University First Hospital

Beijing, , China

Site Status

The First Hospital of Jilin University

Changchun, , China

Site Status

West China School of Medicine/West China Hospital, Sichuan University

Chengdu, , China

Site Status

The First Affiliated Hospital Sun Yat sen University

Guangzhou, , China

Site Status

Nanfang Hospital of Southern Medical Hospital

Guangzhou, , China

Site Status

Shandong Provincial Hospital

Jinan, , China

Site Status

Ningbo First Hospital

Ningbo, , China

Site Status

Shengjing Hospital Of China Medical University

Shenyang, , China

Site Status

TongJi Hospital of TongJi Medical College of Huazhong University of Science & Technology

Wuhan, , China

Site Status

The First Affiliated Hospital of Xian Jiaotong University

Xi'an, , China

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Hopital Cochin

Paris, , France

Site Status

Chu Rennes Hopital Pontchaillou

Rennes, , France

Site Status

Gustave Roussy

Villejuif, , France

Site Status

Universitaetsklinikum der RWTH Aachen

Aachen, , Germany

Site Status

Klinikum Augsburg

Augsburg, , Germany

Site Status

Universitaetsklinikum Koelnt

Cologne, , Germany

Site Status

Universitaetsklinikum Carl Gustav Carus TU Dresden

Dresden, , Germany

Site Status

Universitatsklinikum Schleswig Holstein Campus Lubeck

Lübeck, , Germany

Site Status

Klinikum rechts der Isar - der Technischen Universität München

München, , Germany

Site Status

Studienpraxis Urologie Nurtingen

Nürtingen, , Germany

Site Status

Universitatsklinikum Wurzburg

Würzburg, , Germany

Site Status

SCIENTIA Investigacion Clinica SC

Chihuahua City, , Mexico

Site Status

Consultorio de Especialidad en Urologia Privado

Durango, , Mexico

Site Status

Medical Care & Research SA de CV

Mérida, , Mexico

Site Status

Cuidados Oncologicos

Querétaro, , Mexico

Site Status

Centrum Onkologii im Prof F Lukaszczyka

Bydgoszcz, , Poland

Site Status

Szpital Wojewodzki im Mikolaja Kopernika w Koszalinie

Koszalin, , Poland

Site Status

Narodowy Instytut Onkologii im Marii Sklodowskiej Curie Panstwowy Instytut Badawczy

Warsaw, , Poland

Site Status

Szpital Grochowski Im Dr Med Rafala Masztaka Sp Z O O

Warsaw, , Poland

Site Status

Polimed Specjalistyczna Przychodnia Lekarska Wieslaw Grazyna Tupikowski Bednarek Tupikowska S C

Wroclaw, , Poland

Site Status

Countries

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United States Australia Brazil Canada China France Germany Mexico Poland

Other Identifiers

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56021927PCR3020

Identifier Type: OTHER

Identifier Source: secondary_id

2022-502686-24-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

CR109327

Identifier Type: -

Identifier Source: org_study_id