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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03431350
Other study ID # CR108406
Secondary ID 64091742PCR20022
Status Active, not recruiting
Phase Phase 1/Phase 2
First received
Last updated
Start date March 2, 2018
Est. completion date December 31, 2024

Study information

Verified date June 2024
Source Janssen Research & Development, LLC
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to: a) establish the recommended phase 2 dose (RP2D) and to evaluate the antitumor activity and safety of niraparib combination therapies (Combinations 1 and 2) and b) to determine the relative bioavailability of niraparib and abiraterone acetate (AA) in combination (Combination 3) in participants with metastatic castration-resistant prostate cancer (mCRPC).


Description:

This multicenter study will evaluate safety and efficacy of niraparib in combination with other anti-cancer agents. Combination 1 will combine niraparib with the anti-programmed cell death protein (PD)-1 monoclonal antibody cetrelimab, in participants with mCRPC. Combination 1 has 2 parts: in Part 1 (dose selection), participants will be enrolled to establish RP2D doses of niraparib and cetrelimab; and Part 2 (dose expansion) will evaluate the combination therapy in an expanded number of participants into 2 cohorts (biomarker positive or biomarker negative). Combination 2 will combine niraparib with abiraterone acetate plus prednisone (AA-P) in mCRPC participants with DNA-repair gene defects (DRD). Combination 3 will evaluate the relative bioavailability (BA) of niraparib and AA in combination. In a pharmacokinetics (PK) assessment phase, niraparib and AA will be administered, and in an extension phase, niraparib and AA-P will be administered. Combinations 1 and 2 will have 5 phases: A Pre-screening Phase, a Screening Phase, a Treatment Phase, a Follow-up Phase, and a Long-term Extension (LTE) Phase; Combination 3 has 3 phases: A Screening Phase, A PK Assessment Phase, an Extension Phase (including LTE phase). Study evaluations will include efficacy, PK, PK/pharmacodynamics, biomarkers, safety and tolerability.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 136
Est. completion date December 31, 2024
Est. primary completion date August 31, 2021
Accepts healthy volunteers No
Gender Male
Age group 18 Years and older
Eligibility Inclusion Criteria for Combination 3: - Diagnosed with mCRPC, who in the opinion of the investigator may benefit from treatment in Combination 3 of this study - Able to continue gonadotropin releasing hormone analogue (GnRHa) therapy during the study if not surgically castrate (that is, subjects who has not undergone bilateral orchiectomy). - Eastern Cooperative Oncology Group Performance Status (ECOG PS) of less than or equal to (<=) 1 - Toxicity associated with prior chemotherapy or radiotherapy has resolved to Grade <= 1 (except alopecia or Grade <= 2 neuropathy) at screening - Participant must agree not to donate sperm while on study treatment, and for 3 months following the last dose of study treatment Exclusion Criteria: - History or current diagnosis of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) - Active malignancies (that is, progressing or requiring treatment change in the last 24 months) other than the disease being treated under study. The only allowed exceptions are: non-muscle invasive bladder cancer; skin cancer (non-melanoma or melanoma); breast cancer; malignancy that is considered cured with minimal risk of recurrence - Active infection requiring systemic therapy - Allergies, hypersensitivity, or intolerance to niraparib or the corresponding excipients Combination 3: - Symptomatic brain metastases - Prior disease progression during combination treatment with AA and poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitor (PARPi). Prior discontinuation of treatment with AA or PARPi due to AA- or PARPi-related toxicity

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Niraparib 200 mg
Participants will receive niraparib 200 mg orally.
Cetrelimab 240 mg
Participants will receive cetrelimab 240 mg IV every 2 weeks.
Cetrelimab 480 mg
Participants will receive cetrelimab 480 mg IV every 4 weeks.
Abiraterone acetate 1000 mg
Participants will receive AA 1000 mg orally.
Prednisone 5 mg
Participants will receive prednisone 5 mg orally.

Locations

Country Name City State
Belgium OLV Ziekenhuis Aalst Aalst
Belgium ZNA Middelheim Antwerpen
Belgium ULB Hôpital Erasme Brussels
Belgium Universitair Ziekenhuis Gent Gent
Belgium Az Groeninge Kortrijk
Belgium Centre Hospitalier Universitaire de Liege Domaine Universitaire du Sart Tilman Liege
Canada Southern Alberta Institute of Urology / Prostate Cancer Centre Calgary Alberta
Canada Centre de Recherche du CHUM Montreal Quebec
Canada University Health Network UHN Princess Margaret Cancer Centre Toronto Ontario
Canada British Columbia Cancer Agency Vancouver British Columbia
Israel Asaf Harofe Medical Center Beer Yaakov
Israel Soroka Hospital Beer-Sheva
Israel Rambam Medical Center Haifa
Israel Rabin Medical Center Petach Tikva
Israel Sheba Medical Center Tel Hashomer Ramat Gan
Italy Azienda Ospedaliera Universitaria Careggi di Firenze Firenze
Italy Azienda Ospedaliera ''Vito Fazzi'' Lecce
Italy UOC Oncologia Ospedale Provinciale di Macerata Macerata
Italy ASST Grande Ospedale Metropolitano Niguarda Milano
Italy IRCCS-Fondazione Pascale Napoli
Spain Hosp. de La Santa Creu I Sant Pau Barcelona
Spain Hospital Vall D'Hebron Barcelona
Spain Hosp Univ Fund Jimenez Diaz Madrid
Spain Hosp. Univ. de La Princesa Madrid
Spain Hosp. Univ. Hm Sanchinarro Madrid
Spain Hosp. Virgen de La Victoria Malaga
United Kingdom Royal United Hospital Bath
United Kingdom University College London Hospitals London
United Kingdom Southampton General Hospital Southampton
United Kingdom The Royal Marsden NHS Trust Sutton Sutton
United Kingdom Royal Cornwall Hospitals NHS Trust - Royal Cornwall Hospital Truro
United States New York Oncology Hematology Albany New York
United States MUSC-Hollings Cancer Center Charleston South Carolina
United States The Urology Center of Colorado Denver Colorado
United States Memorial Sloan Kettering Cancer Center Harrison New York
United States Houston Metro Urology Houston Texas
United States The University of Texas MD Anderson Cancer Center Houston Texas
United States Mayo Clinic - Division Of Hematology/oncology Jacksonville Florida
United States First Urology, PSC Jeffersonville Indiana
United States University of Wisconsin Carbone Cancer Center Madison Wisconsin
United States Carolina Urologic Research Center Myrtle Beach South Carolina
United States Urology Associates Nashville Tennessee
United States Memorial Sloan Kettering Cancer Center New York New York
United States Thomas Jefferson University Philadelphia Pennsylvania
United States University of Pittsburgh Medical Center (UPMC) Pittsburgh Pennsylvania
United States Utah Cancer Specialists Salt Lake City Utah
United States Chesapeake Urology Research Associates Towson Maryland
United States Michigan Institute of Urology Troy Michigan
United States Urological Associates of Southern Arizona, P.C. Tucson Arizona
United States Urology of Virginia, PLCC Virginia Beach Virginia

Sponsors (1)

Lead Sponsor Collaborator
Janssen Research & Development, LLC

Countries where clinical trial is conducted

United States,  Belgium,  Canada,  Israel,  Italy,  Spain,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Combination 1: Part 1: Number of Participants With Specified Toxicity Number of participants with specified toxicity during Cycle 1 was reported. Only toxicities that occurred during safety evaluation period(defined as first 28 days of treatment-Cycle 1 of Part 1) was used for analysis of specified toxicities and for dose reduction decisions. Toxicities were graded for severity as per NCI-CTCAE, version 4.03. Safety evaluation criteria were: Any Grade(G) >=3 non-hematological toxicity without anorexia, or constipation, fatigue improved to G<=2 in <7 days, vomiting and diarrhea resolved in <=3 days, laboratory abnormalities with hospitalization, tumor flare improved to G<=2 in <=7 days, elevation in AST/ALT for <=7 days and G3 hypertension controlled by medical therapy; any treatment-related(TR)G4 or G>=3 thrombocytopenia required platelet transfusion; Any TR G4 neutropenia >=7 days or G3 or 4 neutropenia with infection/fever >38.5 degrees Celsius; Any TR SAE or intolerable toxicity. Cycle 1 (28 days)
Primary Combination 1: Part 2: Objective Response Rate (ORR) ORR of soft tissue (visceral or nodal disease) was defined as percentage of participants with measurable disease who achieved a best response of either complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 with no evidence of bone progression according to prostate cancer working group 3 (PCWG3) criteria. Up to 37 months
Primary Combination 2: Composite Response Rate (RR) Composite response rate was defined as the percentage of participants who had a composite response which is defined as one of the following PCWG3 criteria: Objective response (percentage of participants with measurable disease who achieved a best response of either CR or PR as assessed by RECIST 1.1 with no evidence of bone progression according to PCWG3 criteria) (confirmed per RECIST 1.1), or; circulating tumor cells (CTC) response: defined as CTC=0 per 7.5 milliliters (mL) of blood at 8 weeks for participants who had CTC greater than or equal to (>=) 1 at baseline or CTC less than (<) 5 per 7.5 mL with CTC >=5 at baseline, confirmed by a second consecutive value obtained 4 or more weeks later, or prostate-specific antigen (PSA) declined of >=50 percentage (%), measured twice 3 to 4 weeks apart. This outcome measure was analyzed for specified arms only as pre-planned in the protocol. Up to 31 months
Primary Combination 1: Part 2: Number of Participants With Adverse Events (AEs) AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. Up to 37 months
Primary Combination 2: Number of Participants With Adverse Events (AEs) AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. Up to 31 months
Primary Combination 1: Part 2: Number of Participants With Adverse Events (AEs) of Grade >=3 Severity AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. An assessment of severity grade was made using the National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) as Grade 1 (mild): awareness of symptoms that are easily tolerated, causing minimal discomfort and not interfering with everyday activities; Grade 2 (moderate): sufficient discomfort is present to cause interference with normal activity; Grade 3 (severe): extreme distress, causing significant impairment of functioning or incapacitation, prevents normal everyday activities; Grade 4 (Life-threatening): urgent intervention indicated; and Grade 5 (death). Up to 37 months
Primary Combination 2: Number of Participants With Adverse Events (AEs) of Grade >=3 Severity AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. An assessment of severity grade was made using the NCI-CTCAE as Grade 1 (mild): awareness of symptoms that are easily tolerated, causing minimal discomfort and not interfering with everyday activities; Grade 2 (moderate): sufficient discomfort is present to cause interference with normal activity; Grade 3 (severe): extreme distress, causing significant impairment of functioning or incapacitation, prevents normal everyday activities; Grade 4 (Life-threatening): urgent intervention indicated; and Grade 5 (death). Up to 31 months
Primary Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib and Abiraterone Acetate After a Single Dose Cmax is defined as maximum observed plasma concentration of niraparib and abiraterone acetate (AA) after a single dose. Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Primary Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib Normalized by the Dose(Niraparib) (Cmax/Dose) of Niraparib Administered With AA After a Single Dose Cmax/dose of niraparib was defined as maximum observed plasma concentration of niraparib Cmax normalized by the dose of niraparib administered with AA after a single dose. Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Primary Combination 3: Area Under the Plasma Concentration-Time Curve From Time Zero to 168 Hours (AUC [0-168hr]) of Niraparib Administered With AA After a Single Dose AUC(0-168 hours) was defined as area under the plasma concentration-time curve from time zero to 168 hours of Niraparib administered with AA After a single dose. Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Primary Combination 3: Area Under the Plasma Concentration-Time Curve for Niraparib From Time Zero to 168 Hours (AUC [0-168 Hours]/Dose) of Niraparib Administered With AA After a Single Dose AUC0(168 hours)/dose was defined as area under the plasma concentration-time curve for niraparib from time 0 to 168 hours of niraparib administered with AA after a single dose. Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Secondary Combination 1: Parts 1 and 2: Plasma Concentrations of Niraparib Day 1
Secondary Combination 1: Parts 1 and 2: Maximum Observed Plasma Concentration (Cmax) of Niraparib Day 1
Secondary Combination 1: Parts 1 and 2: Time to Reach the Maximum Plasma Concentration (Tmax) of Niraparib Day 1
Secondary Combination 1: Parts 1 and 2: Minimum Observed (Predose) Concentration Following Multiple Dosing (Ctrough) of Niraparib Day 1
Secondary Combination 1: Parts 1 and 2: Number of Participants With Anti-drug Antibodies of Niraparib From baseline up to end of study (6 years 10 months)
Secondary Combination 1: Part 2 and Combination 2: Circulating Tumor Cells (CTC) Response From baseline up to end of study (6 years 10 months)
Secondary Combination 1: Part 2: Composite Response Rate From baseline up to end of study (6 years 10 months)
Secondary Combination 2: Objective Response Rate (ORR) From baseline up to end of study (6 years 10 months)
Secondary Combination 1: Part 2 and Combination 2: Duration of Objective Response From baseline up to end of study (6 years 10 months)
Secondary Combination 1: Part 2 and Combination 2: Overall Survival From baseline up to end of study (6 years 10 months)
Secondary Combination 3: Cmax of Niraparib and Abiraterone Acetate After a Single Dose For Low-strength FDC Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Secondary Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib Normalized by the Dose(Niraparib) (Cmax/Dose) of Niraparib Administered With AA After a Single Dose for Low-strength FDC Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Secondary Combination 3: Area Under the Plasma Concentration-Time Curve From Time Zero to 168 Hours (AUC [0-168hr]) of Niraparib Administered With AA After a Single Dose For Low-strength FDC Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Secondary Combination 3: Area Under the Plasma Concentration-Time Curve for Niraparib From Time Zero to 168 Hours (AUC [0-168 Hours]/Dose) of Niraparib Administered With AA After a Single Dose For Low-strength FDC Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
Secondary Combination 3: Number of Participants With Adverse Events From baseline up to end of study (6 years 10 months)
Secondary Combination 3: Number of Participants With Clinical Laboratory Parameters From baseline up to end of study (6 years 10 months)
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