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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03834519
Other study ID # 7339-010
Secondary ID MK-7339-010KEYLY
Status Completed
Phase Phase 3
First received
Last updated
Start date May 2, 2019
Est. completion date January 27, 2024

Study information

Verified date January 2024
Source Merck Sharp & Dohme LLC
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to assess the efficacy and safety of the combination of the polyadenosine 5'-diphosphoribose poly (ADP-ribose) polymerase (PARP) inhibitor olaparib and pembrolizumab in the treatment of participants with mCRPC who have failed to respond to either abiraterone acetate or enzalutamide (but not both) and to chemotherapy. The primary study hypotheses are that the combination of pembrolizumab plus olaparib is superior to abiraterone acetate or enzalutamide with respect to: 1. Overall Survival (OS) and 2. Radiographic progression-free survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 as assessed by blinded independent central review (BICR) As of Amendment 06, the Data Monitoring Committee (DMC) is no longer applicable. Participants still on treatment may have the option to continue receiving study intervention or SOC if they are deriving clinical benefit, until criteria for discontinuation are met. Participants who are still on study treatment and deriving clinical benefit will no longer have tumor response assessments by BICR. However, local tumor imaging assessments should continue per SOC schedule. In addition, ePRO assessments will no longer be performed and biomarker samples will no longer be collected.


Recruitment information / eligibility

Status Completed
Enrollment 793
Est. completion date January 27, 2024
Est. primary completion date March 14, 2022
Accepts healthy volunteers No
Gender Male
Age group 18 Years and older
Eligibility Inclusion Criteria: - Has histologically- or cytologically-confirmed adenocarcinoma of the prostate without small cell histology - Has prostate cancer progression while receiving androgen deprivation therapy (or post bilateral orchiectomy) within 6 months before screening - Has current evidence of metastatic disease documented by bone lesions on bone scan and/or soft tissue disease shown by computed tomography/magnetic resonance imaging (CT/MRI) - Has received prior treatment with abiraterone acetate OR enzalutamide, but not both - Have disease that progressed during or after treatment with abiraterone acetate for either metastatic hormone-sensitive prostate cancer (mHSPC) or mCRP or enzalutamide for mCRPC for at least 8 weeks (at least 14 weeks for participants with bone progression) - Participants that received abiraterone acetate for mHSPC may not have received abiraterone acetate or enzalutamide for mCRPC - Have received docetaxel chemotherapy regimen for mCRPC and have had progressive disease during or after treatment with docetaxel - Has ongoing androgen deprivation with serum testosterone <50 ng/dL (<2.0 nM) - If receiving bone resorptive therapy, including but not limited to bisphosphonates or denosumab, must have been receiving stable doses before randomization - Must agree to refrain from donating sperm during the intervention period and for at least the time needed to eliminate each study intervention after the last dose of study intervention PLUS be abstinent from heterosexual intercourse OR must agree to use contraception unless confirmed to be azoospermic - Contraception use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. If the contraception requirements in the local label for any of the study interventions is more stringent than the requirement above, the local label requirements are to be followed. - Has provided tumor tissue from a fresh core or excisional biopsy (obtained within 12 months of screening) from soft tissue not previously irradiated. Samples from tumors progressing at a prior site of radiation are allowed. Participants with bone-only or bone-predominant disease may provide a bone biopsy sample - Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 assessed within 7 days of randomization Exclusion Criteria: - Has a known additional malignancy that is progressing or has required active treatment in the last 3 years - Has an active autoimmune disease that has required systemic treatment in the past 2 years - Has a history of (noninfectious) pneumonitis requiring steroids, or has current pneumonitis - Has known active human immunodeficiency virus (HIV), hepatitis B virus (e.g., hepatitis B surface antigen reactive) or hepatitis C virus (HCV) infection (e.g., HCV RNA [qualitative] is detected) - Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis - Has a history of seizure or any condition that may predispose to seizure - Has a history of loss of consciousness within 12 months of screening - Has myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or has features suggestive of MDS/AML - Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy - Has (=Grade 3) hypersensitivity to pembrolizumab and/or any of its excipients - Has known hypersensitivity to the components or excipients in olaparib, abiraterone acetate, prednisone or prednisolone, or enzalutamide - Has symptomatic congestive heart failure (New York Heart Association Class III or IV heart disease) - Has received an anticancer monoclonal antibody (mAb) before randomization - Has received prior treatment with olaparib or any other PARP inhibitor - Has received prior treatment with apalutamide or darolutamide - Has received prior treatment with enzalutamide or apalutamide for metastatic hormone-sensitive prostate cancer - Has used herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA (e.g., saw palmetto) before the date of randomization - Has received prior treatment with radium or other therapeutic radiopharmaceuticals for prostate cancer - Has received prior treatment with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent, or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g., CTLA-4, OX-40, or CD137) - Is currently receiving either strong or moderate inhibitors of cytochrome P450 [CYP] (CYP3A4) that cannot be discontinued for the duration of the study - Has received a previous allogenic bone marrow transplant or double umbilical cord transplantation (dUCBT) or a solid organ transplant - Has received a live vaccine within 30 days prior to the date of randomization - Is currently participating in or has participated in a study of an investigational agent, or has used an investigational device, within 4 weeks before the date of randomization - Has a bone "superscan" - Is expecting to father children within the projected duration of the study, starting with the screening visit through 90 days after the last dose of study intervention

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
Pembrolizumab
IV infusion
Drug:
Olaparib
Oral tablets
Abiraterone acetate
Oral tablets
Prednisone
Oral tablets
Enzalutamide
Oral tablets or oral capsules
Prednisolone
Oral tablets

Locations

Country Name City State
Argentina Centro de Oncologia e Investigacion Buenos Aires COIBA ( Site 1013) Berazategui Buenos Aires
Argentina Centro de Diagnostico Urologico ( Site 1008) Buenos Aires Caba
Argentina Hospital Aleman ( Site 1004) Buenos Aires
Argentina Hospital Britanico de Buenos Aires ( Site 1006) Buenos Aires Caba
Argentina Instituto de Investigaciones Metabolicas ( Site 1011) Buenos Aires
Argentina Instituto Medico Alexander Fleming ( Site 1010) Buenos Aires
Argentina CEMAIC ( Site 1014) Cordoba
Argentina Sanatorio Parque ( Site 1002) Rosario Santa Fe
Australia Box Hill Hospital ( Site 0146) Box Hill Victoria
Australia St. Vincent's Hospital ( Site 0158) Darlinghurst New South Wales
Australia Royal Brisbane and Women s Hospital ( Site 0155) Herston Queensland
Australia Macquarie University ( Site 0151) Macquarie University New South Wales
Australia Peter MacCallum Cancer Centre ( Site 0152) Melbourne Victoria
Australia Fiona Stanley Hospital ( Site 0162) Murdoch Western Australia
Australia Port Macquarie Base Hospital ( Site 0153) Port Macquarie New South Wales
Australia John Flynn Hospital & Medical Centre ( Site 0164) Tugun Queensland
Australia Calvary Mater Newcastle ( Site 0148) Waratah New South Wales
Australia Southern Medical Day Care Centre ( Site 0160) Wollongong New South Wales
Austria Medizinische Universitat Graz ( Site 0374) Graz Steiermark
Austria Ordensklinikum Linz GmbH Elisabethinen ( Site 0373) Linz Oberosterreich
Austria SCRI-CCCIT GesmbH ( Site 0371) Salzburg
Austria Medizinische Universitaet Wien ( Site 0375) Wien
Brazil Hospital de Caridade de Ijui ( Site 1038) Ijui Rio Grande Do Sul
Brazil Centro de Novos Tratamentos Itajai - Clinica de Neoplasias Litoral ( Site 1035) Itajai Santa Catarina
Brazil Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 1021) Porto Alegre Rio Grande Do Sul
Brazil Hospital de Base de Sao Jose de Rio Preto ( Site 1022) Sao Jose do Rio Preto Sao Paulo
Brazil A.C. Camargo Cancer Center ( Site 1026) Sao Paulo
Brazil IBCC - Instituto Brasileiro de Controle do Câncer ( Site 1040) São Paulo Sao Paulo
Canada William Osler Health System (Brampton Civic Hospital) ( Site 0121) Brampton Ontario
Canada Cross Cancer Institute ( Site 0110) Edmonton Alberta
Canada Nova Scotia Health Authority QEII-HSC ( Site 0114) Halifax Nova Scotia
Canada Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0116) Hamilton Ontario
Canada BC Cancer-Kelowna - Sindi Ahluwalia Hawkins Centre ( Site 0113) Kelowna British Columbia
Canada CHUQ-Univ Laval-Hotel Dieu de Quebec ( Site 0103) Quebec
Canada CIUSSS du Bas Saint Laurent - Hopital Regional de Rimouski ( Site 0102) Rimouski Quebec
Canada CIUSSS de l Estrie - CHUS - Centre Hosp. Univ. Sherbrooke ( Site 0105) Sherbrooke Quebec
Canada Princess Margaret Cancer Centre ( Site 0107) Toronto Ontario
Canada BC Cancer-Vancouver Center ( Site 0112) Vancouver British Columbia
Chile Bradford Hill Centro de Investigaciones Clinicas ( Site 1044) Santiago Region M. De Santiago
Chile Fundacion Arturo Lopez Perez ( Site 1049) Santiago Region M. De Santiago
Chile Pontificia Universidad Catolica de Chile ( Site 1047) Santiago Region M. De Santiago
Chile Centro Investigación del Cáncer James Lind ( Site 1041) Temuco Araucania
Chile Rey y Oreilly Limitada ( Site 1048) Temuco Araucania
France CHU Amiens Picardie Site Sud Amiens ( Site 0438) Amiens Somme
France Institut Sainte Catherine ( Site 0447) Avignon Vaucluse
France CHU Jean Minjoz ( Site 0423) Besancon Doubs
France Institut Bergonie ( Site 0421) Bordeaux Gironde
France CHU de Brest -Site Hopital Morvan ( Site 0441) Brest Bretagne
France Centre Jean Perrin ( Site 0434) Clermont-Ferrand Auvergne
France Centre Leon Berard ( Site 0422) Lyon Rhone
France Institut Paoli Calmettes ( Site 0419) Marseille Bouches-du-Rhone
France Institut Regional du Cancer de Montpellier - ICM ( Site 0443) Montpellier Herault
France Centre D Oncologie de Gentilly ( Site 0432) Nancy Meurthe-et-Moselle
France Centre Hospitalier Regional du Orleans ( Site 0430) Orleans Loiret
France Institut Mutualiste Montsouris ( Site 0446) Paris
France C.H.U. Lyon Sud ( Site 0436) Pierre Benite Rhone
France Institut De Cancerologie De L Ouest ( Site 0448) Saint Herblain Loire-Atlantique
France C.H. de Saint Quentin ( Site 0481) Saint Quentin Aisne
France Clinique Sainte Anne ( Site 0431) Strasbourg Alsace
France Hopital Foch ( Site 0428) Suresnes Hauts-de-Seine
France Institut Claudius Regaud IUCT Oncopole ( Site 0418) Toulouse Haute-Garonne
France Institut Gustave Roussy ( Site 0416) Villejuif Val-de-Marne
Germany Charité Universitaetsmedizin Berlin - Campus Mitte ( Site 0301) Berlin
Germany Universitaetsklinikum Duesseldorf ( Site 0306) Duesseldorf Nordrhein-Westfalen
Germany Universitaetsklinikum Erlangen ( Site 0303) Erlangen Bayern
Germany Universitaetsklinikum Freiburg - Medizinische Klinik ( Site 0304) Freiburg Baden-Wurttemberg
Germany Universitaetsklinikum Jena ( Site 0305) Jena Thuringen
Germany Universitaetsklinikum in Mannheim ( Site 0314) Mannheim Baden-Wurttemberg
Germany Klinikum Rechts der Isar ( Site 0300) Muenchen Bayern
Germany Universitaetsklinik der Paracelsus Medizinischen Privatuniversitaet ( Site 0318) Nuernberg Bayern
Germany Studienpraxis Urologie ( Site 0309) Nuertingen Baden-Wurttemberg
Germany Krankenhaus der Barmherzigen Brueder Trier ( Site 0310) Trier Rheinland-Pfalz
Germany Universitaetsklinik fuer Urologie ( Site 0307) Tuebingen Baden-Wurttemberg
Ireland Tallaght University Hospital ( Site 0730) Dublin
Ireland Mid Western Cancer Centre ( Site 0728) Limerick
Israel Ha Emek Medical Center ( Site 0548) Afula
Israel Assaf Harofe ( Site 0547) Be'er- Ya'akov
Israel Soroka Medical Center ( Site 0549) Beer Sheva
Israel Rambam Medical Center ( Site 0543) Haifa
Israel Hadassah Ein Kerem Medical Center ( Site 0546) Jerusalem
Israel Meir Medical Center ( Site 0544) Kfar Saba
Israel Rabin Medical Center ( Site 0545) Petach-Tikwa
Israel Chaim Sheba Medical Center ( Site 0541) Ramat Gan
Israel Sourasky Medical Center ( Site 0542) Tel-Aviv
Italy Medical Oncology Ospedale San Donato ( Site 0461) Arezzo
Italy Policlinico S.Orsola-Malpighi ( Site 0453) Bologna
Italy Azienda Ospedaliera Cannizzaro ( Site 0458) Catania
Italy Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori ( Site 0462) Meldola Emilia-Romagna
Italy Azienda Ospedaliera San Camillo Forlanini ( Site 0455) Roma
Italy Fondazione Policlinico Universitario A. Gemelli ( Site 0463) Roma
Italy Istituto Clinico Humanitas Research Hospital ( Site 0452) Rozzano Lombardia
Italy Azienda Ospedaliera Santa Maria Terni ( Site 0456) Terni
Italy Presidio Ospedaliero Santa Chiara ( Site 0451) Trento
Japan Chiba Cancer Center ( Site 0704) Chiba
Japan Fuji City General Hospital ( Site 0725) Fuji Shizuoka
Japan Kyushu University Hospital ( Site 0718) Fukuoka
Japan Hamamatsu University Hospital ( Site 0720) Hamamatsu Shizuoka
Japan Saitama Medical University International Medical Center ( Site 0708) Hidaka Saitama
Japan Kanazawa University Hospital ( Site 0701) Kanazawa Ishikawa
Japan Nara Medical University Hospital ( Site 0715) Kashihara Nara
Japan National Cancer Center Hospital East ( Site 0702) Kashiwa Chiba
Japan Kobe City Medical Center General Hospital ( Site 0726) Kobe Hyogo
Japan Dokkyo Medical University Saitama Medical Center ( Site 0707) Koshigaya Saitama
Japan National Hospital Organization Shikoku Cancer Center ( Site 0716) Matsuyama Ehime
Japan University of Miyazaki Hospital ( Site 0721) Miyazaki
Japan Nagano Municipal Hospital ( Site 0723) Nagano
Japan Nagasaki University Hospital ( Site 0719) Nagasaki
Japan Osaka International Cancer Institute ( Site 0722) Osaka
Japan Kindai University Hospital ( Site 0714) Osakasayama Osaka
Japan Kitasato University Hospital ( Site 0705) Sagamihara Kanagawa
Japan Toho University Sakura Medical Center ( Site 0703) Sakura Chiba
Japan Osaka University Hospital ( Site 0713) Suita Osaka
Japan Keio University Hospital ( Site 0710) Tokyo
Japan Nippon Medical School Hospital ( Site 0709) Tokyo
Japan Toranomon Hospital ( Site 0711) Tokyo
Japan Fujita Health University Hospital ( Site 0724) Toyoake Aichi
Japan Yamaguchi University Hospital ( Site 0717) Ube Yamaguchi
Japan Yokohama City University Medical Center ( Site 0706) Yokohama Kanagawa
Korea, Republic of National Cancer Center ( Site 0176) Goyang-si Kyonggi-do
Korea, Republic of Chonnam National University Hwasun Hospital ( Site 0174) Hwasun Gun Jeonranamdo
Korea, Republic of Samsung Medical Center ( Site 0172) Seoul
Korea, Republic of Severance Hospital Yonsei University Health System ( Site 0173) Seoul
Korea, Republic of Asan Medical Center ( Site 0171) Songpagu Seoul
Netherlands Antoni van Leeuwenhoek Ziekenhuis ( Site 0480) Amsterdam Noord-Holland
Netherlands Vrije Universiteit Medisch Centrum ( Site 0479) Amsterdam Noord-Holland
Netherlands Ziekenhuisgroep Twente ( Site 0469) Hengelo Overijssel
Netherlands Spaarne Ziekenhuis ( Site 0473) Hoofddorp Noord-Holland
Netherlands Medisch Centrum Leeuwarden ( Site 0477) Leeuwarden Fryslan
Netherlands Haaglanden MC - locatie Antoniushove ( Site 0471) Leidschendam Zuid-Holland
Netherlands Radboud University Medical Center ( Site 0470) Nijmegen Gelderland
Netherlands Erasmus MC ( Site 0475) Rotterdam Zuid-Holland
Netherlands Franciscus Gasthuis en Vlietland ( Site 0489) Schiedam Zuid-Holland
New Zealand Auckland City Hospital ( Site 0193) Auckland
Russian Federation Chelyabinsk Regional Clinical Oncological Dispensary ( Site 0565) Chelyabinsk Chelyabinskaya Oblast
Russian Federation Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 0585) Krasnoyarsk Krasnoyarskiy Kray
Russian Federation Central Clinical Hospital with Polyclinic ( Site 0562) Moscow Moskva
Russian Federation Russian Scientific Center of Roentgenoradiology ( Site 0559) Moscow Moskva
Russian Federation Omsk Clinical Oncology Dispensary ( Site 0568) Omsk Omskaya Oblast
Russian Federation Clinical Research Center of specialized types medical care-Oncology ( Site 0570) Saint Petersburg Sankt-Peterburg
Russian Federation Russian Scientific Center of Radiology and Surgical Technologies ( Site 0567) Saint Petersburg Sankt-Peterburg
Russian Federation SBHI Leningrad Regional Oncology Dispensary ( Site 0588) Saint Petersburg Sankt-Peterburg
Russian Federation SBHI Samara Regional Clinical Oncology Dispensary ( Site 0576) Samara Samarskaya Oblast
Russian Federation Tomsk National Scientific Medical Center of Russian Academy of Science ( Site 0579) Tomsk Tomskaya Oblast
Spain Hospital Clinic ( Site 0323) Barcelona
Spain Hospital del Mar ( Site 0333) Barcelona
Spain Hospital General Universitari Vall d Hebron ( Site 0334) Barcelona
Spain Hospital San Pedro de Alcantara ( Site 0326) Caceres Extremadura
Spain Hospital Josep Trueta ( Site 0321) Girona Gerona
Spain Instituto Catalan de Oncologia - ICO ( Site 0330) L Hospitalet De Llobregat Barcelona
Spain Hospital Universitario Virgen de la Victoria ( Site 0337) Malaga
Spain Hospital Quiron Madrid ( Site 0325) Pozuelo de Alarcon Madrid
Spain Hospital Parc Tauli ( Site 0335) Sabadell Barcelona
Taiwan China Medical University Hospital ( Site 0132) Taichung
Taiwan Taichung Veterans General Hospital ( Site 0133) Taichung
Taiwan National Cheng Kung University Hospital ( Site 0134) Tainen Tainan
Taiwan National Taiwan University Hospital ( Site 0131) Taipei
Taiwan Taipei Veterans General Hospital ( Site 0135) Taipei
United Kingdom University Hospitals Bristol NHS Foundation Trust ( Site 0530) Bristol Bristol, City Of
United Kingdom Cambridge University Hospitals NHS Trust ( Site 0540) Cambridge Cambridgeshire
United Kingdom Mount Vernon Cancer Centre ( Site 0536) Northwood
United Kingdom University of North Midlands NHS Foundation Trust ( Site 0527) Stoke-on-Trent Staffordshire
United Kingdom Royal Marsden Hospital ( Site 0526) Sutton England
United Kingdom Musgrove Park Hospital ( Site 0537) Taunton England
United Kingdom Torbay Hospital ( Site 0532) Torquay Devon
United States University of New Mexico Cancer Center ( Site 0048) Albuquerque New Mexico
United States Georgia Cancer Center at Augusta University ( Site 0026) Augusta Georgia
United States Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins ( Site 0005) Baltimore Maryland
United States St. Vincent Frontier Cancer Center ( Site 0016) Billings Montana
United States Beth Israel Deaconess Medical Ctr. ( Site 0093) Boston Massachusetts
United States Dana Farber Cancer Institute ( Site 0033) Boston Massachusetts
United States Gabrail Cancer Center-Research ( Site 0097) Canton Ohio
United States Duke Cancer Center Cary ( Site 0010) Cary North Carolina
United States The Urology Group- Cincinnati ( Site 0094) Cincinnati Ohio
United States University Hospitals of Cleveland Seidman Cancer Center ( Site 0036) Cleveland Ohio
United States Barbara Ann Karmanos Cancer Institute ( Site 0077) Detroit Michigan
United States Henry Ford Health System ( Site 0039) Detroit Michigan
United States St. Joseph Heritage Healthcare ( Site 0069) Fullerton California
United States Memorial Medical Center ( Site 0095) Las Cruces New Mexico
United States Comprehensive Cancer Centers of Nevada ( Site 0092) Las Vegas Nevada
United States UCLA Hematology/Oncology - Santa Monica ( Site 0081) Los Angeles California
United States Froedtert and Medical College of Wisconsin ( Site 0045) Milwaukee Wisconsin
United States Carolina Urologic Research Center ( Site 0070) Myrtle Beach South Carolina
United States Tulane Cancer Center ( Site 0066) New Orleans Louisiana
United States Nebraska Cancer Specialists ( Site 0034) Omaha Nebraska
United States Quincy Medical Group ( Site 0021) Quincy Illinois
United States Virginia Cancer Institute ( Site 0052) Richmond Virginia
United States Blue Ridge Cancer Care ( Site 0086) Roanoke Virginia
United States Huntsman Cancer Institute ( Site 0002) Salt Lake City Utah
United States Seattle Cancer Care Alliance ( Site 0079) Seattle Washington
United States Associated Medical Professionals of NY ( Site 0060) Syracuse New York
United States Chesapeake Urology Research Associates ( Site 0076) Towson Maryland
United States Sibley Memorial Hospital ( Site 0096) Washington District of Columbia
United States UMass Memorial Medical Center ( Site 0053) Worcester Massachusetts

Sponsors (1)

Lead Sponsor Collaborator
Merck Sharp & Dohme LLC

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Austria,  Brazil,  Canada,  Chile,  France,  Germany,  Ireland,  Israel,  Italy,  Japan,  Korea, Republic of,  Netherlands,  New Zealand,  Russian Federation,  Spain,  Taiwan,  United Kingdom, 

References & Publications (1)

Antonarakis ES, Park SH, Goh JC, Shin SJ, Lee JL, Mehra N, McDermott R, Sala-Gonzalez N, Fong PC, Greil R, Retz M, Sade JP, Yanez P, Huang YH, Begbie SD, Gafanov RA, De Santis M, Rosenbaum E, Kolinsky MP, Rey F, Chiu KY, Roubaud G, Kramer G, Sumitomo M, M — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Overall Survival (OS) Overall survival (OS) is defined as the time from randomization to death due to any cause. The nonparametric Kaplan-Meier method was used to estimate the survival curves. Up to ~31 months
Primary Radiographic Progression-Free Survival (rPFS) rPFS is defined as the time from randomization to the first documented progressive disease (PD) per PCWG-modified RECIST 1.1 based on BICR or death due to any cause, whichever occurred first. Per PCWG-modified RECIST 1.1, PD is defined as =20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of =5 mm. The appearance of one or more new lesions or =2 new bone lesions was also considered PD. PCWG-modified RECIST is similar to RECIST 1.1 with the exception that a confirmation assessment of PD (>4 weeks after the initial PD) is required for participants who remain on treatment following a documented PD per RECIST 1.1 and PCWG rules include new bone lesions. The rPFS per PCWG-modified RECIST as assessed by BICR for all participants is presented. The nonparametric Kaplan-Meier method was used to estimate the survival curves. Up to ~31 months
Secondary Time to Initiation of the First Subsequent Anticancer Therapy (TFST) TFST is the time from randomization to initiation of the first subsequent anticancer therapy defined as the first anti-cancer treatment not part of the study arm for a given participant, or death, whichever occurs first. The nonparametric Kaplan-Meier method was used to estimate the survival curves. Up to ~31 months
Secondary Objective Response Rate (ORR) ORR is defined as the percentage of participants with Complete Response (CR: disappearance of all target lesions per RECIST 1.1 and no evidence of disease (NED) bone scan) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions per RECIST 1.1 and Non-PD, non-evaluable (NE), or NED bone scan or CR with non-PD or NE bone scan.) The percentage of participants who experienced CR or PR as assessed by BICR is presented. Up to ~31 months
Secondary Duration of Response (DOR) DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death. Per PCWG-modified RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of = 2 new bone lesions is also considered PD. DOR as assessed by BICR is presented. Up to ~24 months
Secondary Time to Prostate-Specific Antigen (PSA) Progression Time to PSA progression is defined as the time from randomization to PSA progression. PSA progression date is defined as the date of:
1) =25% increase and =2 ng/mL above the nadir, confirmed by a second value =3 weeks later if there is PSA decline from baseline, OR 2) =25% increase and =2 ng/mL increase from baseline beyond 12 weeks if there is no PSA decline from baseline. The nonparametric Kaplan-Meier method was used to estimate the survival curves.
Up to ~31 months
Secondary Time to First Symptomatic Skeletal-Related Event (SSRE) SSRE is defined as the time from randomization to the first symptomatic skeletal-related event, defined as whichever occurs first:
First use of external-beam radiation therapy (EBRT) to prevent or relieve skeletal symptoms;
Occurrence of new symptomatic pathologic bone fracture (vertebral or nonvertebral);
Occurrence of spinal cord compression; or
Tumor-related orthopedic surgical intervention
Up to ~31 months
Secondary Time to Radiographic Soft Tissue Progression Time to radiographic soft tissue progression is defined as the time from randomization to radiographic soft tissue progression per soft tissue rule of PCWG-modified RECIST 1.1. Progression is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. Time to radiographic soft tissue progression as assessed by BICR is presented. Up to ~31 months
Secondary Time to Pain Progression (TTPP) TTPP is defined as the time from randomization to pain progression as determined by Item 3 of the Brief Pain Inventory Short Form (BPI-SF) and by the Analgesic Quantification Algorithm (AQA) score.
Pain progression is defined as:
For participants who are asymptomatic at baseline, a =2-point change from baseline in the average (4-7 days) BPI-SF item 3 score at 2 consecutive visits OR initiation of opioid use for pain
For participants who are symptomatic at baseline (average BPI-SF Item 3 score >0 and/or currently taking opioids), a =2-point change from baseline in the average BPI-SF Item 3 score and an average worst pain score =4 and no decrease in average opioid use (=1-point decrease in AQA score from a starting value of 2 or higher) OR any increase in opioid use at 2 consecutive follow-up visits.
Participants who had more than 2 consecutive visits that were not evaluable for pain progression were censored at the last evaluable assessment.
Up to ~31 months
Secondary Number of Participants Who Experience an Adverse Event (AE) An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who experienced an adverse event are presented. Up to ~31 months
Secondary Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE) The number of participants who discontinue study treatment due to an AE are presented. Up to ~880 Days
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