Resumen

Este es un estudio de Fase 3, aleatorizado, abierto, de opevesostat en comparación con abiraterone acetato o enzalutamida alternativos en participantes con cáncer de próstata metastásico resistente a la castración (mCRPC), con respecto a la supervivencia global (SG) en participantes con mCRPC previamente tratados con un agente hormonal de nueva generación (NHA) y quimioterapia basada en taxanos. Se hipotetiza que opevesostat es superior con respecto a la SG en participantes con mutación negativa y positiva en el dominio de unión al ligando del receptor androgénico (AR LBD).

Elegibilidad

Sexo: ALL

Criterios de inclusión

Has histologically- or cytologically-confirmed adenocarcinoma of the prostate without small cell histology.
Has prostate cancer progression while on androgen deprivation therapy (or post bilateral orchiectomy) within 6 months before Screening
Has current evidence of distant metastatic disease (M1 disease) documented by either bone lesions on bone scan and/or soft tissue disease by computed tomography/magnetic resonance imaging (CT/MRI).
Has disease that progressed during or after treatment with 1 novel hormonal agent (NHA)
Has received 1 but no more than 2 taxane-based chemotherapy regimens for metastatic castration-resistant prostate cancer (mCRPC) and has had progressive disease (PD) during or after treatment
Has ongoing androgen deprivation with serum testosterone \<50 ng/dL (\<1.7 nM)
Has provided tumor tissue from a fresh core or excisional biopsy from soft tissue not previously irradiated
Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 assessed within 7 days of randomization
Has had prior treatment with PARPi or were deemed ineligible to receive treatment by the investigator or have refused PARPi treatment
Has received prior 177Lu-PSMA-617 or were deemed ineligible to receive 177Lu-PSMA-617 treatment by the investigator or refused 177Lu-PSMA-617 treatment
Participants who have not received cabazitaxel can be enrolled if they are ineligible for cabazitaxel treatment as determined by the investigator or have refused treatment
If participant received first generation anti-androgen therapy before screening, the participant has evidence of disease progression \>4 weeks since the last flutamide treatment and \>6 weeks since the last bicalutamide or nilutamide treatment
Participants receiving bone resorptive therapy (including, but not limited to, bisphosphonate or denosumab) must have been on stable doses for ≥ 4 weeks before the date of randomization
Participants with human immunodeficiency virus (HIV) infection must have well controlled HIV on antiretroviral therapy (ART)
Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load before randomization
Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at Screening.
Participants who can produce sperm must agree to the following during the study treatment period and for at least 7 days after the last dose of opevesostat, for at least 30 days after the last dose of abiraterone acetate, and for at least 3 months after the last dose of enzalutamide: EITHER be abstinent OR must agree to use male condom

Criterios de exclusión

Has a gastrointestinal disorder that might affect absorption
Has a history of pituitary dysfunction
Has poorly controlled diabetes mellitus
Has clinically significant abnormal serum potassium or sodium level
Has a history of active or unstable cardio/cerebro-vascular disease, including thromboembolic events
Has a history of seizure within 6 months of providing documented informed consent or any condition that may predispose to seizures within 12 months before the date of randomization
Has a history of clinically significant ventricular arrhythmias
Has received an anticancer monoclonal antibody (mAb) within 4 weeks before the date of randomization, or has not recovered from adverse events (AEs) due to mAbs administered more than 4 weeks before the date of randomization
Has undergone major surgery, including local prostate intervention (except prostate biopsy), within 28 days before the date of randomization, and has not recovered from the toxicities and/or complications
Participants who have not adequately recovered from major surgery or have ongoing surgical complications
Has used herbal or medicinal products that may have hormonal anti-prostate cancer activity and/or are known to decrease prostate-specific Antigen (PSA) (eg, saw palmetto, megesterol acetate, citrus pectin polysaccharide) within 4 weeks before the date of randomization
Has received radium-223 or lutetium-177 within 4 weeks before the date of randomization, or has not recovered to Grade ≤1 or baseline from AEs due to radium-223 or lutetium-177 administered more than 4 weeks before the date of randomization
Has received treatment with 5-αreductase inhibitors (eg, finasteride or dutasteride), estrogens, or cyproterone within 4 weeks before the date of randomization
Has received colony-stimulating factors within 28 days before the date of randomization
Has received a whole blood transfusion in the last 120 days before the date of randomization. Packed red blood cells and platelet transfusions are acceptable if not given within 28 days of the date of randomization
Has received prior targeted small molecule therapy or NHA treatment within 4 weeks before the first dose of study intervention as follows: enzalutamide or apalutamide within 3 weeks or abiraterone acetate + prednisone or darolutamide within 2 weeks
Has a "superscan" bone scan
Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study medication
Has a known additional malignancy that is progressing or has required active treatment within the past 3 years
Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
Has an active autoimmune disease that has required systemic treatment in past 2 years
Has an active infection requiring systemic therapy
Has concurrent active HBV or known active HCV infection
Has a history of long QTc syndrome
Has any of the following at Screening Visit: hypotension (systolic BP \<110 mm Hg) or uncontrolled hypertension (systolic BP ≥160 mm Hg or diastolic BP ≥90 mm Hg, in 2 out of 3 recordings with optimized antihypertensive therapy)
Is unable to swallow capsules/tablets
Is currently being treated with cytochrome 450-inducing antiepileptic drugs for seizures
Participants on an unstable dose of thyroid hormone therapy within 6 months before the start of the study intervention
Received prior systemic anticancer therapy including investigational agents within 4 weeks before the first dose of study intervention
Received prior radiotherapy within 2 weeks of start of study intervention, or radiation-related toxicities, requiring corticosteroids
Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
Systemic use of the following medications within 2 weeks before the first dose of study intervention: strong CYP3A4 inducers (eg, avasimibe, carbamazepine, lumacaftor, phenobarbital, rifampicin, rifapentine, or St John's Wort); P-gp inhibitors (eg, erythromycin, clarithromycin, rifampicin, ketoconazole, itraconazole, posaconazole, artesunate-pyronaridine, ritonavir, indinavir, nelfinavir, atazanavir, glecaprevir-pibrentasvir, simeprevir, ledipasvir-sofosbuvir, verapamil, diltiazem, dronedarone, propafenone, quinidine, cyclosporine, valspodar, or milk thistle \[Silybum marianum\])
Use of aldosterone antagonist (eg, spironolactone, eplerenone) and phenytoin within 4 weeks before the start of the study intervention

Intervenciones

drug

Opevesostat

Administered orally

drug

Abiraterone acetate

Administered orally

drug

Enzalutamide

Administered orally

drug

Hydrocortisone

Administered orally or IM as a rescue medication

drug

Fludrocortisone acetate

Administered orally

drug

Prednisone

Administered orally

drug

Dexamethasone

Administered orally as rescue medication

Ubicaciones

Hospital Británico de Buenos Aires-Oncology ( Site 0202)

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Study Coordinator · 1143096839

RECRUITING

Instituto de Investigaciones Clínicas Mar del Plata ( Site 0201)

Mar del Plata, Buenos Aires, Argentina

Study Coordinator · 02234963224

RECRUITING

Instituto Alexander Fleming-Alexander Fleming ( Site 0206)

Buenos Aires, Buenos Aires F.D., Argentina

Study Coordinator · 1-888-577-8839

RECRUITING

Asociación de Beneficencia Hospital Sirio Libanés ( Site 0205)

Buenos Aires, Buenos Aires F.D., Argentina

Study Coordinator · 1-888-577-8839

RECRUITING

Sanatorio Parque ( Site 0208)

Rosario, Santa Fe Province, Argentina

Study Coordinator · 1-888-577-8839

RECRUITING

Hospital Aleman-Oncology ( Site 0207)

Buenos Aires, Argentina

Study Coordinator · 01148277000

RECRUITING

Fundacion Centro Oncologico de Integración Regional-Medical Oncology ( Site 0204)

Mendoza, Argentina

ACTIVE_NOT_RECRUITING

Resumen

Elegibilidad

Criterios de inclusión

Criterios de exclusión

Intervenciones

Opevesostat

Abiraterone acetate

Enzalutamide

Hydrocortisone

Fludrocortisone acetate

Prednisone

Dexamethasone

Ubicaciones

Hospital Británico de Buenos Aires-Oncology ( Site 0202)

Instituto de Investigaciones Clínicas Mar del Plata ( Site 0201)

Instituto Alexander Fleming-Alexander Fleming ( Site 0206)

Asociación de Beneficencia Hospital Sirio Libanés ( Site 0205)

Sanatorio Parque ( Site 0208)

Hospital Aleman-Oncology ( Site 0207)

Fundacion Centro Oncologico de Integración Regional-Medical Oncology ( Site 0204)

Patrocinadores

Contactos

Toll Free Number