E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
High- or very-high risk, localized or locally advanced prostate cancer |
Cancro alla prostata ad alto o altissimo rischio, localizzato o localmente avanzato |
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E.1.1.1 | Medical condition in easily understood language |
prostate cancer |
cancro alla prostata |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10029104 |
E.1.2 | Term | Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine if Apalutamide plus gonadotropin releasing hormone (GnRH) agonist in subjects with high-risk, localized or locally advanced prostate cancer receiving primary radiation therapy (RT) results in an improvement of metastasis-free survival (MFS) evaluated by blinded independent central review (BICR) |
Determinare se Apalutamide, in associazione con un agonista dell'ormone secernente gonadotropina (GnRH) in soggetti con cancro alla prostata ad alto rischio, localizzato o localmente avanzato, candidati alla radioterapia primaria, porta ad un aumento nella sopravvivenza libera da metastasi (MFS) valutata da review indipendente in cieco (BICR) |
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E.2.2 | Secondary objectives of the trial |
- To characterize the safety profile of Apalutamide plus GnRH agonist in subjects with high-risk, localized or locally advanced prostate cancer receiving primary RT - To determine if JNJ-56021927 plus GnRH agonist in subjects with highrisk, localized or locally advanced prostate cancer receiving primary RT results in an improvement of: -- Time to local-regional recurrence -- Time to castration-resistant prostate cancer (CRPC) -- Time to distant metastasis -- Overall survival (OS) |
- Caratterizzare il profilo di sicurezza di Apalutamide in associazione con un agonista del GnRH in pazienti con cancro alla prostata ad alto rischio, localizzato o localmente avanzato, candidati a radioterapia primaria (RT) - determinare se Apalutamide in associazione con un agonista di GnRH in pazienti con cancro alla prostata ad alto rischio, localizzato o localmente avanzato, candidati a radioterapia primaria (RT) porta a miglioramento in: -- tempo alla ricorrenza loco-regionale -- tempo di resistenza alla castrazione del carcinoma prostatico (CRPC) -- tempo alla comparsa di una metastasi distante -- sopravvivenza globale (overall survival) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Age >= 18 years - Indicated and planned to receive primary radiation therapy for prostate cancer - Histologically confirmed adenocarcinoma of an intact prostate, and 1 of the following at diagnosis: 1) Gleason score >=8 and >=cT2c stage per AJCC 8th Edition, 2) Gleason score >=7, PSA >=20 nanogram per mililiters (ng/mL), and >=cT2c stage per AJCC 8th Edition - Charlson comorbidity index (CCI) <=3 - An Eastern Cooperative Oncology Group (ECOG) Performance Status(PS) grade of 0 or 1 - Adequate organ function: aspartate aminotransferase (AST), alanine aminotransferase (ALT), <2 * within limit of normal (ULN). - total bilirubin WNL - Serum Creatinine <1.5 mg / dL (<133 µmol / L) - Platelets> = 140,000 / µL, independent of transfusion and / or growth factors within 3 months before randomization - Hemoglobin> = 12.0 g / dL (7.4 mmol), independent of transfusion and / or growth factors within 3 months before randomization - Participants who are sexually active (even men with vasectomies) and willing to use a condom and agree not to donate sperm during the trial - Signed, written, informed consent - Be able to swallow whole study drug tablets |
- età maggiore di 18 anni; - candidati a radioterapia primaria per cancro alla prostata; - adenocarciroma di una prostata intatta istologicamente confermato, e una delle seguenti diagnosi: 1) Punteggio Gleason >=8 e >=cT2c stage per AJCC 8th Edition; 2) Punteggio Gleason >=7, PSA >=20 nanogrammi per millilitro e >=cT2c stage per AJCC 8th Edition; - Charlson comorbidity index (CCI) <=3 - Eastern Cooperative Oncology Group (ECOG) Performance Status(PS) grado 0 o 1; - adeguata funzionalità dell’organo determinata dai seguenti valori del laboratorio centrale: 1) aspartato aminotransferasi (AST), alanina aminotrasferasi (ALT) entro limiti di normalità (WNL) - bilirubina totale WNL - Creatinina Sierica <1.5 mg/dL (<133 µmol/L) - Piastrine >= 140.000/µL, indipendente da trasfusione e/o dai fattori di crescita entro 3 mesi prima della randomizzazione - Emoglobina >= 12.0 g/dL (7.4 mmol), indipendente da trasfusione e/o dai fattori di crescita entro 3 mesi prima della randomizzazione. - partecipanti sessualmente attivi (anche uomini vasectomizzati) disposti ad utilizzare preservativo e acconsentono a non donare lo sperma durante lo studio; - firmare un consenso informato scritto; - essere in grado di inghiottire le compresse intere |
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E.4 | Principal exclusion criteria |
- Presence of distal metastases (clinical stage M1). Pelvic nodal disease isolated under the iliac bifurcation (clinical stage N1) is not an exclusion. The diagnosis of distal metastases (clinical M stage; M0 versus M1a, M1b, M1c) and pelvic nodal disease (clinical N stage; N1 versus N0) will be assessed by central radiological examination. Patients are considered eligible only if the central radiological examination confirms the clinical stage M0. - Prior treatment with GnRH analogue or antiandrogen or both for >3 months prior to randomization - Bilateral orchiectomy - History of pelvic radiation - Prior systemic (eg, chemotherapy) or local (eg, prostatectomy, cryotherapy) treatment for prostate cancer - History of seizure or any other condition that may predispose to seizure (including, but not limited to prior stroke, transient ischemic attack or loss of consciousness <= 1 year prior to randomization; brain arteriovenous malformation; or intracranial masses such as schwannomas and meningiomas that are causing edema or mass effect) - Prior treatment with enzalutamide, abiraterone acetate, orteronel, galeterone, ketoconazole, aminoglutethimide, estrogens, megestrol acetate, and progestational agents for prostate cancer (cyproterone acetate included) - Prior treatment with radiopharmaceutical agents (eg, strontium 89) or immunotherapy (eg, sipuleucel-T) for prostate cancer - Prior treatment with systemic glucocorticoids =4 weeks prior to randomization or is expected to require long-term use of corticosteroids during the study - Use of 5-alpha reductase inhibitors (eg, dutasteride, finasteride) <=4 weeks prior to randomization - Use of any investigational agent <=4 weeks prior to randomization - Current chronic use of opioid analgesics for >=3 weeks for oral or >7 days for non-oral formulations - Major surgery <=4 weeks prior to randomization - Current or prior treatment with antiepileptic medications for the treatment of seizures - Gastrointestinal conditions affecting absorption - Known or suspected contraindications or hypersensitivity to Apalutamide, bicalutamide or GnRH agonists or any of the components of the formulations - Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject |
- Presenza di metastasi distali (clinical stage M1). La malattia nodale pelvica isolata sotto la biforcazione iliaca (clinical stage N1) non è un’esclusione. La diagnosi di metastasi distali (clinical M stage; M0 versus M1a, M1b, M1c) e la malattia nodale pelvica (clinical N stage; N1 versus N0) sarà valutata mediante esame radiologico centrale. I pazienti sono considerati eleggibili solo se l’esame radiologico centrale conferma il clinical stage M0. - trattamento precedente con analoghi del GnRH o antiandrogeni o entrambi per un tempo superiore a 3 mesi prima della randomizzazione; - orchiectomia bilaterale; - storia di terapia con radiazioni alle pelvi; - precedenti trattamenti sistemici (chemioterapia) o locali(prostatectomia radicale, crioterapia) per il trattamento del cancro alla prostata; - storia di convulsioni o qualsiasi condizioni che potrebbero predisporre a convulsioni (incluso ma non limitato a: ictus, attacchi ischemici transitori o perdita di coscienza nell'ultimo anno prima della randomizzazione); malformazioni cerebrali aterovenose, masse intracraniche come schwannomi e meningiomi che causino edema o compressione; - trattamenti precedenti con enzalutamide, abiraterone acetato, orteronel, galeterone, chetoconazolo, aminoglutetimide, estrogeni, megestrol acetato, agenti progestinici (incluso il ciproterone acetato) per cancro alla prostata; - trattamenti precedenti con radiofarmaci (es: stronzio 89) o immunoterapia (es: sipuleucel-T) per il cancro alla prostata; - trattamenti precedenti con glucocorticoidi sistemici, entro 4 settimane dalla randomizzazione o ci si aspetta un uso a lungo termine di corticosteroidi durante lo studio; - uso di inibitori della 5-alfa-reduttasi (es: dutasteride e finasteride) entro 4 settimane prima della randomizzazione); - uso di altri farmaci sperimentali entro 4 settimane prima della randomizzazione; - uso cronico o attuale di analgesici oppioidi per un periodo maggiore uguale a 3 settimane per via orale o maggiore a 7 giorni per formulazioni non orali; - chirurgia maggiore entro 4 settimane dalla randomizzazione; trattamenti correnti o precedenti con farmaci antiepilettici per il trattamento delle convulsioni; condizioni gastrointestinali agenti sull'assorbimento; -controindicazioni o ipersensibilità conosciute o sospettate al prodotto Apalutamide, alla bicalutamide, o agli agonisti GnRH o qualsiasi componente delle formulazioni; - qualsiasi condizione per cui, secondo l'opinione del medico, la partecipazione allo studio non sarebbe nell'interesse del paziente |
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E.5 End points |
E.5.1 | Primary end point(s) |
Metastasis-free survival |
sopravvivenza libera da metastasi |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- Time to Local-regional Recurrence - Time to Castration-resistant Prostate Cancer (CRPC) - Time to Distant Metastasis - overall survival (OS) |
- tempo alla ricorrenza loco-regionale - tempo di resistenza alla castrazione del carcinoma prostatico (CRPC) - tempo alla comparsa di una metastasi distante - sopravvivenza globale (OS)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
- 72 months - 72 months - 72 months - 72 months
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- 72 mesi - 72 mesi - 72 mesi - 72 mesi |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 18 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 375 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Brazil |
Canada |
China |
Israel |
Korea, Republic of |
Malaysia |
Mexico |
Russian Federation |
Taiwan |
Turkey |
United States |
Belgium |
Bulgaria |
France |
Germany |
Italy |
Netherlands |
Poland |
Romania |
Spain |
Sweden |
United Kingdom |
Czechia |
Argentina |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 9 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 9 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |