E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Castration-Resistant Prostrate Cancer (mCRPC) |
|
E.1.1.1 | Medical condition in easily understood language |
mCRPC is prostate cancer that is resistant to medical (e.g., hormonal) or surgical treatments that lower testosterone, and has spread to other parts of the body |
|
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 | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10036909 |
E.1.2 | Term | Prostate cancer metastatic |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10076506 |
E.1.2 | Term | Castration-resistant prostate cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
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 evaluate the efficacy of atezolizumab/enzalutamide compared with enzalutamide alone |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of atezolizumab/enzalutamide compared with enzalutamide alone To evaluate the safety and tolerability of atezolizumab/enzalutamide compared with enzalutamide alone To characterize the pharmacokinetics (PK)of atezolizumab when given in combination with enzalutamide To characterize the PK of enzalutamide and its active metabolite N-desmethyl enzalutamide when enzalutamide is administered alone or in combination with atezolizumab To evaluate the immune response to atezolizumab
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Eastern Cooperative Oncology Group performance status of 0 or 1 - Life expectancy >= 3 months - Histologically confirmed adenocarcinoma of the prostate - Progressive, castrate-resistant disease prior to screening by prostate-specific antigen (PSA) or imaging per prostate cancer working group 3 (PCWG3) criteria during or following the direct prior line of therapy in the setting of medical or surgical castration - One prior regimen/line of a taxane-containing regimen for mCRPC or refusal or ineligibility of a taxane-containing regimen - Progression on prior regimen/line of an androgen synthesis inhibitor for prostate cancer - Availability of a representative tumor specimen from a site not previously irradiated that is suitable for determination of programmed death ligand 1 (PD L1) status via central testing - Adequate hematologic and end organ function
|
|
E.4 | Principal exclusion criteria |
Cancer-specific exclusions -Prior treatment with enzalutamide or any other newer hormonal androgen receptor inhivitor (e.g. apalutamide, ODM 201) -Treatment with any approved anti-cancer therapy, including chemotherapy, immunotherapy, radiopharmaceutical or hormonal therapy (with the exception of abiraterone), within 4 weeks prior to initiation of study treatment - Treatment with abiraterone within 2 weeks prior to study treatment - Structurally unstable bone lesions suggesting impending fracture - Known or suspected brain metastasis or active leptomeningeal disease General medical exclusions - Major surgical procedure other than for diagnosis within 4 weeks prior to initiation of study treatment or anticipation of need for a major surgical procedure during the course of the study Exclusion criteria related to atezolizumab - Active or history of autoimmune disease or immune deficiency - Prior allogeneic stem cell or solid organ transplantation - History of pulmonary fibrosis/inflammation - Positive HIV test, active hepatitis B or C virus infection, or active tuberculosis - Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti Cytotoxic T Lymphocyte-Associated (CTLA) 4, anti programmed death 1 (PD 1), and anti PD L1 therapeutic antibodies - Treatment with systemic immunostimulatory agents within 4 weeks or five half-lives of the drug, whichever is shorter, prior to initiation of study treatment - Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study Exclusion criteria related to enzalutamide - History of seizure or any condition that may predispose to seizure within 12 months prior to study treatment including history of unexplained loss of consciousness or transient ischemic attack within 12 months prior to study treatment
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Up to approximately 42 months |
|
E.5.2 | Secondary end point(s) |
1. Time to first symptomatic skeletal event 2. Radiographic progression-free survival (rPFS), as assessed by the investigator and adapted from the PCWG3 criteria 3. PSA response rate 4. Time to PSA progression 5. Objective response rate determined by the investigator through use of PCWG3 criteria and immune modified response evaluation criteria in solid tumors criteria 6. Incidence, nature, frequency, and severity of adverse events, with severity determined through use of the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4 7. Serum concentration of atezolizumab at specified timepoints 8. Plasma concentration of enzalutamide and N-desmethyl enzalutamide at specified timepoints in the safety run in phase and in a PK cohort in the randomized phase 9. Incidence of anti-therapeutic antibodies (ATAs) against atezolizumab
|
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-6. Up to approximately 42 months 7. Cycle (C) 1 Day (D) 1, C2D1, C3D1, C4D1, C8D1, C12D1, C16D1; at atezolizumab discontinuation visit; and 120 days after last dose of atezolizumab 8. C1D1, C3D1, and C8D1 9. C1D1, C2D1, C3D1, C4D1, C8D1, C12D1, C16D1; at atezolizumab discontinuation visit; and 120 days after last dose of atezolizumab
|
|
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 | Yes |
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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
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 | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
|
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 97 |
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 | No |
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 |
Australia |
Austria |
Belgium |
Canada |
China |
Czech Republic |
Denmark |
European Union |
France |
Germany |
Greece |
Hungary |
Italy |
Japan |
Korea, Republic of |
Poland |
Russian Federation |
Spain |
Switzerland |
Taiwan |
United Kingdom |
United States |
|
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
|
The end of this study is defined as the earliest date of the following: • Receipt of last data point from the last patient • Sponsor decision to end the study |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 42 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 42 |