E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Castration-Resistant Prostrate Cancer (mCRPC) |
Tumore della prostata metastatico resistente alla castrazione (mCRPC) |
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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 |
mCRPC è un tumore della prostata resistente a trattamenti medici (es. ormonali) o chirurgici che abbassano il livello di testosterone, e che si è diffuso in altre parti del corpo. |
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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 | 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) |
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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) |
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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 evaluate the efficacy of atezolizumab/enzalutamide compared with enzalutamide alone |
Valutare l¿efficacia di atezolizumab/enzalutamide rispetto a enzalutamide in monoterapia |
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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
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Valutare l¿efficacia di atezolizumab/enzalutamide rispetto a enzalutamide in monoterapia Valutare la sicurezza e la tollerabilit¿ di atezolizumab/enzalutamide rispetto a enzalutamide in monoterapia Caratterizzare la farmacocinetica di atezolizumab quando somministrato in associazione a enzalutamide Caratterizzare la farmacocinetica di enzalutamide e del suo metabolita attivo N-desmetil enzalutamide quando enzalutamide ¿ somministrata in monoterapia o in associazione ad atezolizumab Valutare la risposta immunitaria ad atezolizumab |
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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 - Progresion 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
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• Performance status ECOG pari a 0 o 1 • Aspettativa di vita = 3 mesi • Adenocarcinoma della prostata istologicamente confermato • Progressione della malattia prima dello screening, durante o dopo una linea di terapia precedente nell’ambito di una castrazione medica o chirurgica, definita in base ai valori del PSA o delle immagini radiologiche valutate secondo i criteri PCWG3 • Una precedente linea di trattamento per l’mCRPC a base di taxani. Sono altresì arruolabili pazienti che hanno rifiutato o sono ineleggibili ad una linea di trattamento a base di Taxani • Progressione durante una precedente linea di trattamento/regime con un inibitore della sintesi degli androgeni per il trattamento del carcinoma prostatico • Disponibilità di un campione tumorale rappresentativo prelevato da una sede non precedentemente irradiata, che sia adatto per la determinazione dello stato del ligando di morte programmata-1 (PD L1) tramite analisi condotta a livello centrale • Adeguata funzione ematologica e degli organi |
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E.4 | Principal exclusion criteria |
Cancer-specific exclusions - Prior treatment with enzalutamide or any other newer hormonal androgen receptor inhibitor (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 unexplained loss of consciousness or transient ischemic attack
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Criteri di esclusione specifici del tumore • Precedente trattamento con enzalutamide o qualunque altro inibitore dei recettori degli androgeni di nuova generazione (es: apalutamide, ODM-201). • Trattamento con qualsiasi terapia antineoplastica approvata, incluse chemioterapia, immunoterapia, terapia con radiofarmaci o terapia ormonale (con l’eccezione dell’abiraterone), nelle 4 settimane precedenti l’inizio del trattamento in studio • Trattamento con abiraterone nelle 2 settimane precedenti l’inizio del trattamento in studio • Lesioni ossee strutturalmente instabili che suggeriscono una frattura imminente • Metastasi cerebrali note o sospette o malattia leptomeningea attiva Criteri medico-generici di esclusione • Procedura chirurgica maggiore, se non a scopo diagnostico, nelle 4 settimane precedenti l’avvio del trattamento in studio o previsione della necessità di una procedura chirurgica maggiore durante il corso dello studio Criteri di esclusione correlati ad atezolizumab • Malattia autoimmune o deficit immunologico attivi o in anamnesi • Precedente trapianto allogenico di cellule staminali o organi solidi • Anamnesi di fibrosi polmonare idiopatica/polmonite • Positività al test per l’HIV, infezione attiva da virus dell’epatite B o C, o tubercolosi • Precedente trattamento con agonisti di CD137 o con terapie di blocco del checkpoint immunitario, inclusi anticorpi terapeutici anti-CTLA-4, anti-morte programmata 1 (PD-1) e anti-PD-L1 • Trattamento con agenti immunostimolatori per via sistemica nelle 4 settimane o cinque emivite del farmaco precedenti l’avvio del trattamento in studio, a seconda di quale sia il periodo più lungo • Trattamento con medicinali immunosoppressori per via sistemica nelle 2 settimane precedenti l’avvio del trattamento in studio Criteri di esclusione correlati a enzalutamide • Precedenti di convulsioni o di qualsiasi altra patologia che potrebbe predisporre alle convulsioni, nei 12 mesi precedenti l’inizio del trattamento in studio, compresi precedenti di perdita di coscienza inspiegabile o attacco ischemico transitorio |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Overall survival (OS) |
1. Sopravvivenza complessiva (OS) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Up to approximately 42 months |
1. Fino a circa 42 mesi |
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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 |
1. Tempo al primo Evento Scheletrico Sintomatico 2. Sopravvivenza libera da progressione radiografica (rPFS), valutata dallo sperimentatore e adattata dai criteri PCWG3 3. Tasso di risposta del PSA 4. Tempo alla progressione del PSA 5. Tasso di risposta obiettiva rilevata dallo sperimentatore attraverso l'uso dei criteri PCWG3 e dei criteri RECIST modificati per l'immunoterapia 6. Incidenza, natura, frequenza e severità degli eventi avversi, la cui gravità sarà stabilita mediante i criteri NCI CTCAE v 4.0 7. Concentrazioni sieriche di atezolizumab in momenti temporali specifici 8. Concentrazioni plasmatiche di enzalutamide e N desmetil enzalutamide in momenti temporali specifici nella fase di run-in di sicurezza e in una coorte di PK nella fase randomizzata 9. Incidenza di anticorpi anti-terapeutici (ATA) diretti contro atezolizumab |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-6. Fino a circa 42 mesi 7. Ciclo (C) 1 Giorno (D) 1, C2D1, C3D1, C4D1, C8D1, C12D1, C16D1; alla visita di discontinuazione di atezolizumab; e 120 giorni dopo l'ultima dose di atezolizumab 8. C1D1, C3D1, e C8D1 9. C1D1, C2D1, C3D1, C4D1, C8D1, C12D1, C16D1; alla visita di discontinuazione di atezolizumab; e 120 giorni dopo l'ultima dose di atezolizumab |
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 |
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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 | 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 |
Enzalutamide |
Enzalutamide |
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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 | 14 |
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 | 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 |
Australia |
Canada |
China |
Japan |
Korea, Republic of |
Russian Federation |
Taiwan |
United States |
Austria |
Belgium |
Denmark |
France |
Germany |
Greece |
Hungary |
Italy |
Poland |
Spain |
Switzerland |
European Union |
United Kingdom |
Czechia |
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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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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 |
La conclusione di questo studio coincider¿ con la manifestazione di uno dei seguenti eventi: ¿ Acquisizione degli ultimi dati dell¿ultimo paziente ¿ Decisione dello sponsor di porre fine allo studio |
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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 | 0 |
E.8.9.1 | In the Member State concerned months | 42 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 42 |
E.8.9.2 | In all countries concerned by the trial days | 0 |