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    Clinical Trial Results:
    Targeted drug intervention to inhibit cancer progression in men on active surveillance for prostate cancer. Therapeutics in Active Prostate cancer Surveillance (TAPS01)

    Summary
    EudraCT number
    2017-001700-29
    Trial protocol
    GB  
    Global end of trial date
    25 Jul 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    31 Jul 2020
    First version publication date
    31 Jul 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    TAPS01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03365297
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
    Sponsor organisation address
    Box 277, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom, CB2 0QQ
    Public contact
    Carrie Bayliss, CCTU, +44 1223 596474, cctu@addenbrookes.nhs.uk
    Scientific contact
    Carrie Bayliss, CCTU, +44 1223 596474, cctu@addenbrookes.nhs.uk
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 Mar 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    25 Jul 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Jul 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to test if short-term use of apalutamide can reduce image defined tumour volumes in men with prostate cancer and a detectable lesion on multi-parametric MRI (mpMRI) who are being managed by Active Surveillance (AS).
    Protection of trial subjects
    Drug compliance monitoring throughout treatment (self-administered therapy). Permitted dose reductions and omissions based on presence of drug-related toxicities. safety review every 15 days throughout treatment, using CTCAE v4.03. Laboratory investigations to detect adverse blood results at baseline, every 30 days through treatment, and at follow up. Trial Steering Committee safety review of trial subjects. Quality of life assessments at baseline, every 30 days through treatment, and at follow up.
    Background therapy
    N/A
    Evidence for comparator
    N/A
    Actual start date of recruitment
    05 Jun 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 11
    Worldwide total number of subjects
    11
    EEA total number of subjects
    11
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    2
    From 65 to 84 years
    9
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    First patient first visit: 15 Jun 2018; Last Patient last visit: 25 Jul 2019. 11 patients were enrolled in total in the UK (England), of which 9 were evaluable (target: at least 8 evaluable patients and up to 10) and 2 were non-evaluable. Evaluability was as per defined in the protocol. 1 patient did not complete treatment and 1 did not start.

    Pre-assignment
    Screening details
    A total of 31 patients were screened according to the eligibility criteria defined in the protocol, of which 11 were enrolled into the trial. Out of the 20 patients not enrolled, 4 patients were deemed non-eligible and 16 did not enrolled into the study due to a variety of reasons (personal, health, IMP concerns, no reason given and lost contact)

    Period 1
    Period 1 title
    Overall Period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Apalutamide
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Apalutamide
    Investigational medicinal product code
    ARN509
    Other name
    Erleada
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Patients were administered 240 mg (four 60 mg tablets) of apalutamide orally, once daily, for 90 consecutive days. Tablets to be swallowed whole with or without food. Protocol allowed for one dose reduction per subject to 120 mg daily. The dose was not permitted to be re-escalated back to 240 mg daily. A temporary break in apalutamide was acceptable in the event of a non-drug related AE. Patients were allowed to re-start apalutamide, at the previous dose, if the reason for the break had resolved within 30 days and patients did not meet the withdrawal criteria, as per defined in the study protocol. Dose modifications were also allowed for patients presenting drug-related adverse reactions, as per defined in the trial protocol (including but not limited to rash and pruritus with no rash).

    Number of subjects in period 1 [1]
    Apalutamide
    Started
    10
    Completed
    9
    Not completed
    1
         Adverse event, non-fatal
    1
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: The baseline period accounts for extra participants that were consented but did not meet the eligibility criteria to be formally enrolled in the trial.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Period
    Reporting group description
    -

    Reporting group values
    Overall Period Total
    Number of subjects
    10 10
    Age categorical
    Units: Subjects
        60-69 years
    4 4
        70-74 years
    5 5
        75 plus years
    1 1
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    70 ( 5 ) -
    Gender categorical
    Units: Subjects
        Female
    0 0
        Male
    10 10
    ECOG
    Units: Subjects
        No
    0 0
        Yes
    10 10
    ECOG performance status
    Units: Subjects
        Zero
    10 10
        One
    0 0
        Two
    0 0
    T stage
    Units: Subjects
        T1
    0 0
        T2
    10 10
    Prostate cancer histology
    Units: Subjects
        Adenocarcinoma
    10 10
        Other
    0 0
    Gleason Grade: Grade X:
    Units: Subjects
        Gleason sum 6
    10 10
        Gleason =7
    0 0
        Gleason >=8
    0 0
    Gleason Grade: Grade Y
    Units: Subjects
        Gleason sum 6
    10 10
        Gleason =7
    0 0
        Gleason >=8
    0 0
    Height (cm):
    Units: cm
        arithmetic mean (standard deviation)
    173 ( 6 ) -
    Weight
    Units: Kg
        arithmetic mean (standard deviation)
    78.4 ( 8.6 ) -
    Pulse
    Units: beats/min
        arithmetic mean (standard deviation)
    71 ( 15 ) -
    Systolic blood pressure
    Units: mmHg
        arithmetic mean (standard deviation)
    139 ( 12 ) -
    Diastolic blood pressure
    Units: mmHg
        arithmetic mean (standard deviation)
    80 ( 6 ) -
    Temperature
    Units: Degress celcious
        arithmetic mean (standard deviation)
    36.6 ( 0.3 ) -

    End points

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    End points reporting groups
    Reporting group title
    Apalutamide
    Reporting group description
    -

    Primary: Percentage change in tumour size measured by mpMRI (tumour volume - cm3)

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    End point title
    Percentage change in tumour size measured by mpMRI (tumour volume - cm3) [1]
    End point description
    Percentage change in tumour size measured by mpMRI (tumour volume3) or absence of a lesion between baseline and day 90. The percentage of patients achieving tumour downsizing with their 95% confidence interval was estimated using the primary lesion (i.e. the largest lesion if a patient had more than one lesion).
    End point type
    Primary
    End point timeframe
    Tumour volume (cm^3) change from baseline at day 90.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: It's a single arm study.
    End point values
    Apalutamide
    Number of subjects analysed
    9
    Units: tumour volume (cm^3)
    arithmetic mean (standard deviation)
        Percentage change
    51.86 ( 17.1 )
    No statistical analyses for this end point

    Other pre-specified: Change in total tumour volume

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    End point title
    Change in total tumour volume
    End point description
    Percentage change in total tumour size measured by mpMRI (tumour volume3) or absence of a lesion between baseline and day 90.
    End point type
    Other pre-specified
    End point timeframe
    Percentage change from baseline at day 90
    End point values
    Apalutamide
    Number of subjects analysed
    9
    Units: total tumour volume - cm^3
        arithmetic mean (standard deviation)
    52.4 ( 17.4 )
    No statistical analyses for this end point

    Other pre-specified: Change in gland volume

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    End point title
    Change in gland volume
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Gland volume (cm^3) change from baseline at day 90
    End point values
    Apalutamide
    Number of subjects analysed
    9
    Units: Gland volume in cm^3
        arithmetic mean (standard deviation)
    36.2 ( 8.7 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Timeframe for AE
    Adverse event reporting additional description
    AE additional description
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Treatment
    Reporting group description
    -

    Serious adverse events
    Treatment
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 10 (10.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Investigations
    Neutrophil Count Decreased
    Additional description: Neutrophil Count Decreased
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Treatment
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 10 (100.00%)
    Vascular disorders
    Hot flashes
    Additional description: Hot flashes
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Hypertension
    Additional description: Hypertension
         subjects affected / exposed
    3 / 10 (30.00%)
         occurrences all number
    4
    General disorders and administration site conditions
    Fatigue
    Additional description: Fatigue
         subjects affected / exposed
    4 / 10 (40.00%)
         occurrences all number
    6
    Flu like symptoms
    Additional description: Flu like symptoms
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Nipple tenderness
    Additional description: Nipple tenderness
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Non-cardiac chest pain
    Additional description: Non-cardiac chest pain
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Pain
    Additional description: Pain
         subjects affected / exposed
    2 / 10 (20.00%)
         occurrences all number
    2
    Reproductive system and breast disorders
    Breast pain
    Additional description: Breast pain
         subjects affected / exposed
    4 / 10 (40.00%)
         occurrences all number
    4
    Erectile Dysfunction
    Additional description: Erectile Dysfunction
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Laryngeal inflammation
    Additional description: Laryngeal inflammation
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
    Additional description: Anxiety
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Libido decreased
    Additional description: Libido decreased
         subjects affected / exposed
    2 / 10 (20.00%)
         occurrences all number
    2
    Investigations
    Alanine aminotransferase increased
    Additional description: Alanine aminotransferase increased
         subjects affected / exposed
    6 / 10 (60.00%)
         occurrences all number
    6
    Aspartate aminotransferase increased
    Additional description: Aspartate aminotransferase increased
         subjects affected / exposed
    3 / 10 (30.00%)
         occurrences all number
    3
    Lymphocyte count decreased
    Additional description: Lymphocyte count decreased
         subjects affected / exposed
    4 / 10 (40.00%)
         occurrences all number
    8
    Serum amylase increased
    Additional description: Serum amylase increased
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    White Blood Cell Decreased
    Additional description: White Blood Cell Decreased
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Nervous system disorders
    Dizziness
    Additional description: Dizziness
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Dysgeusia
    Additional description: Dysgeusia
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Headache
    Additional description: Headache
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anemia
    Additional description: Anemia
         subjects affected / exposed
    2 / 10 (20.00%)
         occurrences all number
    2
    Ear and labyrinth disorders
    Vertigo
    Additional description: Vertigo
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    2
    Gastrointestinal disorders
    Abdominal Pain
    Additional description: Abdominal Pain
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Dyspepsia
    Additional description: Dyspepsia
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Vomiting
    Additional description: Vomiting
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Pruritus
    Additional description: Pruritus
         subjects affected / exposed
    3 / 10 (30.00%)
         occurrences all number
    3
    Rash maculo-papular
    Additional description: Rash maculo-papular
         subjects affected / exposed
    2 / 10 (20.00%)
         occurrences all number
    5
    Renal and urinary disorders
    Cystitis Noninfective (Nocturia)
    Additional description: Cystitis Noninfective (Nocturia)
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Cystitis noninfective (Dysuria)
    Additional description: Cystitis noninfective (Dysuria)
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Proteinuria
    Additional description: Proteinuria
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Renal and urinary disorders - Other,
    Additional description: Renal and urinary disorders - Other,
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Urinary Frequency
    Additional description: Urinary Frequency
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    2
    Urinary Tract Pain
    Additional description: Urinary Tract Pain
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Endocrine disorders
    Hyperthyroidism
    Additional description: Hyperthyroidism
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
    Additional description: Arthralgia
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Infections and infestations
    Upper respiratory tract infection
    Additional description: Upper respiratory tract infection
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Hypertriglyceridemia
    Additional description: Hypertriglyceridemia
         subjects affected / exposed
    8 / 10 (80.00%)
         occurrences all number
    10
    Metabolism and nutrition disorders
    Additional description: Metabolism and nutrition disorders
         subjects affected / exposed
    1 / 10 (10.00%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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