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    Summary
    EudraCT Number:2017-003295-31
    Sponsor's Protocol Code Number:C3441021
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-21
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2017-003295-31
    A.3Full title of the trial
    A Phase 3, Randomized, Double-blind, Placebo-controlled Study Of Talazoparib With Enzalutamide In Metastatic Castration-resistant Prostate Cancer
    STUDIO CONTROLLATO CON PLACEBO DI FASE 3, RANDOMIZZATO, IN DOPPIO CIECO, SU TALAZOPARIB CON ENZALUTAMIDE NEL TUMORE PROSTATICO METASTATICO, RESISTENTE ALLA CASTRAZIONE
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study Of Talazoparib With Enzalutamide In Metastatic Castration-resistant Prostate Cancer
    Studio di Talazoparib con Enzalutamide nel Tumore Prostatico Metastatico, Resistente alla Castrazione
    A.3.2Name or abbreviated title of the trial where available
    TALAPRO-2
    TALAPRO-2
    A.4.1Sponsor's protocol code numberC3441021
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03395197
    A.5.4Other Identifiers
    Name:US INDNumber:129,642
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPFIZER INC
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPfizer Inc., 235 East 42nd Street, New York, NY 10017
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc
    B.5.2Functional name of contact pointClinical Trials.gov Call Center
    B.5.3 Address:
    B.5.3.1Street Address235 East 42nd Street
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeNY 10017
    B.5.3.4CountryUnited States
    B.5.4Telephone number0018007181021
    B.5.5Fax number0013037391119
    B.5.6E-mailclinicaltrials.govcallcenter@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTalazoparib
    D.3.2Product code [PF-06944076]
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTalazoparib
    D.3.9.2Current sponsor codePF-06944076
    D.3.9.3Other descriptive nameTALAZOPARIB TOSYLATE
    D.3.9.4EV Substance CodeSUB183862
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Xtandi
    D.2.1.1.2Name of the Marketing Authorisation holderAstellas Pharma Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameXtandi 40 mg soft capsules
    D.3.2Product code [ENZALUTAMIDE]
    D.3.4Pharmaceutical form Capsule, soft
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNENZALUTAMIDE
    D.3.9.1CAS number 915087-33-1
    D.3.9.2Current sponsor codeEnzalutamide
    D.3.9.4EV Substance CodeSUB77412
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTalazoparib
    D.3.2Product code [PF-06944076]
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTalazoparib
    D.3.9.2Current sponsor codePF-06944076
    D.3.9.3Other descriptive nameTALAZOPARIB TOSYLATE
    D.3.9.4EV Substance CodeSUB183862
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Metastatic Castration-resistant Prostate Cancer
    TUMORE PROSTATICO METASTATICO, RESISTENTE ALLA CASTRAZIONE
    E.1.1.1Medical condition in easily understood language
    Metastatic Castration-resistant Prostate Cancer
    TUMORE PROSTATICO METASTATICO, RESISTENTE ALLA CASTRAZIONE
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10036909
    E.1.2Term Prostate cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10076506
    E.1.2Term Castration-resistant prostate cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    - To demonstrate that talazoparib in combination with enzalutamide is superior to placebo in combination with enzalutamide in prolonging rPFS, in patients with mCRPC unselected for DDR status.
    - To demonstrate that talazoparib in combination with enzalutamide is superior to placebo in combination with enzalutamide in prolonging rPFS, in patients with mCRPC harboring DDR deficiencies.
    • Dimostrare che talazoparib in combinazione con enzalutamide è superiore a placebo in combinazione con enzalutamide nel prolungare la sopravvivenza libera da progressione radiografica (rPFS) in pazienti con mCRPC non selezionati per lo stato DDR.
    • Dimostrare che talazoparib in combinazione con enzalutamide è superiore a placebo in combinazione con enzalutamide nel prolungare la rPFS in pazienti con mCRPC portatori di deficit DDR.
    E.2.2Secondary objectives of the trial
    Key Seconday Objectives
    - To demonstrate that talazoparib in combination with enzalutamide is superior to placebo in combination with enzalutamide in prolonging OS in patients with mCRPC unselected for DDR status.
    - To demonstrate that talazoparib in combination with enzalutamide is superior to placebo in combination with enzalutamide in prolonging OS in patients with mCRPC harboring DDR deficiencies.

    Other Secondary Objectives:
    - To evaluate anti-tumor activity in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies with respect to the following:
    - Objective response in measurable soft tissue disease;
    - Duration of response in measurable soft tissue disease;
    - PSA response;
    - Time to PSA progression;
    - Time to initiation of cytotoxic chemotherapy;
    - Time to initiation of antineoplastic therapy;
    - Time to first symptomatic skeletal event;
    - PFS on next line therapy (PFS2);
    • Dimostrare che talazoparib in combinazione con enzalutamide è superiore a placebo in combinazione con enzalutamide nel prolungare la sopravvivenza complessiva (OS) in pazienti con mCRPC non selezionati per lo stato DDR.
    • Dimostrare che talazoparib in combinazione con enzalutamide è superiore a placebo in combinazione con enzalutamide nel prolungare l’OS in pazienti con mCRPC portatori di deficit DDR.
    Altri obiettivi secondari:
    • Valutare l’attività antitumorale in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR rispetto ai seguenti parametri:
    • risposta obiettiva della malattia dei tessuti molli misurabile;
    • durata della risposta della malattia dei tessuti molli misurabile;
    • risposta dell’antigene prostatico specifico (PSA);
    • tempo alla progressione del PSA;
    • tempo all’avvio di una chemioterapia citotossica;
    • tempo all’avvio di una terapia antineoplastica;
    • tempo al primo evento scheletrico sintomatico
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Patients must meet all of the following inclusion criteria to be eligible for
    enrollment into the study:
    1. At least 18 years of age. For Japan, at least 20 years of age.
    2. Histologically or cytologically confirmed adenocarcinoma of the prostate without small cell or signet cell features. If the patient does not have a prior histological diagnosis, a baseline de novo biopsy must be used to confirm the diagnosis and to support biomarker analysis.
    3. Asymptomatic or mildly symptomatic metastatic castration resistant prostate cancer (mCRPC) (score on BPI-SF Question #3 must be <4).
    4. For enrollment into Part 2 only (optional in Part 1): assessment of DDR mutation status by prospective analysis (de novo or archival tissue), or historical analysis (with Sponsor pre-approval), of most recent tumor tissue per FoundationOne testing. (Note: for patients enrolling in Part 1, DDR deficiency testing is optional).
    5. For enrollment into Part 2 only (optional for Part 1): Unless prohibited by local regulations or ethics committee decision, consent to a saliva sample collection for retrospective sequencing of the same DDR genes tested on tumor tissue, or a subset thereof, and to serve as a germline control in identifying tumor mutations.
    6. Surgically or medically castrated, with serum testosterone =50 ng/dL (=1.73 nmol/L) at screening. Or ongoing androgen deprivation therapy with a gonadotropin releasing hormone (GnRH) agonist or antagonist for patients who have not undergone bilateral orchiectomy must be initiated at least 4 weeks before Day 1 (Part 1) or randomization (Part 2) and must continue throughout the study.
    7. Metastatic disease in bone documented on bone scan or in soft tissue documented on CT/MRI scan. Scans obtained as part of standard of care in the 6 weeks (42 days) prior to Day 1 (Part 1) or randomization (Part 2) can be used if they meet study requirements (Table 2). Measurable soft tissue disease is not required. (Adenopathy below the aortic bifurcation alone does not qualify).
    8. Progressive disease at study entry in the setting of medical or surgical castration as defined by 1 or more of the following 3 criteria:
    - Prostate specific antigen (PSA) progression defined by a minimum of 2 rising PSA values from 3 consecutive assessments with an interval of at least 7 days between assessments. The screening laboratory PSA value must be =2 ¿g/L (=2 ng/mL) if qualifying solely by PSA progression.
    - Soft tissue disease progression as defined by RECIST 1.1.
    - Bone disease progression defined by Prostate Cancer Working Group 3 (PCWG3) with 2 or more new metastatic bone lesions on a whole body radionuclide bone scan.
    9. Bisphosphonate or denosumab dosage must have been stable for at least 4 weeks before Day 1 (Part 1) or randomization (Part 2) for patients receiving these therapies.
    10. Eastern Cooperative Oncology Group (ECOG) performance status =1.
    11. Life expectancy >/-12 months as assessed by the investigator.
    12. Able to swallow the study treatment and have no known intolerance to study treatments or excipients.
    13. Sexually active participants that in the opinion of the investigator are capable of ejaculating, must agree to use a condom when having sex with a partner (female or male) from the time of the first dose of study treatment through 4 months after last dose of study treatment. Must also agree for female partner of childbearing potential to use an additional highly effective form of contraception (Section 4.4.1) from the time of the first dose of study treatment through 4 months after last dose of study treatment when having sex with a non-pregnant female
    partner of childbearing potential.
    14. Must agree not to donate sperm from the first dose of study treatment to 4 months after the last dose of study treatment.
    Per essere idonei all’arruolamento nello studio, i pazienti devono soddisfare tutti i criteri di inclusione elencati di seguito:
    1. Età pari almeno a 18 anni. Per il Giappone, età pari almeno a 20 anni.
    2. Diagnosi istologicamente o citologicamente confermata di adenocarcinoma della prostata senza caratteristiche proprie del carcinoma a piccole cellule o del carcinoma a cellule ad anello con castone. Se il paziente non dispone di una precedente diagnosi istologica, è necessario utilizzare una biopsia basale de novo per confermare la diagnosi e supportare l’analisi dei biomarcatori.
    3. Tumore prostatico metastatico resistente alla castrazione (mCRPC), asintomatico o lievemente sintomatico (il punteggio per la domanda n. 3 del BPI-SF deve essere <4).
    4. Solo per l’arruolamento nella Parte 2 (facoltativo nella Parte 1): valutazione dello stato mutazionale DDR mediante analisi prospettica (tessuto de novo o d’archivio) o analisi storica (con approvazione preliminare dello sponsor) del tessuto tumorale più recente secondo il test FoundationOne. (Nota: per i pazienti arruolati nella Parte 1, il test del deficit DDR è facoltativo).
    • Non è ammesso eseguire biopsie dell’encefalo, del polmone/mediastino o del pancreas oppure procedure endoscopiche che si estendano oltre l’esofago, lo stomaco o l’intestino al solo scopo di determinare l’idoneità allo studio.
    5. Solo per l’arruolamento nella Parte 2 (facoltativo per la Parte 1): salvo se proibito dalla normativa locale o per decisione del Comitato etico, consenso alla raccolta di un campione di saliva per il sequenziamento retrospettivo degli stessi geni DDR testati sul tessuto tumorale, o di un loro sottogruppo, e per l’uso come controllo germinale nell’identificazione delle mutazioni tumorali.
    6. Castrazione chirurgica o medica, con testosterone sierico </-50 ng/dl (</-1,73 nmol/l) allo screening. In alternativa, per i pazienti non sottoposti a orchiectomia bilaterale, terapia di deprivazione androgenica in corso con un agonista o antagonista dell’ormone di rilascio delle gonadotropine (GnRH), avviata almeno 4 settimane prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2) e proseguita per tutta la durata dello studio.
    7. Malattia metastatica all’osso documentata alla scintigrafia ossea o ai tessuti molli documentata alla TC/RM. Laddove soddisfino i requisiti dello studio, è possibile utilizzare scansioni ottenute nell’ambito dello standard di cura entro 6 settimane (42 giorni) prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2) (Tabella 2). Non è necessaria la presenza di malattia dei tessuti molli misurabile. (Un’eventuale adenopatia al di sotto della biforcazione aortica non soddisfa da sola i criteri di idoneità).
    8. Nel paziente sottoposto a castrazione medica o chirurgica, malattia progressiva all’ingresso nello studio come definita in base a 1 o più dei seguenti 3 criteri:
    • Progressione dell’antigene prostatico specifico (PSA) definita da un minimo di 2 valori in aumento del PSA in 3 valutazioni consecutive, con un intervallo di almeno 7 giorni tra le valutazioni. Il valore di laboratorio del PSA ottenuto allo screening deve essere >/-2 u-g/l (>/-2 ng/ml) in caso di idoneità stabilita esclusivamente in base alla progressione del PSA.
    • Progressione della malattia dei tessuti molli come definita in base ai RECIST 1.1.
    • Progressione della malattia ossea definita in base ai criteri del Prostate Cancer Working Group 3 (PCWG3) con 2 o più lesioni ossee metastatiche di nuova insorgenza osservate in una scintigrafia ossea con radionuclide total-body.
    9. Il dosaggio dei bifosfonati o di denosumab deve essere rimasto stabile per almeno 4 settimane prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2) per i pazienti che ricevono queste terapie.
    10. Stato di validità secondo l’Eastern Cooperative Oncology Group (ECOG) </-1.
    11. Aspettativa di vita >/-12 mesi secondo la valutazione dello sperimentatore.
    E.4Principal exclusion criteria
    Patients with any of the following characteristics/conditions will be
    excluded:
    1. Any prior systemic cancer treatment initiated in the non-metastatic CRPC and mCRPC disease state. This includes prior treatment with taxane-based chemotherapy or NHT of enzalutamide, apalutamide, or darolutamide initiated after onset of castration resistance setting.
    2. Patients whose only evidence of metastasis is adenopathy below the aortic bifurcation.
    3. Prior treatment with a PARP inhibitor, cyclophosphamide, or mitoxantrone for prostate cancer.
    4. Prior treatment with platinum-based chemotherapy within 6 months prior to Day 1 (Part 1) or randomization (Part 2), or any history of disease progression on platinum-based therapy at any time in the past.
    5. Treatment with cytotoxic chemotherapy, biologic therapy including sipuleucel-T (other than approved bone-targeting agents and GnRH agonist/antagonist therapy), or radionuclide therapy in the 28 days prior to Day 1 (Part 1) or randomization (Part 2). Hormonal therapy (eg, bicalutamide, nilutamide, flutamide, estrogens, 5 alpha reductase inhibitors are not exclusionary if discontinued prior to randomization.
    *Corticosteroid use of >10 mg/day is exclusionary. (The concomitant use of systemic glucocorticoid administration such as "stress dose" glucocorticoid is permitted when clinically indicated for a life threatening medical condition).
    6. Treatment with any investigational agent within 4 weeks or 5 halflives of the drug (whichever is longer) before Day 1 (Part 1) or randomization (Part 2).
    7. Prior treatment with opioids for pain related to either primary prostate cancer or metastasis within 28 days prior to Day 1 (Part 1) or randomization (Part 2) unless no pain related to prostate cancer has been reported in the 28 days prior to Day 1 (Part 1) or randomization (Part 2).
    8. Current use within 7 days prior to Day 1 (Part 1) or randomization (Part 2) or anticipated use during the study of the following medications:
    - Potential DDI with talazoparib: P-gp inhibitors (amiodarone, carvedilol, clarithromycin, cobicistat, darunavir, dronedarone, erythromycin, indinavir, itraconazole, ketoconazole, lapatinib, lopinavir, propafenone, quinidine, ranolazine, ritonavir, saquinavir, telaprevir, tipranavir, verapamil, and valspodar).
    - Potential DDI with enzalutamide: strong cytochrome P450 2C8 (CYP2C8) inducers (eg, rifampin), strong CYP3A4 inducers (eg, carbamazepine, phenobarbital, phenytoin, rifabutin and rifapentine), moderate CYP3A4 inducers (eg, bosentan, efavirenz, etravirine, modafinil and nafcillin), and substrates of CYP3A4 (eg, alfentanil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus and tacrolimus), CYP2C9 (eg, phenytoin), or CYP2C19 (eg, S mephenytoin) with a narrow therapeutic index.
    9. Major surgery (as defined by the investigator) within 2 weeks before Day 1 (Part 1) or randomization (Part 2).
    10. Clinically significant cardiovascular disease, including any of the following:
    - Myocardial infarction or symptomatic cardiac ischemia within 6 months before Day 1 (Part 1) or randomization (Part 2).
    - Congestive heart failure New York Heart Association class III or IV.
    - History of clinically significant ventricular arrhythmias (eg, sustained ventricular tachycardia, ventricular fibrillation, torsade de pointes) within 1 year before screening.
    - History of Mobitz II second degree or third degree heart block unless a permanent pacemaker is in place.
    - Hypotension as indicated by systolic blood pressure <86 mm Hg at screening.
    - Bradycardia as indicated by a heart rate of <45 beats per minute on the screening electrocardiogram.
    - Uncontrolled hypertension as indicated by systolic blood pressure >170 mm Hg or diastolic blood pressure >105 mm Hg at screening. However, patients can be rescreened after adequate control of blood pressure is achieved.
    Please refer to protocol for the full list of exclusion criteria.
    Saranno esclusi i pazienti che presentino una qualsiasi delle seguenti caratteristiche/condizioni:
    1. Qualsiasi trattamento antitumorale sistemico precedente, avviato nello stato patologico di CRPC non metastatico e mCRPC. È incluso il precedente trattamento con chemioterapia a base di taxani o con le NHT enzalutamide, apalutamide o darolutamide avviato dopo lo sviluppo di resistenza alla castrazione.
    2. Pazienti la cui sola evidenza di metastasi consista in un’adenopatia al di sotto della biforcazione aortica.
    3. Precedente trattamento con PARP inibitori, ciclofosfamide o mitoxantrone per tumore prostatico.
    4. Precedente trattamento con chemioterapia a base di platino somministrata entro 6 mesi prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2), oppure qualsiasi anamnesi di progressione della malattia durante una terapia a base di platino somministrata in qualunque momento nel passato.
    5. Trattamento con chemioterapia citotossica, terapia biologica, compreso sipuleucel-T (diversa dagli agenti mirati all’osso approvati e dalla terapia con agonisti/antagonisti di GnRH) o terapia con radionuclidi nei 28 giorni precedenti il Giorno 1 (Parte 1) o la randomizzazione (Parte 2). La terapia ormonale (per es., bicalutamide, nilutamide, flutamide, estrogeni, inibitori della 5-alfa reduttasi) non costituisce motivo di esclusione se interrotta prima della randomizzazione. *L’uso di corticosteroidi a una dose >10 mg/die comporta l’esclusione. (L’uso concomitante di glucocorticoidi sistemici, per es. una “dose da stress” di glucocorticoidi, è ammesso ove clinicamente indicato per una condizione medica pericolosa per la vita).
    6. Trattamento con qualsiasi agente sperimentale entro 4 settimane o 5 emivite del farmaco (a seconda di quale sia il periodo più lungo) prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2).
    7. Precedente trattamento con oppioidi per dolore correlato al tumore prostatico primario o alle metastasi entro 28 giorni prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2), a meno che non sia stato segnalato alcun dolore correlato al tumore prostatico nei 28 giorni precedenti il Giorno 1 (Parte 1) o la randomizzazione (Parte 2).
    8. Attuale uso, entro 7 giorni prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2), oppure uso previsto durante lo studio dei seguenti farmaci:
    • Potenziale DDI con talazoparib: inibitori della P-gp (amiodarone, carvedilolo, claritromicina, cobicistat, darunavir, dronedarone, eritromicina, indinavir, itraconazolo, ketoconazolo, lapatinib, lopinavir, propafenone, chinidina, ranolazina, ritonavir, saquinavir, telaprevir, tipranavir, verapamil e valspodar).
    • Potenziale DDI con enzalutamide: induttori potenti del citocromo P450 2C8 (CYP2C8) (per es., rifampicina), induttori potenti di CYP3A4 (per es., carbamazepina, fenobarbital, fenitoina, rifabutina e rifapentina), induttori moderati di CYP3A4 (per es., bosentan, efavirenz, etravirina, modafinil e nafcillina) e substrati di CYP3A4 (per es., alfentanil, ciclosporina, diidroergotamina, ergotamina, fentanil, pimozide, chinidina, sirolimus e tacrolimus), CYP2C9 (per es., fenitoina) o CYP2C19 (per es., S-mefenitoina) con indice terapeutico ristretto.
    9. Intervento chirurgico maggiore (come definito dallo sperimentatore) entro 2 settimane prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2).
    10. Malattia cardiovascolare clinicamente significativa, inclusa una qualsiasi delle seguenti:
    • Infarto miocardico o ischemia cardiaca sintomatica entro 6 mesi prima del Giorno 1 (Parte 1) o della randomizzazione (Parte 2).
    • Insufficienza cardiaca congestizia in classe III o IV secondo la New York Heart Association (Associazione dei cardiologi di New York).
    • Anamnesi di aritmie ventricolari clinicamente significative (per es., tachicardia ventricolare sostenuta, fibrillazione ventricolare, torsione di punta) entro 1 anno prima dello screening.
    Fare riferimento al protocollo per la lista completa
    E.5 End points
    E.5.1Primary end point(s)
    - rPFS per RECIST 1.1 (soft tissue disease) and PCWG3 (bone disease) in patients with mCRPC unselected for DDR status.
    - rPFS per RECIST 1.1 (soft tissue disease) and PCWG3 (bone disease) in patients with mCRPC harboring DDR deficiencies.
    • rPFS secondo i Criteri di valutazione della risposta nei tumori solidi (RECIST) 1.1 (malattia dei tessuti molli) e i criteri del Gruppo di lavoro sul tumore prostatico 3 (PCWG3) (malattia ossea) in pazienti con mCRPC non selezionati per lo stato DDR.
    • rPFS secondo i RECIST 1.1 (malattia dei tessuti molli) e i criteri del PCWG3 (malattia ossea) in pazienti con mCRPC portatori di deficit DDR.
    E.5.1.1Timepoint(s) of evaluation of this end point
    As per protocol
    Come da protocollo
    E.5.2Secondary end point(s)
    Key Secondary Endpoints:
    - OS in patients with mCRPC unselected for DDR status (alphaprotected).
    - OS patients with mCRPC harboring DDR deficiencies (alpha-protected).
    Other Secondary Endpoints:
    - Proportion of patients with measurable soft tissue disease at baseline with an objective response per RECIST 1.1 in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Duration of soft tissue response per RECIST 1.1 in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Proportion of patients with PSA response =50% in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Time to PSA progression in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Time to initiation of cytotoxic chemotherapy in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Time to initiation of antineoplastic therapy in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Time to first symptomatic skeletal event in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - PFS2 based on investigator assessment separately in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Time to opiate use for prostate cancer pain in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies.
    - Incidence of adverse events characterized by type, severity (graded by NCI CTCAE version 4.03), timing, seriousness and relationship to study treatment.
    - PK characterized by pre-dose trough and post-dose plasma concentrations of talazoparib, enzalutamide and its N-desmethyl metabolite.
    - PROs in patients with mCRPC unselected for DDR status and in patients with mCRPC harboring DDR deficiencies:
    - Change from baseline in patient-reported pain symptoms per BPI-SF;
    - Change from baseline in patient-reported general health status per EQ-5D-5L;
    - Change from baseline in patient-reported cancer-specific global health status/QoL, functioning, and symptoms per EORTC QLQ-C30;
    - Time to deterioration in patient-reported pain symptoms per BPI-SF;
    - Time to definitive deterioration in patient-reported global health status/QoL per EORTC QLQ-C30;
    - Time to definitive deterioration in patient-reported disease-specific urinary symptoms per EORTC QLQ-PR25.; Endpoint secondari chiave (con protezione dall’errore alfa)
    • OS in pazienti con mCRPC non selezionati per lo stato DDR (con protezione dall’errore alfa).
    • OS in pazienti con mCRPC portatori di deficit DDR (con protezione dall’errore alfa).
    Altri endpoint secondari
    • Proporzione di pazienti con malattia dei tessuti molli misurabile al basale e risposta obiettiva secondo i RECIST 1.1 in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Durata della risposta dei tessuti molli secondo i RECIST 1.1 in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Proporzione di pazienti con risposta del PSA ¿50% in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Tempo alla progressione del PSA in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Tempo all’avvio di una chemioterapia citotossica in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Tempo all’avvio di una terapia antineoplastica in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Tempo al primo evento scheletrico sintomatico in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • PFS2 secondo la valutazione dello sperimentatore in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Tempo all’uso di oppioidi per il dolore da tumore prostatico in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR.
    • Incidenza di eventi avversi caratterizzati per tipo, gravità (valutata secondo i Criteri comuni di tossicità per gli eventi avversi [CTCAE] del National Cancer Institute [NCI] [Istituto nazionale per il cancro] versione 4.03), tempistica, gravità e relazione con il trattamento dello studio.
    • PK caratterizzata in base alle concentrazioni plasmatiche pre-dose (di valle) e post-dose di talazoparib ed enzalutamide e del metabolita N-desmetil di enzalutamide.
    • Esiti riferiti dal paziente (PRO) in pazienti con mCRPC non selezionati per lo stato DDR e in pazienti con mCRPC portatori di deficit DDR:
    • variazione rispetto al basale nei sintomi di dolore riferiti dal paziente secondo il Qu
    E.5.2.1Timepoint(s) of evaluation of this end point
    As per protocol
    Come da protocollo
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic Yes
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Parte 1 e Parte 2. Parte 2 coorti sequenziali
    Part 1 and Part 2. Part 2 sequential cohorts
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA90
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Afghanistan
    Argentina
    Australia
    Brazil
    Canada
    Chile
    Israel
    Korea, Republic of
    New Zealand
    Peru
    South Africa
    Belgium
    Czechia
    Denmark
    Finland
    France
    Germany
    Hungary
    Italy
    Norway
    Poland
    Portugal
    Spain
    Sweden
    United Kingdom
    E.8.7Trial 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
    LPLV
    LPLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days1
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days1
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 800
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 72
    F.2 Gender
    F.2.1Female No
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state14
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 240
    F.4.2.2In the whole clinical trial 872
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    Nessuno
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-05-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-02-06
    P. End of Trial
    P.End of Trial StatusOngoing
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