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    Summary
    EudraCT Number:2018-002011-10
    Sponsor's Protocol Code Number:D081SC00001
    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:2021-06-14
    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 number2018-002011-10
    A.3Full title of the trial
    A Randomised, Double-blind, Placebo-controlled, Multicentre Phase III Study of Olaparib Plus Abiraterone Relative to Placebo Plus Abiraterone as First-line Therapy in Men with Metastatic Castration-resistant Prostate Cancer
    Studio di fase III Randomizzato, in Doppio Cieco, controllato da Placebo, multicentrico di Olaparib più Abiraterone verso Placebo più Abiraterone, come Terapia di Prima Linea in Uomini affetti da Tumore alla Prostata Metastatico Resistente alla Castrazione
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study on Olaparib Plus Abiraterone as First-line Therapy in Men with Metastatic Castration-resistant Prostate Cancer
    Studio di Olaparib più Abiraterone come Terapia di Prima Linea in Uomini affetti da Tumore alla Prostata Metastatico Resistente alla Castrazione.
    A.3.2Name or abbreviated title of the trial where available
    PROpel
    PROpel
    A.4.1Sponsor's protocol code numberD081SC00001
    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 SponsorASTRAZENECA AB
    B.1.3.4CountrySweden
    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 supportAstraZeneca AB
    B.4.2CountrySweden
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAstraZeneca AB
    B.5.2Functional name of contact pointInformation Center
    B.5.3 Address:
    B.5.3.1Street Addressna
    B.5.3.2Town/ cityna
    B.5.3.3Post codena
    B.5.3.4CountrySweden
    B.5.6E-mailinformation.center@astrazeneca.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 Yes
    D.2.1.1.1Trade name Lynparza 100 mg film coated Tablet
    D.2.1.1.2Name of the Marketing Authorisation holderAstraZeneca AB, SE-151 85 Södertälje, Sweden
    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 nameOlaparib 100mg
    D.3.2Product code [AZD2281]
    D.3.4Pharmaceutical form Film-coated tablet
    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 INNolaparib
    D.3.9.1CAS number 763113-22-0
    D.3.9.2Current sponsor codeAZD2281
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(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.IMP: 2
    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 Yes
    D.2.1.1.1Trade name Lynparza 150mg film coated tablet
    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 nameOlaparib 150mg
    D.3.2Product code [AZD2281]
    D.3.4Pharmaceutical form Film-coated tablet
    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 INNolaparib
    D.3.9.1CAS number 763113-22-0
    D.3.9.2Current sponsor codeAZD2281
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameZytiga (abiraterone acetate)
    D.3.2Product code [Zytiga (abiraterone acetate)]
    D.3.4Pharmaceutical form Tablet
    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 INNabiraterone acetato
    D.3.9.2Current sponsor codena
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(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: 4
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameprednisone
    D.3.2Product code [na]
    D.3.4Pharmaceutical form Tablet
    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 INNPREDNISONE
    D.3.9.2Current sponsor codena
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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: 5
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameprednisolone
    D.3.2Product code [na]
    D.3.4Pharmaceutical form Tablet
    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 INNPrendisolone
    D.3.9.2Current sponsor codena
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    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 placeboFilm-coated tablet
    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 alla Prostata Metastatico Resistente alla Castrazione
    E.1.1.1Medical condition in easily understood language
    Prostate cancer
    Tumore alla Prostata
    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 determine the efficacy of the combination of olaparib and abiraterone vs placebo and abiraterone by investigator assessment of rPFS in patients with mCRPC who have received no prior cytotoxic chemotherapy or NHA at mCRPC stage.
    Determinare l’efficacia della combinazione di olaparib e abiraterone verso placebo e abiraterone tramite valutazione con rPFS in pazienti con mCRPC che non hanno ricevuto un precedente trattamento chemioterapico citotossico o con NHA allo stadio di mCRPC
    E.2.2Secondary objectives of the trial
    TTo determine the efficacy of the combination of olaparib and abiraterone vs placebo and abiraterone by assessment of OS, TFST, and TTPP.
    To further evaluate the efficacy of the combination of olaparib and abiraterone vs placebo and abiraterone by assessment of time to opiate use, time to an SSRE, and PFS2.
    To assess the effect of the combination of olaparib and abiraterone vs placebo and abiraterone on disease related symptoms and HRQoL using BPI-SF and FACT - Prostate Cancer (FACT-P).
    To evaluate tumour and blood samples for mutations in BRCA1, BRCA2, ATM and 11 other HRR genes.
    To determine steady-state exposure to abiraterone and its active metabolite ¿4-abiraterone in the presence and absence of olaparib.
    To evaluate the safety and tolerability of the combination of olaparib and abiraterone vs placebo and abiraterone.
    To determine steady-state exposure to olaparib when co-administered with abiraterone.
    Determinare l’efficacia della combinaz di olaparib e abiraterone vs placebo e abiraterone valutata come OS, TFST e TTPP
    Valutare ulteriormente l’efficacia della combinaz di olaparib e abiraterone vs placebo e abiraterone attraverso la valutazione del tempo di uso degli oppiacei, del tempo di un SSRE e PFS2.
    Determinare l’effetto della combinaz di olaparib e abiraterone vs placebo e abiraterone sui sintomi correl alla patologia e su HRQoL usando BPI-SF e FACT - Prostate Cancer (FACT-P).
    Analizz campioni di sangue e tumore per mutaz in BRCA1, BRCA2, ATM e 11 altri geni HRR.
    Determinare lo stato stazionario di esposizione all’abiraterone e al suo metabolita attivo ¿4-abiraterone in presenza e in assenza di olaparib.
    Valutare la sicurezza e la tollerabilità della combinaz di olaparib e abiraterone vs placebo e abiraterone.
    Determinare lo stato stazionario di esposizione a olaparib quando co-somministrato con abiraterone
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form and in the study protocol.
    2. Provision of signed and dated, written informed consent form prior to any mandatory study specific procedures, sampling, and analyses.
    3. For inclusion in i) the optional exploratory genetic research and ii) the optional biomarker research, patients must fulfil the following criteria:
    - Provision of informed consent for genetic research prior to collection of sample.
    - Provision of informed consent for biomarker research prior to collection of sample.
    If a patient declines to participate in the optional exploratory genetic research or the optional biomarker research, there will be no penalty or loss of benefit to the patient. The patient will not be excluded from other
    aspects of the study.
    4. Patients must be >=18 years of age (or =19 years of age in South Korea) at the time of signing the informed consent form. For patients enrolled in Japan who are <20 years of age, written informed consent should be obtained from the patient and from his legally acceptable.
    5. Histologically or cytologically confirmed prostate adenocarcinoma.
    6. Metastatic status defined as at least 1 documented metastatic lesion on either a bone scan or a CT/MRI scan.
    7. First-line mCRPC:
    - Patients must be treatment naïve at mCRPC stage.
    - Treatment with first-generation antiandrogen agents treatment before randomisation is allowed, but there must be a washout period of 4 weeks.
    - Docetaxel treatment is allowed during neoadjuvant/adjuvant treatment for localised prostate cancer and at mHSPC stage, as long as no signs of failure or disease
    progression occurred during or immediately after such treatment.
    - Prior to mCRPC stage, treatment with second-generation antiandrogen agents (except abiraterone) without PSA progression/clinical progression/radiographic progression during treatment is allowed, provided the treatment was stopped at least 12 months before randomisation.
    8. Ongoing androgen deprivation with gonadotropin-releasing hormone analogue or bilateral orchiectomy, with serum testosterone <50 ng/dL (<2.0 nmol/L) within 28 days before randomisation. Patients receiving
    ADT at study entry should continue to do so throughout the study.
    9. Candidate for abiraterone therapy with documented evidence of progressive disease.
    10. Patients must have normal organ and bone marrow function measured within 28 days prior to administration of study treatment.
    11. Eastern Cooperative Oncology Group (ECOG) performance status 0-1 (see Appendix B), with no deterioration over the previous 2 weeks.
    12. The participant has, in the opinion of the investigator, a life expectancy of at least 6 months.
    13. Prior to randomisation, sites must confirm availability of either an archival FFPE tumour tissue sample, or a new biopsy taken during the screening window, which meets the minimum pathology and sample requirements in order to enable HRR status subgroup analysis of the primary endpoint rPFS. If there is not written confirmation of the availability of tumour tissue prior to randomisation, the patient is not eligible for the study.
    14. Male patients must use a condom during treatment and for 3 months after the last dose of olaparib+abiraterone when having sexual intercourse with a pregnant woman or with a woman of childbearing potential. Female partners of male patients should also use a highly effective form of contraception (see Appendix I for acceptable methods) if they are of childbearing potential. Male patients should not donate sperm throughout the period of taking olaparib and for 3 months following the last dose of olaparib.
    1. In grado di dare consenso informato (CI) firmato, che include la conformità con i requisiti e le restrizioni elencati nel CI e nel protocollo di studio.
    2. Fornire un CI scritto firmato e datato prima di ogni procedura specifica di studio, campionamento e analisi.
    3. Per l'inclusione in i) la ricerca genetica esplorativa facoltativa e ii) la ricerca biomarker facoltativa, i pazienti devono soddisfare i seguenti criteri:
    - Fornitura del CI per la ricerca genetica prima della raccolta del campione.
    - Fornitura del CI per la ricerca sui biomarcatori prima della raccolta del campione.
    Se un paziente rifiuta di partecipare alla ricerca genetica esplorativa facoltativa o alla ricerca facoltativa sui biomarcatori, non vi sarà alcuna penalità o perdita di beneficio per il paziente. Il paziente non sarà escluso dagli altri aspetti dello studio.
    4. I pazienti devono avere >= 18 anni al momento della firma del CI. Per i pazienti arruolati in Giappone che hanno meno di 20 anni, il CI scritto deve essere ottenuto dal paziente e dal suo tutore legale.
    5. Adenocarcinoma prostatico confermato istologicamente o citologicamente.
    6. Lo stato metastatico definito come almeno 1 lesione metastatica documentata su una scintigrafia ossea o TAC / RMN.
    7. mCRPC di prima linea:
    - I pazienti devono essere trattati per la prima volta allo stadio di mCRPC.
    -Trattamento con agenti antiandrogeni di prima generazione prima che la randomizzazione sia consentita, ma deve esserci a periodo di washout di 4 settimane
    -Il trattamento con Docetaxel è consentito durante il trattamento neoadiuvante/adiuvante per cancro alla prostata localizzato e allo stadio mHSPC, a patto che non vi siano segni di insuccesso o che la progressione malattia si sia verificata durante o immediatamente dopo tale trattamento.
    -Prima dello stadio mCRPC, trattamento con agenti antiandrogeni di seconda generazione (ad eccezione di abiraterone) senza progressione del PSA/progressione clinica/progressione radiografica durante il trattamento è permesso, a condizione che il trattamento sia stato interrotto per almeno 12 mesi prima della randomizzazione.
    8. Deprivazione androgenica in atto con ormone analogo di rilascio della gonadotropina o orchiectomia bilaterale, con testosterone sierico <50 ng/dl (<2,0 nmol/L) entro 28 giorni prima della randomizzazione. Pazienti che ricevono
    L'ADT all'entrata nello studio dovrebbero continuare a farlo durante lo studio.
    9. Candidato per terapia con abiraterone con evidenza documentata di malattia progressiva.
    10. I pazienti devono avere una normale funzione di organo e midollo osseo misurata entro 28 giorni prima della somministrazione del trattamento in studio.
    11. Performance status 0-1 del Eastern Cooperative Oncology Group (ECOG) (vedere Appendice B), senza degrado nelle 2 settimane precedenti.
    12. Il partecipante ha, secondo il parere dello sperimentatore, un'aspettativa di vita di almeno 6 mesi.
    13. Prima della randomizzazione, i siti devono confermare la disponibilità di un campione di tessuto tumorale FFPE archiviato, o una nuova biopsia prelevata durante la finestra di screening, che soddisfa i requisiti minimi per la patologia e per il campione al fine di consentire l'analisi del sottogruppo sullo stato HRR dell'endpoint primario rPFS . Se non vi è una conferma scritta della disponibilità di tessuto tumorale prima della randomizzazione, il paziente non è idoneo per lo studio.
    14. I pazienti di sesso maschile devono usare un preservativo durante il trattamento e per 3 mesi dopo l'ultima dose di olaparib + abiraterone quando hanno rapporti sessuali con una donna incinta o con una donna potenzialmente in età fertile. Anche le donne partner di pazienti di sesso maschile dovrebbero usare una forma di contraccezione molto efficace (vedi Appendice I per metodi accettabili) se sono potenzialmente fertili. I pazienti maschi non dovrebbero donare sperma per tutto il periodo di assunzione di olaparib e per 3 mesi
    dopo l'ultima dose di olaparib.
    E.4Principal exclusion criteria
    1. Has known additional malignancy that has had progression or has required active treat in the last 5 years.
    2. Patients with MDS/AML or with features suggestive of MDS/AML.
    3. Clinically significant cardiovascular disease Association Class II-IV heart failure or cardiac ejection fraction measurement of <50% during screening as assessed by echocardiography or multigated acquisition scan.
    4 Planned or scheduled cardiac surgery or percutaneous coronary intervention procedure.
    5. Prior revascularisation procedure (significant coronary, carotid, or peripheral artery stenosis).
    6. Uncontrolled hypertens (systolic BP=160 mmHg or diastolic BP=95 mmHg).
    7. History of uncontrolled pituitary or adrenal dysfunct.
    8. Active infection or other medical condition that would make prednisone/prednisolone use contraindic.
    9. Any chronic medical condition requiring a systemic dose of corticosteroid >10 mg prednisone/prednisolone per day.
    10. Patients who are considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection.
    11. Persistent toxicities (Common Terminology Criteria for Adverse Events [CTCAEs] grade >2) caused by previous cancer therapy, excluding alopecia.
    12. Patients with brain metastases. A scan to confirm the absence of brain metastases is not required.
    13. Patients with spinal cord compression are excluded unless they are considered to have received definitive treatment for this and have evidence of clinically stable disease for 4 weeks.
    14. Patients who are unevaluable for both bone and soft tissue progression
    15. Patients who are unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication.
    16. Immunocompromised patients
    17. Patients with known active hepatitis infection (ie, B or C).
    18. Any previous treatment with PARP inhibitor, includ olaparib.
    19. Patients receiving any systemic chemotherapy or radiotherapy (except for palliative reasons) within 3 weeks prior to study treatment. Patients who receive palliative radiotherapy need to stop radiotherapy 1
    week before randomisation.
    20. Any previous exposure to a CYP17 (17a-hydroxylase/C17,20-lyase) inhibitor (eg abiraterone, orteronel).
    21. Concomitant use of known strong CYP3A inhibitors (eg, itraconazole, telithromycin, clarithromycin, protease inhibitors boosted with ritonavir or cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) or
    moderate CYP3A inhibitors (eg, ciprofloxacin, erythromycin, diltiazem, fluconazole, verapamil). The required washout period prior to starting study treatment is 2 weeks.
    22. Concomitant use of known strong CYP3A inducers (eg phenobarbital, enzalutamide, phenytoin, rifampicin, rifabutin, rifapentine, carbamazepine, nevirapine or St John's wort) or moderate
    CYP3A inducers (eg bosentan, efavirenz or modafinil). The required period prior to starting study treatment is 5 weeks for phenobarbital and enzalutamide and 3 weeks for other agents.
    23. Major surgery within 2 weeks of starting study treatment and patients must have recovered from any effects of any major surgery.
    24. Previous allogenic bone marrow transplant or double umbilical cord blood transplantation (dUCBT).
    25. Participation in another clinical study with an investigational product or investigational medical devices within 1 month of randomisation.
    26. History of hypersensitivity to olaparib or abiraterone, any of the excipients of olaparib or abiraterone, or drugs with a similar chemical structure or class to olaparib or abiraterone.
    27. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca and Merck staff and/or staff at the study site).
    28. Judgment by the investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements.
    29. Previous randomisation in the present study.
    1. Ha neoplasia addizionale conosciuta con progressione o ha richiesto un trattamento attivo negli ultimi 5 anni.
    2. Paz con MDS/AML o con caratteristiche che suggeriscono MDS/AML.
    3. Insuff cardiaca Associaz Class II-IV clinic significativa o misuraz della fraz di eiez cardiaca inf a 50% durante lo screening, valutata con ecocardiografia o scans con acquisizione a gate multipli.
    4 Intervento di cardiochirurg o procedura di interv coronarico percutaneo programmato.
    5. Procedura precedente di rivascolarizzaz (significat stenosi coronarica, carotidea o dell'art periferica).
    6. Ipertens non controllata (press sistolica =160 mmHg o press diastolica =95mmHg).
    7. Anamn di disfunz ipofisaria o surrenale incontrollata.
    8. Infez attiva o altre condiz mediche che potrebbero rendere l'uso di prednisone/prednisolone controind.
    9. Qualsiasi condiz medica cronica che richiede una dose sistemica di corticosteroide>10mg di prednisone/prednisolone al giorno.
    10. Pazienti considerati scarsamente rischiosi per malatt medica grave e incontrollata, malatt sistemica non maligna o infez attiva e incontrollata.
    11. Tossicità persistente (Terminologia Comune per Criteri di Eventi Avversi [CTCAEs] grade>2) causata da preced terap antitumorale, esclusa alopecia.
    12. Paz con metast cerebrali. Non è richiesta scans per confermare assenza di metast cerebrali.
    13. I paz con compress del mid spinale sono esclusi a meno che non si ritenga che abbiano ricevuto un tratt definitivo per questo ed abbiano evid di malattia clinic stabile per 4 sett.
    14. Paz invalutabili per progressione nell'osso e nei tessuti molli
    15. Paz non in grado di ingerire farmaci somministr per os e paz con disturbi gastrointest che potrebbero interf con l'assorb del farmaco in stud.
    16. Paz immunocompromessi.
    17. Paz con nota infez da Epatite attiva (es. B o C).
    18. Qualsiasi precedente tratt con inibitore di PARP, incluso olaparib.
    19. Paz sottoposti a chemioterapia sistemica o radioterap (eccetto per motivi palliativi) entro 3 sett prima del tratt di studio. I paz che ricevono radioterapia palliativa devono interromp la radioterapia 1sett prima della randomizz.
    20. Qualsiasi precedente esposiz ad inibit del CYP17 (ad es. Abiraterone, orteronel).
    21. Uso concomit di noti inibit potenti del CYP3A (es. Itraconazolo, telitromicina, claritromicina, inibitori della prot potenziati con ritonavir o cobicistat, indinavir, saquinavir, nelfinavir, boceprevir, telaprevir) o inibit moderati del CYP3A (es. ciproflox, eritromic, diltiazem, fluconaz, verapamil). Il periodo di washout richiesto prima di iniziare il trattamento di studio è di 2 sett.
    22. Uso concomit di induttori potenti del CYP3A (ad es. fenobarbital, enzalutamide, fenitoina, rifampicina, rifabutina, rifapentina, carbamazepina, nevirapina o erba di San Giovanni) o induttori moderati del CYP3A (ad esempio bosentan, efavirenz o modafinil). Il periodo richiesto prima di iniz il tratt di studio è di 5 sett per il fenobarbitale e l'enzalutamide e di 3 sett per altri agenti.
    23. Intervent chirurgico maggiore entro 2 sett dall'inizio del tratt di studio e i paz devono essere guariti da qualsiasi effetto di qualsiasi intervento chirurgico maggiore.
    24. Precedente trapianto allogenico di mid osseo o doppio trapianto di sangue del cord ombelicale.
    25. Partecipaz a altro stud clin con prodotto speriment o disp medici speriment entro 1 mese dalla randomizz.
    26. Anamnesi di ipersensibilità a olaparib o abiraterone, uno qualsiasi degli eccipienti di olaparib o abiraterone, o farmaci con strutt chimica simile a olaparib o abiraterone.
    27. Coinvolgimento nella pianificaz e/o nella conduz dello stud (si applica sia allo staff di AstraZeneca che a quello di Merck e/o al personale del sito di stud).
    28. Giudizio del ricercatore secondo cui il paz non dovrebbe partecipare allo stud se è improbabile che il paz rispetti le procedure, le restriz e i requisiti dello stud.
    29. Precedente randomizz nel presente stud.
    E.5 End points
    E.5.1Primary end point(s)
    Radiological progression free survival (rPFS) - defined as the time from randomisation to
    1) radiological progression, assessed by investigator per RECIST 1.1 (soft tissue) and PCWG-3 criteria (bone), or
    2) death from any cause, whichever occurs first
    Sopravvivenza libera da progressione radiologica (rPFS) - definita come il tempo dalla randomizzazione a
    1) progressione radiologica, valutata dallo sperimentatore secondo i criteri RECIST 1.1 (tessuti molli) e PCWG-3 (osso), o
    2) morte per qualsiasi causa, a seconda di quale si verifica prima
    E.5.1.1Timepoint(s) of evaluation of this end point
    At baseline and every 8 weeks (± 7 days) until week 24 and every 12 weeks (± 7 days) thereafter, relative to the date of randomisation, until objective radiological disease progression is confirmed by the investigator.
    Al basale e ogni 8 settimane (± 7 giorni) fino alla settimana 24 e ogni 12 settimane (± 7 giorni) da allora in poi, relative alla data della randomizzazione, fino a che la progressione oggettiva della malattia radiologica è confermata dall'investigatore.
    E.5.2Secondary end point(s)
    1. Overall survival (OS)
    2. Time to first subsequent anticancer therapy or death (TFST)
    3. Time to pain progression (TTPP)
    4. Time to first opiate use for cancer-related pain
    5. Time to first symptomatic skeletal-related event (SSRE)
    6. Time to second progression or death (PFS2)
    7. BPI-SF: progression in pain severity domain, change in pain interference domain
    8. FACT-P total score, FACT-G total score, trial outcome index, functional well-being, physical well being, prostate cancer subscale, and FACT Advanced Prostate Symptom Index 6 (FAPSI 6)
    9. HRR gene status
    10. Plasma concentration data at steady state for olaparib, abiraterone, and ¿4-abiraterone in the subset of patients evaluable for PK
    1. Sopravvivenza globale (OS)
    2. Tempo alla prima terapia antitumorale successiva o morte (TFST)
    3. Tempo di progressione del dolore (TTPP)
    4. Tempo al primo uso di oppiacei per il dolore correlato al tumore.
    5. Tempo al primo evento sintomatico correlato alle ossa (SSRE)
    6. Tempo alla seconda progressione o morte (PFS2)
    7. BPI-SF: progressione nel dominio della gravità del dolore, cambiamento del dominio di interferenza del dolore.
    8. Punteggio totale FACT-P, punteggio totale FACT-G, indice degli esiti sperimentali, benessere funzionale , benessere fisico , cancro alla prostata sottoscala, e FACT Advanced Prostate Symptom Index-6 (FAPSI-6).
    9. Stato del gene HRR
    10. Dati di concentrazione plasmatica allo stato stazionario per olaparib, abiraterone, e D4-abiraterone nel sottogruppo di pazienti valutabili per PK.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Time from randomisation to the earlier of the first subsequent anticancer therapy start date following study treatment discontinuation or death from any cause.
    2. Time from randomisation to pain progression
    3. Time from randomisation to death from any cause.
    4. Time from randomisation to the first opiate use for cancer-related pain.
    5. Time from randomisation to the first SSRE.
    6. Time from randomisation to second progression or clinical progression or death.
    7. Subjects will complete the BPI-SF daily on the ePRO device for 7 days just prior to day 1 baseline visit and every 4 weeks.
    8. Every 4 weeks (starting on Day 1) in the first year and every 8 weeks thereafter.
    9. At baseline
    10. Visit 4
    1. Tempo dalla randomiz al precedente della prima successiva data di inizio della terap antitumorale a seguito di interruz del tratt dello stud o morte per qualsiasi causa.
    2. Tempo dalla randomiz alla progress del dolore
    3. Tempo dalla randomiz alla morte per qualsiasi causa.
    4. Tempo dalla randomiz al primo uso di oppiacei per il dolore correl al cancro.
    5. Tempo dalla randomiz al primo SSRE.
    6. Tempo dalla randomiz alla seconda progressione o progress clinica o morte.
    7. I soggetti completeranno il BPI-SF quotidianamente sul dispositivo ePRO per 7 gg appena prima della visita di baseline al giorno 1 e ogni 4 sett.
    8. Ogni 4 sett (a partire dal giorno 1) nel primo anno e ogni 8 sett da allora in poi.
    9. Alla baseline
    10. Visita 4
    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 Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    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 Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA54
    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
    Australia
    Brazil
    Canada
    Chile
    China
    Japan
    Korea, Republic of
    Turkey
    United States
    Belgium
    France
    Germany
    Italy
    Netherlands
    Slovakia
    Spain
    United Kingdom
    Czechia
    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
    The end of the study is defined as 'the last visit of the last patient undergoing the study'.
    LSLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    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: 324
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 396
    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 state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 270
    F.4.2.2In the whole clinical trial 720
    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)
    After end of treatment with study drug, patients should be managed according to local standard of care.
    Dopo la fine del trattamento con il farmaco in studio, i pazienti devono essere trattati secondo la terapia standard locale.
    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 Decision2018-12-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-11-28
    P. End of Trial
    P.End of Trial StatusOngoing
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