E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Castration-resistant Prostate Cancer (mCRPC) |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10036909 |
E.1.2 | Term | Prostate cancer metastatic |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10060862 |
E.1.2 | Term | Prostate cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- Radiographic progression-free survival (rPFS) per Prostate Cancer Working Group (PCWG3)
[Time Frame: Approximately 2 years]
- Overall Survival (OS)
[Time Frame: Approximately 3 years]
The purpose of this study is to test the safety and effectiveness of nivolumab with docetaxel in men with advanced castration resistant prostate cancer who have progressed after second-generation hormonal manipulation. |
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E.2.2 | Secondary objectives of the trial |
- Objective Response Rate (ORR) per Prostate Cancer Working Group (PCWG3)
[Time Frame: Approximately 3 years]
- Duration of response (DOR) per Prostate Cancer Working Group (PCWG3)
[Time Frame: Approximately 3 years]
- PSA Response Rate (PSA-RR)
[Time Frame: Approximately 3 years]
- Time to Response per PCWG3 (TTR-PCWG3) assessed by BICR
[Time Frame: Approximately 3 years]
- Time to pain progression
[Time Frame: Approximately 3 years]
- Time to PSA Progression (TTP-PSA)
[Time Frame: Approximately 3 years]
- Incidence of AEs (Adverse Events)
[Time Frame: Approximately 3 years]
- Incidence of SAEs ( Serious Adverse Events)
[Time Frame: Approximately 3 years] |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Histologic confirmation of adenocarcinoma of the prostate without small cell features
-Current evidence of metastatic disease documented by either bone lesions on radionuclide bone scan and/or soft tissue lesions on computerized
tomography/magnetic resonance imaging (CT/MRI)
-Eastern Cooperative Oncology Group (ECOG) performance status 0-1
-Ongoing androgen deprivation therapy (ADT) with a gonadotropin-releasing hormone (GnRH) analogue or bilateral orchiectomy
-Documented prostate cancer progression per Prostate Cancer Working Group (PCWG3) criteria within 6 months prior to screening
-Chemotherapy-naïve for metastatic castration-resistant prostate cancer (mCRPC), with 1 to 2 prior second generation hormonal therapies in the recurrent nonmetastatic setting and/or metastatic setting, and no more than 1 second generation hormonal therapy in the mCRPC setting. Must have progressed during or after second generation hormonal therapy or have documented intolerance to second generation hormonal therapy
-Participants must meet one of the following criteria regarding tissue submission:
i) Sufficient tumor samples from a newly obtained (“fresh”) biopsy (obtained during screening); or
ii) Archival tumor tissue in the form of formalin-fixed paraffin-embedded (FFPE) block or unstained tumor tissue slides (at least 15 recommended). The specimen would preferably be obtained within 1 year prior to the enrollment date, either from a metastatic tumor lesion (preferred) or from a primary tumor lesion that has not been previously irradiated. Tumor samples collected more than 1 year prior to the enrollment date are also acceptable; or
iii) For participants with bone-only disease or inaccessible soft tissue lesions or if the biopsy procedure would pose an unacceptable clinical risk for the participant, submission of tumor tissue obtained from a fresh biopsy is not required. An archival SOFT tissue specimen in the form of FFPE block or multiple unstained slides must be submitted if available.
-Men must agree to follow specific methods of contraception, if applicable |
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E.4 | Principal exclusion criteria |
-Active brain metastases
-Active, known, or suspected autoimmune disease
-Condition requiring systemic treatment with corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of start of study treatment. Inhaled or topical steroids or adrenal replacement steroid doses are permitted in the absence of active autoimmune disease
-Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways
-Prior treatment with docetaxel or other chemotherapy for mCRPC. Prior docetaxel for metastatic castration-sensitive prostate cancer is permitted if at least 12 months have elapsed from last dose of docetaxel
-Concurrent malignancy (present during screening) requiring treatment or history of prior malignancy active within the previous 2 years prior to randomization (ie participants with a history of prior malignancy are eligible if treatment was completed at least 2 years before randomization and the participant has no evidence of disease).
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E.5 End points |
E.5.1 | Primary end point(s) |
1 - rPFS for all randomized participants is the time between randomization and the first date of documented progression or death due to any cause, whichever occurs first. The radiographic progression will be assessed by Blinded Independent Central Review (BICR) per PCWG3. The rPFS will be censored at the last tumor assessment up to the start of subsequent systemic cancer therapy for those without progression.
2 - OS for all randomized participants is the time between randomization and the date of death from any cause. For participants who are alive, their survival time will be censored at the last date that they were known to be alive. OS will be censored for participants at the date of randomization if they had no follow-up. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
During treatment and post treatment follow up until progression, death or lost to follow up |
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E.5.2 | Secondary end point(s) |
- Objective Response Rate per PCWG3 (ORR-PCWG3) is the proportion of participants who have a confirmed complete or partial best overall response (BOR) per PCWG3 among randomized participants who have measurable disease at baseline. The BOR is defined as the best response designation, as determined by the BICR, recorded between the date of randomization and the date of objectively documented progression per PCWG3 or the date of subsequent systemic cancer therapy, whichever occurs first. For participants without documented progression or subsequent systemic cancer therapy, all available response assessments will contribute to the BOR assessment.
- Time to Response per PCWG3 (TTR-PCWG3) is the time from randomization to the date of the first documented CR or PR per PCWG3, as determined by BICR.
- Duration of Response per PCWG3 (DOR-PCWG3) is the time between the date of first response (CR/PR per PCWG3) to the date of first documented radiographic progression per PCWG3, as determined by BICR, or death due to any cause. Participants who neither progress nor die will be censored at the last tumor assessment up to the start of subsequent systemic cancer therapy.
- PSA Response Rate (PSA-RR) is the proportion of randomized participants with a 50% or greater decrease in PSA from baseline to the lowest post-baseline PSA result. A second consecutive value obtained 3 or more weeks later is required to confirm the PSA response.
- PSA response will be calculated for all participants with PSA values at baseline and at least one post baseline assessment.
- Time to PSA Progression (TTP-PSA) is the time between randomization to the date of PSA progression per PCWG3 in randomized participants. For participants with an initial PSA decline from baseline, the date of PSA progression is the date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from the nadir are documented and confirmed by a second consecutive PSA value at least 3 weeks later. For participants with no PSA decline from baseline, the date of PSA progression is the date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from baseline are documented beyond Week 13. TTPPSA will be censored at the date of last PSA evaluation prior to the start of subsequent systemic cancer therapy. The time will be censored at the date of randomization for participants with no post-baseline PSA evaluation.
- Overall safety and tolerability will be measured by the incidence of AEs, SAEs, AEs leading to discontinuation, immune-mediated AEs, select AEs, deaths, and laboratory abnormalities and changes from baseline.
- Median time to pain progression as assessed by Brief Pain Inventory-Short Form (BPI-SF)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Incidence of AEs, SAEs, deaths and laboratory abnormalities in all
treated participants |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 90 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Brazil |
Canada |
Chile |
China |
Hong Kong |
Israel |
Japan |
Korea, Democratic People's Republic of |
Mexico |
New Zealand |
Russian Federation |
Singapore |
Taiwan |
Turkey |
United States |
Austria |
Belgium |
France |
Germany |
Italy |
Poland |
Romania |
Spain |
United Kingdom |
Czechia |
Argentina |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The last visit or scheduled procedure for the last participant |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 5 |