Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43851   clinical trials with a EudraCT protocol, of which   7283   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Print Download

    Summary
    EudraCT Number:2019-003633-41
    Sponsor's Protocol Code Number:MK-3475-991
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2020-01-10
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2019-003633-41
    A.3Full title of the trial
    A Phase 3, Randomized, Double-blind Trial of Pembrolizumab (MK-3475) Plus Enzalutamide Plus ADT Versus Placebo Plus Enzalutamide Plus ADT in Participants With Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) (KEYNOTE-991)
    Ensayo de fase 3, aleatorizado y doble ciego de pembrolizumab (MK-3475) más enzalutamida más ADT en comparación con un placebo más enzalutamida más
    ADT en participantes con cáncer de próstata hormonosensible metastásico (CPHSm)
    (KEYNOTE-991)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 3 Study of Pembrolizumab/Placebo plus Enzalutamide plus ADT in mHSPC
    Estudio de fase 3 de pembrolizumab/placebo más enzalutamida más ADT en CPHSm
    A.4.1Sponsor's protocol code numberMK-3475-991
    A.5.4Other Identifiers
    Name:INDNumber:122753
    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 SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., 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 supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28037
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    B.5.6E-mailensayos_clinicos@merck.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 namePEMBROLIZUMAB
    D.3.2Product code MK-3475
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEMBROLIZUMAB
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    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 KEYTRUDA (pembrolizumab, MK-3475)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme 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.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEMBROLIZUMAB
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    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.2.1.1.1Trade name Xtandi (enzalutamide) capsule
    D.2.1.1.2Name of the Marketing Authorisation holderAstellas Pharma US, Inc.
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    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.3.4Pharmaceutical form Capsule
    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.3.9.4EV 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 No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    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 placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)
    Cáncer de próstata hormonosensible metastásico (CPHSm)
    E.1.1.1Medical condition in easily understood language
    Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)
    Cáncer de próstata hormonosensible metastásico (CPHSm)
    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 PT
    E.1.2Classification code 10071119
    E.1.2Term Hormone-dependent 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
    1. To compare pembrolizumab (MK-3475) plus enzalutamide plus androgen deprivation therapy (ADT) versus placebo plus enzalutamide plus ADT with respect to radiographic progression-free survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as assessed by blinded independent central review (BICR) where soft tissue will be assessed per RECIST 1.1 modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, and bone disease will be assessed per PCWG criteria.
    2. To compare pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT with respect to overall survival (OS).
    1. Comparar pembrolizumab más enzalutamida más ADT con placebo más
    enzalutamida más ADT en lo que respecta a la supervivencia sin progresión
    radiológica (SSPr) conforme a los criterios RECIST 1.1 modificados por el PCWG
    según lo evaluado mediante una RCIE, en la que la afectación de partes blandas se evaluará conforme a los criterios RECIST 1.1 modificados para hacer un seguimiento de un máximo de 10 lesiones diana y un máximo de 5 lesiones diana por órgano, mientras que la afectación ósea se evaluará conforme a los criterios PCWG.
    2. Comparar pembrolizumab más enzalutamida más ADT con placebo más
    enzalutamida más ADT en cuanto a la SG.
    E.2.2Secondary objectives of the trial
    1. To compare pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT with respect to TFST.
    2. To compare pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT with respect to TTSSRE.
    3. To assess pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT with respect to the: time to PSA progression; time to radiographic soft tissue progression per soft tissue rules of PCWG-modified RECIST 1.1, as assessed by BICR; TTPP; and PFS2.
    4. To assess pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT with respect to the: PSA response rate; PSA undetectable rate; and ORR and DOR per PCWG-modified RECIST 1.1 as assessed by BICR.
    5. To assess the safety and tolerability of pembrolizumab plus enzalutamide plus ADT versus placebo plus enzalutamide plus ADT.
    1.Comparar pembrolizumab+enzalutamida+ADT con placebo+enzalutamida+ADT en lo que respecta al TPTP
    2.Comparar pembrolizumab+enzalutamida+ADT con placebo+enzalutamida+ADT en lo que respecta al TEOS
    3.Evaluar pembrolizumab+enzalutamida+ADT en comparación con placebo+enzalutamida+ADT con respecto a: Tiempo transcurrido hasta la progresión del PSA; Tiempo transcurrido hasta la progresión radiológica en las partes blandas conforme a las normas sobre partes blandas de los criterios RECIST 1.1 modificados por el PCWG según lo evaluado mediante una RCIE; TPD; SSP2 determinada por la evaluación del investigador
    4.Evaluar pembrolizumab+ enzalutamida+ADT en comparación con placebo+enzalutamida+ADT con respecto a: Tasa de respuesta por PSA; Tasa de PSA indetectable; TRO y DR conforme a los criterios RECIST 1.1 modificados por el PCWG, según lo evaluado mediante una RCIE
    5.Evaluar la seguridad y la tolerabilidad de pembrolizumab+enzalutamida+ADT en comparación con placebo+enzalutamida+ADT
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Has histologically- or cytologically-confirmed (if acceptable according to local health authority regulations) adenocarcinoma of the prostate without small cell histology. Diagnosis must be stated in a pathology report and confirmed by the investigator.
    2. Has metastatic disease as assessed by investigator and verified by BICR (prior to randomization) by either ≥2 bone lesions on bone scan and/or visceral disease (eg, lung or liver) by CT/MRI. Participants whose metastatic disease is limited to lymph nodes are not eligible.
    3. Once randomized, participant must be willing to maintain continuous ADT with a LHRH agonists or antagonists during study treatment or have a history of bilateral orchiectomy.
    4. Has an ECOG performance status of 0 or 1 assessed within 10 days of randomization.
    5. Participants receiving bone resorptive therapy (including, but not limited to, bisphosphonate or denosumab) must have been on stable doses for ≥4 weeks prior to randomization.
    6. Demonstrates adequate organ function; all screening labs should be performed in central laboratory within 10 days of the first dose of study intervention.
    7. Is male, ≥18 years of age at the time of signing the informed consent.
    8. Male participants are eligible to participate if they agree to the following during the intervention period and for at least 120 days after the last dose of study intervention:
    • Refrain from donating sperm PLUS either:
    • Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent OR
    • Must agree to use contraception, unless confirmed to be azoospermic (vasectomized or secondary to medical cause), as detailed below:
    - Agree to use a male condom plus partner use of an additional contraceptive method when having penile-vaginal intercourse with a WOCBP who is not currently pregnant.
    9. Male participants must agree to use male condom when engaging in any activity that allows for passage of ejaculate to another person of any sex.
    10. The participant (or legally acceptable representative if applicable) provides written informed consent/assent for the study.
    11. Has provided newly obtained core or excisional biopsy (obtained within 12 months of screening) from soft tissue not previously irradiated (samples from tumors progressing in a prior site of radiation are allowed; other exceptions may be considered after Sponsor consultation). Participants with bone only or bone predominant disease may provide a bone biopsy sample (decalcification not allowed). However, if obtaining a new biopsy is not feasible, then participants may provide an archival tumor tissue sample after Sponsor consultation (SCF). Formalin-fixed, paraffin embedded (FFPE) tissue blocks are preferred to slides. Newly obtained biopsies are preferred to archive tissue. Adequacy of these specimens for PD-L1 biomarker analysis will be required by a central laboratory prior to randomization.
    1. Tener un adenocarcinoma de próstata confirmado por métodos histológicos o citológicos (siempre que sea aceptable conforme a la normativa de las autoridades sanitarias locales), sin histología microcítica. El diagnóstico debe estar consignado en un informe anatomopatológico y ser confirmado por el investigador.
    2. Presencia de enfermedad metastásica, evaluada por el investigador y verificada mediante una RCIE (antes de la aleatorización), por ≥ 2 lesiones óseas en la gammagrafía ósea o enfermedad visceral (por ejemplo, pulmón o hígado) mediante TC/RM. No podrán participar pacientes con la enfermedad metastásica limitada a los ganglios linfáticos.
    3. Una vez aleatorizados, los participantes deben estar dispuestos a mantener el tratamiento ADT continuo con un agonista o antagonista de la LHRH durante el tratamiento del estudio o tener antecedentes de orquiectomía bilateral.
    4. Estado funcional del ECOG de 0 o 1 determinado en los 10 días previos a la
    aleatorización.
    5. Los participantes que se encuentren en tratamiento antirresortivo óseo (con bisfosfonatos o denosumab, entre otros) deberán haber recibido dosis estables durante al menos cuatro semanas antes de la aleatorización.
    6. Presentar una función orgánica adecuada; todos los análisis de selección deberán realizarse en el laboratorio central en los 10 días previos a la primera dosis de la intervención del estudio.
    7. Varón con una edad mínima de 18 años en el momento de la firma del consentimiento informado.
    8. Podrán participar en el estudio varones que se comprometan a todo lo siguiente durante el período de intervención y hasta al menos 120 días después de recibir la última dosis de la intervención del estudio:
    - Abstenerse de donar semen.
    MÁS:
    - Abstenerse de mantener relaciones heterosexuales como modo de vida habitual y preferido (abstinencia a largo plazo y constante) y compromiso de mantener la abstinencia.
    O
    - Utilizar métodos anticonceptivos a menos que se confirme la existencia de
    azoospermia (por vasectomía o secundaria a una causa médica [apéndice 5]) tal como se detalla a continuación:
    - Comprometerse a utilizar preservativo masculino más uso por parte de la pareja de un método anticonceptivo adicional cuando mantengan relaciones sexuales con penetración vaginal con mujeres en edad fértil que no estén embarazadas.
    9. Los varones participantes deberán comprometerse a utilizar preservativo masculino en cualquier actividad que permita el paso de eyaculado a otra persona de cualquier sexo.
    10. El participante (o su representante legal cuando proceda) otorga su
    consentimiento/asentimiento informado por escrito para el estudio.
    11. El participante debe proporcionar tejido tumoral procedente de una biopsia reciente con aguja gruesa o por escisión (obtenida en los 12 meses previos a la selección) de partes blandas no irradiadas previamente (se permiten muestras de tumores que hayan progresado en un foco de irradiación previo; podrán considerarse otras excepciones previa consulta con el promotor). En los participantes con afectación exclusivamente ósea o con predominio óseo podrá obtenerse una muestra de biopsia ósea (no se permite la descalcificación). Sin embargo, cuando no sea factible obtener una biopsia reciente, los participantes podrán proporcionar una muestra de tejido tumoral de archivo previa consulta con el promotor (SCF). Se prefieren los bloques de tejido fijados en formol e incluidos en parafina (FFIP) a los cortes para microscopio. Se prefiere el uso de biopsias recientes al tejido de archivo. Antes de la aleatorización, el laboratorio central evaluará la idoneidad de estas muestras para el análisis del biomarcador PD-L1.
    E.4Principal exclusion criteria
    1. Has a known additional malignancy that is progressing or has required active treatment in the last 3 years. Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ that have undergone potentially curative therapy are not excluded.
    2. Has an active autoimmune disease that has required systemic treatment in past 2 years. Replacement therapy is not considered a form of systemic treatment.
    3. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study intervention.
    4. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant’s participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator.
    5. Has undergone major surgery including local prostate intervention (excluding prostate biopsy) within 28 days prior to randomization and not recovered adequately from the toxicities and/or complications.
    6. Has a gastrointestinal disorder affecting absorption.
    7. Is unable to swallow tablets/capsules.
    8. Has an active infection (including tuberculosis) requiring systemic therapy.
    9. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
    10. Has known active HIV, hepatitis B virus or HCV. Testing for Hepatitis B and Hepatitis C is not required unless mandated by local regulation.
    11. Has known or suspected CNS metastases and/or carcinomatous meningitis.
    12. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
    13. Has a history of seizure or any condition that may predispose to seizure (including, but not limited to prior cerebrovascular accident, transient ischemic attack, or brain arteriovenous malformation; or intracranial masses such as a schwannoma or meningioma that is causing edema or mass effect).
    14. Has a history of loss of consciousness within 12 months of the Screening Visit.
    15. Has had myocardial infarction or uncontrolled angina within 6 months prior to randomization.
    16. Has New York Heart Association class III or IV congestive heart failure or a history of New York Heart Association class III or IV congestive heart failure unless a screening echocardiogram or multigated acquisition scan performed within 3 months prior to randomization date demonstrates a left ventricular ejection fraction >45%.
    17. Has a history of clinically significant ventricular arrhythmias (eg, ventricular tachycardia, ventricular fibrillation, torsades de pointes).
    18. Has a history of Mobitz II second degree or third degree heart block without a permanent pacemaker in place.
    19. Has hypotension as indicated by systolic blood pressure <86 millimeters of mercury (mmHg) at the Screening Visit.
    20. Has bradycardia as indicated by a heart rate of <50 beats per minute on the Screening ECG.
    21. Has uncontrolled hypertension as indicated by systolic blood pressure >170 mm Hg or diastolic blood pressure >105 mm Hg at the Screening visit.
    22. Has severe hypersensitivity (Grade ≥3) to pembrolizumab and/or any of its excipients.
    23. Has hypersensitivity reaction to enzalutamide or any of its capsule components, including Labrasol, butylated hydroxyanisole, and butylated hydroxytoluene.
    24. Has received any prior pharmacotherapy, radiation therapy or surgery for metastatic prostate cancer with some exceptions
    25. Has received prior ADT as neoadjuvant/adjuvant therapy for non-metastatic prostate cancer for >39 months in duration or within 9 months prior to randomization or with evidence of disease progression while receiving ADT.
    26. Has had prior treatment with a next generation hormonal agent (eg, abiraterone, enzalutamide, apalutamide, darolutamide).
    27. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137).
    28. Has used herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (eg, saw palmetto) within 4 weeks prior to randomization.
    29. Has received treatment with 5-α reductase inhibitors (eg, finasteride, dutasteride), estrogens, cyproterone acetate and/or androgens within 4 weeks prior to randomization.
    30. Has received a live vaccine within 30 days prior to randomization.
    31. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to randomization.
    32. Has a “superscan” bone scan.
    33. Has had an allogenic tissue/solid organ transplant
    1.Presencia de otra neoplasia maligna conocida en progresión/ha precisado tratamiento activo en los últimos 3 años. No se excluirá a los participantes con carcinoma basocelular o espinocelular de piel o carcinoma in situ que se hayan sometido a un tratamiento potencialmente curativo. 
    2.Presencia de enfermedad autoinmunitaria activa que ha precisado tratamiento sistémico en los 2 últimos años. El tratamiento de reposición no se considera sistémico. 
    3.Diagnóstico de inmunodeficiencia o recepción de tratamiento sistémico crónico con esteroides (en dosis superiores a 10 mg/día de prednisona o equivalente) o cualquier otra forma de tratamiento inmunodepresor en los 7 días previos a la 1ª dosis de la intervención del estudio. 
    4.Antecedentes o datos presentes de cualquier proceso, tratamiento o anomalía analítica que, en opinión del investigador, podría confundir los resultados del estudio, dificultar la participación o motivar que la participación no sea lo más conveniente para el posible participante. 
    5.Práctica de una intervención de cirugía mayor, incluida una intervención prostática local (excepto biopsia de próstata), en los 28 días previos a la aleatorización sin recuperación adecuada de la toxicidad y/o complicaciones.  
    6.Presencia de un trastorno digestivo que afecte a la absorción. 
    7.Incapacidad de tragar comprimidos/cápsulas. 
    8.Presencia de una infección activa con necesidad de tratamiento sistémico. 
    9.Antecedentes de neumonitis (no infecciosa) que haya precisado la administración de esteroides o presencia de una neumonitis activa. 
    10.Presencia de infección activa conocida por el VIH, el virus de la hepatitis B o el VHC.
    11.Presencia o sospecha de metástasis activas en el SNC y/o de meningitis carcinomatosa.  
    12.Presencia de un trastorno psiquiátrico o por abuso de sustancias que pueda dificultar el cumplimiento de los requisitos del estudio. 
    13.Antecedentes de convulsiones o cualquier trastorno que pueda predisponer a sufrirlas. 
    14.Antecedentes de pérdida del conocimiento en los 12 meses previos a la visita de selección. 
    15.Infarto de miocardio o angina de pecho no controlada en los 6 meses previos a la aleatorización. 
    16.Insuficiencia cardíaca congestiva de clase III o IV de la NYHA o antecedentes.
    17.Antecedentes de arritmias ventriculares de importancia clínica.
    18.Antecedentes de bloqueo cardíaco de 2º grado de tipo Mobitz II o de 3er grado sin implantación de un marcapasos permanente. 
    19.Presencia de hipotensión (presión arterial sistólica < 86 mm Hg) en la selección. 
    20.Presencia de bradicardia (frecuencia cardíaca < 50 latidos por minuto) en el ECG de selección. 
    21.Presencia de hipertensión no controlada (presión arterial sistólica > 170 mm Hg / diastólica > 105 mm Hg) en la selección. 
    22.Hipersensibilidad grave (grado ≥ 3) a pembrolizumab y/o a cualquiera de sus excipientes. 
    23.Presencia de una reacción de hipersensibilidad a enzalutamida o a cualquiera de sus componentes en cápsulas.
    24.Ha recibido cualquier farmacoterapia, radioterapia o cirugía previa para el cáncer de próstata metastásico, con algunas excepciones. 
    25.Tratamiento previo con ADT como neoadyuvante/adyuvante para el cáncer de próstata no metastásico durante > 39 meses o en los 9 meses previos a la aleatorización o con signos de progresión de la enfermedad durante el tratamiento ADT.  
    26.Tratamiento previo con un fármaco hormonal de última generación.
    27.Tratamiento previo con un fármaco anti-PD-1, anti-PD-L1 o anti-PD-L2 o con un fármaco dirigido contra otro receptor de los linfocitos T estimulador o coinhibidor. 
    28.Utilización de productos de herbolario que podrían tener actividad hormonal contra el cáncer de próstata y/o que se sabe que disminuyen las concentraciones de PSA en las cuatro semanas previas a la aleatorización. 
    29.Haber recibido tratamiento con inhibidores de la 5-α reductasa, estrógenos, acetato de ciproterona y/o andrógenos en las cuatro semanas previas a la aleatorización. 
    30.Haber recibido una vacuna de microorganismos vivos en los 30 días previos a la aleatorización.
    31.Participación activa/pasada en un estudio de un fármaco en investigación o uso de un dispositivo en investigación en las cuatro semanas previas a la aleatorización. 
    32.Presencia de una gammagrafía ósea con patrón “superscan”, de modo que no puede evaluarse la presencia de nuevas metástasis en el futuro.  
    33.Recepción de un alotrasplante de órgano sólido/tejidos. 
    E.5 End points
    E.5.1Primary end point(s)
    1. Radiographic Progression-free Survival (rPFS) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
    2. Overall Survival (OS)
    1. Supervivencia sin progresión radiológica (SSPr) conforme a los criterios RECIST 1.1 modificados por el PCWG, evaluado mediante una RCIE
    2. Supervivencia Global (SG)
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 77 months
    2. Up to approximately 77 months
    1. Hasta aproximadamente 77 meses.
    2. Hasta aproximadamente 77 meses.
    E.5.2Secondary end point(s)
    1. Time to Initiation of the First Subsequent Anti-cancer Therapy or Death (TFST)
    2. Time to Symptomatic Skeletal-Related Event (TTSSRE)
    3. Time to Prostate-specific Antigen (PSA) Progression
    4. Time to Radiographic Soft Tissue Progression Per Soft Tissue Rules of Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
    5. Time to Pain Progression (TTPP) as Assessed by Brief Pain Inventory-Short Form (BPI-SF) Item 3 ("Worst Pain in 24 Hours") and Opiate Use
    6. Time from Randomization to Disease Progression as Determined by Investigator Assessment after Next-line of Therapy or Death from Any Cause, Whichever Occurs First (PFS2)
    7. Prostate-specific Antigen (PSA) Response Rate
    8. Prostate-specific antigen (PSA) Undetectable Rate
    9. Objective Response Rate (ORR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
    10. Duration of Response (DOR) Per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review
    11. Number of Participants Who Experience an Adverse Event (AE)
    12. Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)
    1. Tiempo transcurrido entre la aleatorización y el inicio del primer tratamiento antineoplásico posterior o la muerte (TPTP)
    2. Tiempo transcurrido entre la aleatorización y el primer episodio óseo sintomático (TEOS)
    3. Tiempo transcurrido hasta la progresión del PSA
    4. Tiempo transcurrido hasta la progresión radiológica en las partes blandas conforme a las normas sobre partes blandas de los criterios RECIST 1.1 modificados por el PCWG, según lo evaluado mediante una RCIE
    5. Tiempo transcurrido hasta la progresión del dolor (TPD) según el apartado 3 del BPI-SF “peor dolor en 24 horas” y el uso de opioides
    6. Tiempo transcurrido entre la aleatorización y la progresión de la enfermedad según lo determinado por la evaluación del investigador tras la siguiente línea de tratamiento o la muerte por cualquier causa, lo que ocurra antes (SSP2)
    7. Tasa de respuesta por PSA
    8. Tasa de PSA indetectable
    9. Tasa de Respuesta Objetiva (TRO) conforme a los criterios RECIST 1.1 modificados por el PCWG, según lo evaluado mediante una RCIE
    10. Duración de la Respuesta (DR) conforme a los criterios RECIST 1.1 modificados por el PCWG, según lo evaluado mediante una RCIE
    11. Número de participantes que experimentan un acontecimiento adverso (AA)
    12. Número de participantes que suspenda el tratamiento debido a un acontecimiento adverso (AA)
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 77 months
    2. Up to approximately 77 months
    3. Up to approximately 77 months
    4. Up to approximately 77 months
    5. Up to approximately 77 months
    6. Up to approximately 77 months
    7. Up to approximately 77 months
    8. Up to approximately 77 months
    9. Up to approximately 77 months
    10. Up to approximately 77 months
    11. Up to approximately 77 months
    12. Up to approximately 77 months
    1. Hasta aproximadamente 77 meses.
    2. Hasta aproximadamente 77 meses.
    3. Hasta aproximadamente 77 meses.
    4. Hasta aproximadamente 77 meses.
    5. Hasta aproximadamente 77 meses.
    6. Hasta aproximadamente 77 meses.
    7. Hasta aproximadamente 77 meses.
    8. Hasta aproximadamente 77 meses.
    9. Hasta aproximadamente 77 meses.
    10. Hasta aproximadamente 77 meses.
    11. Hasta aproximadamente 77 meses.
    12. Hasta aproximadamente 77 meses.
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    To identify molecular (genomic, metabolic, and/or proteomic) biomarkers that may be indicative of clinical response/resistance, safety, and/or the mechanism of action, between the experimental and comparator arms, using blood and/or tumor tissue. To compare the experimental and comparator arm with respect to the change from baseline disease-related symptoms and health-related quality of life questionnaires.
    Identificar biomarcadores moleculares que puedan ser indicativos de respuesta clínica/ resistencia, seguridad y/o mecanismo de acción de pembrolizumab + enzalutamida + ADT en comparación con placebo + enzalutamida + ADT, utilizando sangre y/o tejido tumoral. Evaluar pembrolizumab + enzalutamida + ADT en comparación con placebo + enzalutamida + ADT en variación respecto al momento basal de las puntuaciones de síntomas relacionados con la enfermedad y la CVRS utilizando cuestionarios de vida.
    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) 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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA110
    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 No
    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
    Austria
    Brazil
    Canada
    Chile
    China
    Colombia
    Denmark
    Finland
    France
    Germany
    Ireland
    Israel
    Italy
    Japan
    Korea, Republic of
    Mexico
    Netherlands
    New Zealand
    Peru
    Poland
    Russian Federation
    Spain
    Switzerland
    Taiwan
    Thailand
    Turkey
    United Kingdom
    United States
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months5
    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: 406
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 826
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 626
    F.4.2.2In the whole clinical trial 1232
    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
    Ninguno
    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 Decision2020-02-28
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-02-14
    P. End of Trial
    P.End of Trial StatusOngoing
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA