Description:
This is a Phase 1b/2, open-label, multicenter platform trial to evaluate the antitumor
activity and safety of etrumadenant (AB928)-based combination therapy in participants with
metastatic castrate resistant prostate cancer (mCRPC).
Title
- Brief Title: Adenosine Receptor Antagonist Combination Therapy for Metastatic Castrate Resistant Prostate Cancer
- Official Title: A Phase 1b/2, Open-Label, Randomized Platform Study Evaluating the Efficacy and Safety of AB928-Based Treatment Combinations in Patients With Metastatic Castrate Resistant Prostate Cancer
Clinical Trial IDs
- ORG STUDY ID:
ARC-6
- NCT ID:
NCT04381832
Conditions
- Prostatic Neoplasms, Castration-Resistant
- Androgen-Resistant Prostatic Neoplasms
- Castration Resistant Prostatic Neoplasms
- Prostatic Cancer, Castration-Resistant
Interventions
Drug | Synonyms | Arms |
---|
Etrumadenant | AB928 | Stage 1 and 2: Etrumadenant + AB680 |
Zimberelimab | AB122 | Stage 1 and 2: Etrumadenant + zimberelimab |
AB680 | | Stage 1 and 2: Etrumadenant + AB680 |
Enzalutamide | Xtandi | Stage 1 and 2: Etrumadenant + zimberelimab + enzalutamide |
Docetaxel | Taxotere | Stage 1 and 2: Etrumadenant + zimberelimab + docetaxel |
Purpose
This is a Phase 1b/2, open-label, multicenter platform trial to evaluate the antitumor
activity and safety of etrumadenant (AB928)-based combination therapy in participants with
metastatic castrate resistant prostate cancer (mCRPC).
Detailed Description
This study has several treatment arms and each treatment arm has 2 stages. During Stage 1 -
Etrumadenant plus zimberelimab (AB122) alone, etrumadenant plus zimberelimab with or without
a standard of care treatment (enzalutamide or docetaxel), or etrumadenant plus AB680 with or
without zimberelimab will be administered to participants with mCRPC.
During Stage 2 - Additional participants with mCRPC may receive an etrumadenant-based
combination therapy evaluated in Stage 1 or, a standard of care treatment.
A pharmacokinetic (PK) Sub-Study (etrumadenant plus zimberelimab) will be conducted
separately.
Treatment may continue until unacceptable toxicity or progressive disease, or other reasons
specified in the protocol.
Trial Arms
Name | Type | Description | Interventions |
---|
Stage 1 and 2: Etrumadenant + zimberelimab + enzalutamide | Experimental | Participants will receive oral etrumadenant in combination with intravenous (IV) zimberelimab and standard oral enzalutamide | - Etrumadenant
- Zimberelimab
- Enzalutamide
|
Stage 2: enzalutamide | Active Comparator | Participants will receive standard oral enzalutamide | |
Stage 1 and 2: Etrumadenant + zimberelimab + docetaxel | Experimental | Participants will receive oral etrumadenant in combination with IV zimberelimab and standard IV docetaxel | - Etrumadenant
- Zimberelimab
- Docetaxel
|
Stage 2: docetaxel | Active Comparator | Participants will receive standard dose of IV docetaxel | |
Stage 1 and 2: Etrumadenant + zimberelimab | Experimental | Oral etrumadenant in combination IV zimberelimab | |
Stage 1 and 2: Etrumadenant + zimberelimab + AB680 | Experimental | Participants will receive oral etrumadenant in combination with IV zimberelimab and IV AB680 | - Etrumadenant
- Zimberelimab
- AB680
|
Stage 1 and 2: Etrumadenant + AB680 | Experimental | Participants will receive oral etrumadenant in combination with IV AB680 | |
Stage 1: Etrumadenant + zimberelimab PK Sub-Study | Experimental | Participants will receive oral etrumadenant in combination with IV zimberelimab | |
Eligibility Criteria
General Inclusion Criteria:
- Male participants; age ≥ 18 years
- Metastatic castrate-resistant prostate cancer while on anti-androgen treatment with
castrate levels of testosterone (≤1.7 nmol/L or 50 ng/dL)
- Measurable or non-measurable disease as per radiographic evaluation
- Participants with measurable disease may require a fresh tumor biopsy at study entry
- Performance status of 0 or 1
- Life expectancy of at least 3 months
- Adequate hematologic and end-organ function
- Inclusion Criteria for Participants receiving an enzalutamide-containing treatment
- Disease progression after prior treatment with abiraterone
- Inclusion Criteria for Participants receiving a docetaxel-containing treatment
- Disease progression after prior androgen synthesis inhibitor therapy
- Inclusion Criteria for all other Participants
- Disease progression after prior androgen synthesis inhibitor treatment and up to
2 prior lines of taxane chemotherapy
General Exclusion Criteria:
- Prior treatment with immune checkpoint blockade therapy
- Prior anticancer treatment including approved agents, systemic radiotherapy, or
investigational therapy, within 2-4 weeks prior first study treatment
- ECG (Electrocardiogram) result with QTcF ≥480 msec
- Prior stem cell or solid organ transplantation
- Prior treatment with drugs that stimulate the immune system within 4 weeks prior to
first study treatment
- Prior treatment with drugs that suppress the immune system within 2 weeks prior to
first study treatment
- Received a live, attenuated vaccine within 4 weeks prior to first study treatment, or
may need to receive a vaccine during study treatment
- Presence of metastases in the brain or cancer spreading into the cerebrospinal fluid -
CSF (leptomeningeal disease)
- Prior pulmonary fibrosis, pneumonia, or pneumonitis
- Cancer other than prostate within 2 years prior to study entry, except for some
cancers with a low risk of spreading like non-melanoma skin
- Prior treatment with an agent targeting the adenosine pathway
- No oral or IV antibiotics within 2 weeks prior to first study treatment
- No severe infection within 4 weeks prior to first study treatment
- No clinically significant cardiac disease
- Inability to swallow oral medications
- HIV, Hepatitis B, and C test results negative prior to first study treatment
- Exclusion Criteria for Participants receiving an enzalutamide-containing treatment
- Prior treatment with docetaxel, cabazitaxel, or other taxane chemotherapy (prior
docetaxel [up to 6 cycles] for hormone-sensitive prostate cancer is allowed if
the last dose was at least 6 months prior to study treatment initiation)
- Prior treatment with enzalutamide or similar therapy other than abiraterone
- Active or history of autoimmune disease or immune deficiency
- History of severe allergic reactions to antibody therapy
- Concomitant use of a medication prohibited by the protocol (including certain
transporter substrates as well as known strong CYP3A4 inducers and CYP3A4
inhibitors) within 4 weeks prior to and throughout study treatment
- Exclusion Criteria for Participants receiving a docetaxel-containing treatment
- Prior treatment with docetaxel, cabazitaxel, or other taxane chemotherapy
- Active or history of autoimmune disease or immune deficiency
- History of severe allergic reactions to antibody therapy
- Concomitant use of a medication prohibited by the protocol (including certain
transporter substrates as well as known strong CYP3A4 inducers and CYP3A4
inhibitors) within 4 weeks prior to and throughout study treatment
- Exclusion Criteria for all other Participants
- Prior treatment with 3 or more lines of taxane chemotherapy
- Active or history of autoimmune disease or immune deficiency
- History of severe allergic reactions to antibody therapy
- Concomitant use of a medication prohibited by the protocol (including certain
transporter substrates as well as known strong CYP3A4 inducers and CYP3A4
inhibitors) within 4 weeks prior to and throughout study treatment
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Male |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Objective response rate (ORR), defined as the composite proportion of participants with a PSA and/or radiographic complete and partial response determined by the investigator according to the Prostate Cancer Working Group 3 (PCWG3) criteria |
Time Frame: | From study enrollment until participant discontinuation, first occurrence of progressive disease, or death from any cause, whichever occurs first (approximately 1 year) |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Proportion of participants with a PSA response defined as the proportion of participants with a confirmed PSA decrease from baseline of 50% or more based on two consecutive assessments measured 3 to 4 weeks apart |
Time Frame: | From study enrollment until disease progression or loss of clinical benefit (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Proportion of participants with measurable disease at baseline who achieved a best overall response of CR or PR according to the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 |
Time Frame: | From study enrollment until disease progression or loss of clinical benefit (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Percentage of Participants with measurable disease at baseline who achieved a best overall RECIST response of CR, PR, or SD |
Time Frame: | From study enrollment until disease progression or loss of clinical benefit (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Serum/ Plasma Concentration etrumadenant, zimberelimab, and enzalutamide when administered as part of a combination regimen in Stage 1 & 2. |
Time Frame: | Recorded at baseline (enrollment), during the first 5 months of treatment and 3 additional timepoints in the first year of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Serum/Plasma Concentration for etrumadenant and zimberelimab when administered as part of a combination regimen with docetaxel in Stage 1 & 2. |
Time Frame: | Recorded at baseline (enrollment), during the first 5 months of treatment and 3 additional timepoints in the first year of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Serum/Plasma Concentration for etrumadenant and zimberelimab when administered as part of a combination regimen in Stage 1 & 2. |
Time Frame: | Recorded at baseline (enrollment), during the first 5 months of treatment and 3 additional timepoints in the first year of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Serum/Plasma Concentration for etrumadenant, zimberelimab, and AB680 when administered as part of a combination regimen in Stage 1 & 2. |
Time Frame: | Recorded at baseline (enrollment), during the first 5 months of treatment and 3 additional timepoints in the first year of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Serum/Plasma Concentration for etrumadenant and AB680 when administered as part of a combination regimen in Stage 1 & 2. |
Time Frame: | Recorded at baseline (enrollment), during the first 5 months of treatment and 3 additional timepoints in the first year of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Measure: | Percentage of participants with anti-drug antibodies to zimberelimab |
Time Frame: | Recorded at baseline (enrollment), during the first 4 months of treatment, 4 additional timepoints in the first year of treatment, and at end of treatment. (approximately 1 year) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Arcus Biosciences, Inc. |
Last Updated
July 28, 2021