A MULTINATIONAL, RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE III EFFICACY AND SAFETY STUDY OF ODM-201 IN MEN WITH HIGH-RISK NON-METASTATIC CASTRATION-RESISTANT PROSTATE CANCER

• Register: EUCTR
• Last refreshed on: 19 January 2015
• Main ID: EUCTR2013-003820-36-IT
• Date of registration: 20/08/2014
• Prospective Registration: Yes
• Primary sponsor: Orion Corporation Orion Pharma
• Public title: A MULTINATIONAL, RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE III EFFICACY AND SAFETY STUDY OF ODM-201 IN MEN WITH HIGH-RISK NON-METASTATIC CASTRATION-RESISTANT PROSTATE CANCER
• Scientific title: A MULTINATIONAL, RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE III EFFICACY AND SAFETY STUDY OF ODM-201 IN MEN WITH HIGH-RISK NON-METASTATIC CASTRATION-RESISTANT PROSTATE CANCER - ARAMIS
• Date of first enrolment: 25/09/2014
• Target sample size: 1500
• Recruitment status: Authorised-recruitment may be ongoing or finished
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2013-003820-36
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes Randomised: yes Open: no Single blind: no Double blind: yes Parallel group: yes Cross over: no Other: no If controlled, specify comparator, Other Medicinial Product: no Placebo: yes Other: no Number of treatment arms in the trial: 2

Countries of recruitment

Argentina, Australia, Austria, Belarus, Belgium, Brazil, Bulgaria, Canada, China, Colombia, Czech Republic, Finland, France, Germany, Greece, Hungary, Israel, Italy, Korea, Republic of, Latvia, Malaysia, Netherlands, Peru, Philippines, Poland, Portugal, Romania, Russian Federation, Serbia, Slovakia, South Africa, Spain, Sweden, Taiwan, Thailand, Turkey, Ukraine, United Kingdom, United States

Contacts

• Name: Andrew Wighton
• Affiliation: Orion Corporation Orion Pharma

• Name: Andrew Wighton
• Affiliation: Orion Corporation Orion Pharma

Key inclusion & exclusion criteria

Inclusion criteria:
1. Written informed consent (IC) obtained.
2. Males aged > = 18 years.
3. Histologically or cytologically confirmed adenocarcinoma of prostate without neuroendocrine differentiation or small cell features.
4. Progressive CRPC is defined as 3 consecutive rising PSA level during ADT at least 1 week apart, resulting in 2 > 50% increases over nadir, with the last value >=2 ng/ml despite castrate level of serum testosterone. If the patient has a history of antiandrogen use, the
most recent PSA value must be obtained at least 4 weeks after antiandrogen withdrawal.
5. Castrate level of serum testosterone (< 1.7 nmol/l [50 ng/dl]) on GnRH agonist or antagonist therapy or after bilateral orchiectomy. Patients who have not undergone bilateral orchiectomy must continue GnRH therapy during the study.
6. PSADT of >= 10 months and PSA > 2 ng/ml at screening.
7. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
8. Blood counts at screening: haemoglobin = 9.0 g/dl, absolute neutrophil count = 1500/µl (1.5x10^9/l), platelet count = 100,000/µl (100x10^9/l ) (patient must not have received any growth factor or blood transfusion within 7 days of the haematology laboratory obtained at screening).
9. Screening values of serum alanine aminotransferase (ALT) and/or aspartate transaminase (AST) <=2.5 x upper limit of normal (ULN), total bilirubin >01.5 x ULN (except patients with a diagnosis of Gilbert’s disease), creatinine <=2.0 x ULN.
10. Sexually active patients, unless surgically sterile, must agree to use condoms as an effective barrier method during the study treatment and for 3 months after the end of the study treatment.

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 300
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 1200

Exclusion criteria:
1. History of metastatic disease or presence of detectable metastases by blinded central reading. Presence of pelvic lymph nodes < 2 cm in short axis below the aortic bifurcation is allowed.
2. Symptomatic local-regional disease that requires medical intervention including moderate/severe urinary obstruction or hydronephrosis due to prostate cancer.
3. Acute toxicities of prior treatments and procedures not resolved to grade <=1 or baseline before randomisation.
4. Prior treatment with: second generation AR inhibitors such as enzalutamide, ARN-509, ODM-201, other investigational AR inhibitors,
CYP17 enzyme inhibitor such as abiraterone acetate, TAK-700 or
oral ketoconazole longer than for 28 days.
5. Use of estrogens, 5-a reductase inhibitors (finasteride, dutasteride) or AR inhibitors (bicalutamide, flutamide, nilutamide, cyproterone acetate) within 28 days before randomisation.
6. Prior chemotherapy or immunotherapy for prostate cancer, except adjuvant/neoadjuvant treatment, completed > 2 years before randomisation.
7. Use of systemic corticosteroid with dose greater than the equivalent 10 mg of prednisone/day within 28 days before randomisation.
8. Radiation therapy (external beam radiation therapy [EBRT], brachytherapy, or radiopharmaceuticals) within 12 weeks before randomisation.
9. Severe or uncontrolled concurrent disease, infection or co-morbidity that, in the opinion of the investigator, would make the patient inappropriate for enrolment.
10. Initiation of treatment with bisphosphonate or denosumab within 12 weeks before randomisation. Patients receiving bone loss prevention treatment on a stable dose of e.g. bisphosphonate or denosumab for at least 28 days before randomisation can continue the
treatment during the study.
11. Known hypersensitivity to the study treatment or any of its ingredients.
12. Major surgery within 28 days before randomisation.
13. Any of the following within 6 months before randomisation: stroke, myocardial infarction, severe/unstable angina pectoris, coronary/peripheral artery bypass graft; congestive heart failure New York Heart Association (NYHA) Class III or IV.
14. Uncontrolled hypertension as indicated by a resting systolic BP >=160 mmHg or diastolic BP >=100 mmHg at screening. Patients may be re-screened after adjustments of antihypertensive medications.
15. Prior malignancy. Adequately treated basal cell or squamous cell carcinoma of skin or superficial bladder cancer that has not spread behind the connective tissue layer (i.e. pTis, pTa, and pT1) is allowed, as well as any other cancer for which chemotherapy has been completed >=5 years ago and from which the patient has been disease-free.
16. Gastrointestinal disorder or procedure which expects to interfere significantly with absorption of study treatment.
17. Active viral hepatitis, active human immunodeficiency virus (HIV) or chronic liver disease.
18. Participation in another interventional clinical trial and any concurrent treatment with any investigational drug within 28 days before randomisation.
19. Any condition that in the opinion of the investigator would impair the patients’ ability to comply with the study procedures.
20. Unable to swallow study medications and comply with study requirements.


Age minimum:
Age maximum:
Gender:
Female: no
Male: yes

Health Condition(s) or Problem(s) studied

High-risk, non-metastatic castration-resistant prostate cancer (MedDRA: hormonerefractory prostate cancer)
MedDRA version: 17.0 Level: LLT Classification code 10066489 Term: Progression of prostate cancer System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
MedDRA version: 17.0 Level: PT Classification code 10062904 Term: Hormone-refractory prostate cancer System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)

Therapeutic area: Diseases [C] - Cancer [C04]

Intervention(s)

Product Name: ODM-201
Product Code: ODM-201
Pharmaceutical Form: Tablet
INN or Proposed INN: NA
CAS Number: NA
Current Sponsor code: ODM-201
Other descriptive name: ODM-201
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 300-
Pharmaceutical form of the placebo: Tablet
Route of administration of the placebo: Oral use

Primary Outcome(s)

Primary end point(s): The primary efficacy variable is metastasis free survival (MFS), defined as time between randomisation and evidence of metastasis or death from any cause, whichever occurs first

Secondary Objective: The secondary objectives of this study are to demonstrate the benefit of ODM-201 for:
Overal survival (OS), time to first symptomatic skeletal related event (SSE), time to initiation of first cytotoxic chemotherapy for prostate cancer, time to pain progression and
to characterise the safety and tolerability of ODM-201

Timepoint(s) of evaluation of this end point: Will be evaluated at about 572 events

Main Objective: The primary objective of this study is to demonstrate the superiority of ODM-201 vs. placebo in metastasis free survival (MFS) in patients with high-risk nmCRPC

Secondary Outcome(s)

Secondary end point(s): Overal survival (OS) is defined as time from randomisation to date of death from any cause. Survival status will be assessed from randomisation until the end of follow-up period.
Time to first Symptomatic Skeletal Event (SSE) is defined as time from randomisation to the first occurrence of SSE. SSE is defined as External Beam Radiation Therapy (EBRT) to relieve skeletal symptoms, new symptomatic pathologic bone
fracture, or occurrence of spinal cord compression or tumour-related orthopaedic surgical intervention, whichever comes first.
Time to cytotoxic chemotherapy is defined as time from randomisation to initiation of the first cytotoxic chemotherapy.
Pain progression is defined as an increase of 2 points from baseline in question 3 of Brief Pain Inventory - Short Form (BPI-SF) (related to the worst pain in the last 24 hours) taken as a 7-day average, or initiation of short or long-acting opioids for pain, whichever comes first.

Timepoint(s) of evaluation of this end point: Survival status will be assessed from randomisation until the end of follow-up period.
SSE will be assessed from randomisation until the first occurrence of SSE.
Use of cytotoxic chemotherapy will be assessed from randomisation until the first use of cytotoxic chemotherapy.
Pain will be assessed with the BPI-SF questionnaire (Appendix 4), pain diary and opioid use from screening until the end of follow-up period.

Secondary ID(s)

2013-003820-36-SE

3104007

Source(s) of Monetary Support

Orion Corporation Orion Pharma