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Saruparib (AZD5305) vs Placebo in Men With Metastatic Castration-Sensitive Prostate Cancer Receiving Physician's Choice New Hormonal Agents

PHASE3RECRUITING

The intention of the study is to demonstrate superiority of Saruparib (AZD5305) + physician's choice NHA relative to placebo + physician's choice NHA by assessment of radiographic progression-free survival (rPFS) in participants with mCSPC.

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Study details:

Approximately 1800 adult participants with mCSPC will be assigned to one of two cohorts (550 HRRm and 1250 non-HRRm) and randomized in a 1:1 ratio to receive either Saruparib (AZD5305) with NHA or placebo with NHA. They will receive their assigned treatment and regular tumor evaluation scans until disease progression, or until treatment is stopped for another reason. All patients will be followed for survival until the end of the study.

Independent data monitoring committee (DMC) composed of independent experts will be convened to confirm the safety and tolerability of Saruparib (AZD5305) + physicians choice NHA.

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Eligibility criteria

Researchers look for people who fit a certain description, called eligibility criteria. See if you qualify.

Inclusion criteria

Male ≥ 18 years of age.

Histologically documented prostate adenocarcinoma which is de novo or recurrent and castration-sensitive. Participants with pathologic features of small cell, neuroendocrine, sarcomatoid, spindle cell, or signet cell histology are not eligible.

Metastatic disease as documented by the investigator prior to randomisation, with clear evidence of ≥ 1 bone lesion and/or ≥ 1 soft tissue lesion that is suitable for repeated assessment with CT and/or MRI.

Participant is receiving ADT with a GnRH analogue or has undergone bilateral orchiectomy starting ≥ 14 days and < 4 months prior to randomisation.

ECOG performance status of 0 or 1 with no deterioration over the 2 weeks prior to randomisation.

Provision of FFPE tumour tissue sample and blood sample (for ctDNA).

Confirmed HRRm status by central tumour tissue and/or ctDNA test is required to determine cohort eligibility.

Adequate organ and bone marrow function as described in study protocol.

Participants must not father children or donate sperm from signing ICF, during the study intervention and for 6 months after the last dose of study intervention.

Participants must use a condom from signing ICF, during study intervention, and for 6 months after the last dose of study drug, with all sexual partners.

Exclusion criteria

Participants with a history of MDS/AML or with features suggestive of MDS/AML (as determined by prior diagnostic investigation). In case there is no clinical MDS/AML suspicion, no specific screening for MDS/AML (by BM/bone biopsy) is required.

Participants with any known predisposition to bleeding.

Any history of persisting (> 2 weeks) severe cytopenia.

Refractory nausea and vomiting, chronic gastrointestinal diseases, inability to swallow the formulated product or previous significant bowel resection that would preclude adequate absorption of AZD5305 and/or the assigned NHA.

History of another primary malignancy, with exceptions.

Persistent toxicities (CTCAE Grade ≥ 2) caused by previous anticancer therapy.

Spinal cord compression or brain metastases unless asymptomatic, stable, and not requiring steroids for at least 4 weeks prior to start of study intervention.

Cardiac criteria, including history of arrhythmia and cardiovascular disease.

Any prior anticancer pharmacotherapy or surgery for metastatic prostate cancer, with exceptions.

Prior treatment within 14 days with blood product support or growth factor support.

Participants who are unevaluable for both bone and soft tissue progression.

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Eligibility

Age eligible for study : 18 and older

Healthy volunteers accepted : No

Gender eligible for study: Male

Things to know

Study dates

Study start: 2023-11-21

Primary completion: 2028-01-11

Study completion finish: 2031-04-30

Study type

TREATMENT

Phase

PHASE3

Trial ID

NCT06120491

Intervention or treatment

DRUG: Saruparib

DRUG: Placebo

DRUG: Abiraterone Acetate

DRUG: Darolutamide

DRUG: Enzalutamide

Conditions

• Metastatic Castration-Sensitive Prostate Cancer

Image related to Metastatic Castration-Sensitive Prostate Cancer

Condition: Metastatic Castration-Sensitive Prostate Cancer
DRUG: Saruparib and other drugs
Chermside, Not Specified, Australia and more
Sponsor: AstraZeneca

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Are you running this trial? If you're a clinic or sponsor, you can claim this study. Claim or learn more.

Find a site

Closest Location:

Research Site

Research sites nearby

Select from list below to view details:

Research Site
Chermside, Not Specified, Australia
Research Site
Darlinghurst, Not Specified, Australia
Research Site
Hyde Park, Not Specified, Australia
Research Site
Kurralta Park, Not Specified, Australia

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Participant Group/Arm	Intervention/Treatment
EXPERIMENTAL: Arm 1: Saruparib (AZD5305) + Physician's Choice NHA Saruparib (AZD5305) + physician's choice NHA (Abiraterone, Darolutamide, or Enzalutamide)	DRUG: Saruparib Oral
PLACEBO_COMPARATOR: Arm 2: Placebo + Physician's Choice NHA Placebo + physician's choice NHA (Abiraterone, Darolutamide, or Enzalutamide)	DRUG: Placebo Oral

What is the study measuring?

Primary outcome

Primary Outcome Measure	Primary Outcome Description	Primary Outcome Time Frame
Radiographic Progression-Free Survival (rPFS)	rPFS is defined as the time from randomisation to radiographic progression, as assessed by the investigator per RECIST 1.1 (soft tissue) and/or PCWG3 criteria (bone), or, death due to any cause.	up to approximately 50 months

Secondary outcome

Secondary Outcome Measure	Secondary Outcome Description	Secondary Outcome Time Frame
Overall Survival (OS)	OS is defined as the time from randomisation until the date of death due to any cause.	up to approximately 90 months
Second Progression-Free Survival (PFS2)	Time from randomisation to PFS2 is defined as the time from randomisation to the earliest of progression (defined as radiographic progression, clinical progression, or PSA progression) after initiation of first subsequent treatment following the initial investigator-assessed progression or death.	up to approximately 50 months
Time to First Subsequent Therapy or Death (TFST)	TFST is defined as the time from randomisation to the start date of the first subsequent anticancer therapy after discontinuation of randomised treatment, or death due to any cause.	up to approximately 50 months
Symptomatic Skeletal Event-Free Survival (SSE-FS)	SSE-FS is defined as the time from randomisation to the earliest of the following: * Use of radiation therapy to prevent or relieve skeletal symptoms. * Occurrence of new symptomatic pathological bone fractures (vertebral or non-vertebral). * Occurrence of spinal cord compression. * Orthopaedic surgical intervention for bone metastasis. * Death due to any cause.	up to approximately 50 months
Time to the First Castration-Resistant Event (TTCR)	TTCR is defined as the time from randomisation to the first castration resistant event (radiographic disease progression per RECIST 1.1 \[soft tissue\] and/or PCWG3 criteria \[bone\], PSA progression per PCWG3, or SSE, PSA progression per PCWG3, or SSE), whichever occurs first, with castrate levels of testosterone (below 50 ng/dL).	up to approximately 50 months
Time to Pain Progression (TTPP)	TTPP is defined as the time from randomisation to clinically meaningful pain progression based on a 2-point increase from baseline in the Brief Pain Inventory - Short Form (BPI-SF) Item 3 'worst pain in 24 hours' score and/or initiation of/increase in opioid analgesic use.	up to approximately 50 months
Time To Deterioration in Urinary Symptoms (TTDUS)	TTDUS is defined as the time from randomisation to deterioration in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Prostate Questionnaire (Urinary Symptoms) (QLQPR25 \[US\]) subscale scores.	up to approximately 50 months
Time to Deterioration in Fatigue (TTDF)	TTDF is defined as the time from randomisation to deterioration in Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 7A scores.	up to approximately 50 months
Time to Deterioration in Physical Function (TTDPF)	TTDPF is defined as the time from randomisation to deterioration in PROMIS Physical Function Short Form 8C scores.	up to approximately 50 months
Health-related Quality of Life (HrQoL)	Change from baseline in BPI-SF worst pain score, pain severity, and interference domain scores.	up to approximately 50 months
BRCA and other HRR gene mutation status.	Not Specified	at screening
Plasma concentrations of AZD5305	Not Specified	up to approximately 10 months
Samples will be used to develop complementary or companion diagnostics by analyzing their performance characteristics and calculate their consistency with clinical trial assays used for enrolment onto the study.	Samples will be tested by a CDx to certify consistency with assays used in the study.	up to approximately 50 months
Assessment of PSA (prostate-specific antigen) in participants in mCSPC	proportion of participants achieving a \>= 50% or \>=90% decrease in PSA from baseline; proportion of participants with undetectable PSA (\< 0.2 ng/mL); time to PSA progression	up to approximately 50 months

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References

Clinical Trials Gov: Saruparib (AZD5305) vs Placebo in Men With Metastatic Castration-Sensitive Prostate Cancer Receiving Physician's Choice New Hormonal Agents