Prostate CancerPhase 2STRIVENCT01664923
Safety and Efficacy Study of Enzalutamide Versus Bicalutamide in Men With Prostate Cancer
A Phase 2 study testing Enzalutamide and Bicalutamide in people with Prostate Cancer, run by Pfizer at 109 sites in United States.
Trial summary
The purpose of this study is to determine the safety and efficacy of enzalutamide vs bicalutamide in asymptomatic or mildly symptomatic patients with prostate cancer who have disease progression despite primary androgen deprivation therapy. Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Prostate Cancer
- What is being tested?
- Enzalutamide and Bicalutamide
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 396 participants
- Where
- 109 sitesUnited States
- Study dates
- Aug 2012to Jan 2018
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Males age 18 or older;
- Histologically or cytologically confirmed adenocarcinoma of the prostate;
- Ongoing androgen deprivation therapy;
- Serum testosterone level ≤ 50 ng/dL (1.73 nmol/L) at the Screening visit;
- Progressive disease at study entry defined by prostate-specific antigen (PSA) progression and/or radiographic progression that occurred while the patient was on primary androgen deprivation therapy;
- Asymptomatic or mildly symptomatic from prostate cancer;
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- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1;
- Estimated life expectancy of ≥ 12 months;
- Able to swallow the study drug and comply with study requirements.
- Received randomized double blind treatment in MDV3100-09 as follows:
- Randomized to enzalutamide and receiving enzalutamide at the time of study unblinding;
- Randomized to bicalutamide and receiving bicalutamide at the time of study unblinding;
- Randomized to bicalutamide and discontinued bicalutamide before study unblinding;
- Willing to maintain androgen deprivation therapy with a gonadotropin releasing hormone (GnRH) agonist/antagonist or has had a bilateral orchiectomy.
Who cannot join
- Severe concurrent disease, infection, or co-morbidity;
- Known or suspected brain metastasis or active leptomeningeal disease;
- History of another invasive malignancy within the previous 5 years other than treated non-melanomatous skin cancer and American Joint Committee on Cancer (AJCC) Stage 0 or Stage 1 cancers that have a remote probability of recurrence;
- Absolute neutrophil count < 1,500/µL, or platelet count < 100,000/µL, or hemoglobin < 9 g/dL at the Screening visit;
- Total bilirubin, alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 times the upper limit of normal (ULN) at the Screening visit;
- Creatinine > 2 mg/dL at the Screening visit;
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- Albumin < 3.0 g/dL at the Screening visit;
- History of seizure or any condition that may predispose to seizure;
- Clinically significant cardiovascular disease;
- Gastrointestinal disorder affecting absorption (e.g., gastrectomy, active peptic ulcer disease within last 3 months);
- Major surgery within 4 weeks of enrollment;
- Use of opiate analgesics for pain from prostate cancer within 4 weeks of enrollment;
- Radiation therapy for treatment of the primary tumor within 3 weeks of enrollment;
- Prior radiation or radionuclide therapy for treatment of distant metastases;
- Prior ketoconazole, abiraterone, or cytotoxic chemotherapy for prostate cancer;
- Treatment with hormonal therapy or biologic therapy for prostate cancer within 4 weeks of enrollment;
- Use of antiandrogens within 4 weeks prior to enrollment;
- Prior disease progression, as assessed by the Investigator, while receiving bicalutamide;
- Participation in a previous clinical trial of enzalutamide or an investigational agent that inhibits the androgen receptor or androgen synthesis (patients who received placebo are acceptable);
- Use of an investigational agent within 4 weeks of enrollment;
- Use of herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (e.g., saw palmetto) or systemic corticosteroids for prostate cancer within 4 weeks of enrollment;
- Any condition or reason that, in the opinion of the Investigator, interferes with the ability of the patient to participate in the trial, which places the patient at undue risk, or complicates the interpretation of safety data.
- Open-Label Treatment Period:
- Is currently or has taken commercially available enzalutamide (Xtandi) prior to participation in this open-label extension;
- Discontinued enzalutamide during the double-blind portion of the study prior to unblinding;
- Has any clinically significant cardiovascular, dermatologic, endocrine, gastrointestinal, hematologic, hepatic, infectious, metabolic, neurologic, psychiatric, psychologic, pulmonary, or renal disorder or any other condition, including excessive alcohol or drug abuse, or secondary malignancy, that may interfere with study participation in the opinion of the investigator or medical monitor;
- Has a current or previously treated brain metastasis or leptomeningeal disease;
- Has a history of seizure or any condition that may predispose to seizure (eg, prior cortical stroke or significant brain trauma);
- Has a history of loss of consciousness or transient ischemic attack within 12 months of open label day 1;
- Has taken cytotoxic chemotherapy or investigational therapy within 4 weeks before enrollment (open label day 1).
Trial locations and contacts
109 sites in 1 country.
109 sites in 1 country
United States109 sites
Southern California Permanente Medical Group
Anaheim, California, 92806
Kaiser Permanente Medical Center Lab Drawing Station
Antioch, California, 94509
Kaiser Permanente Medical Center Lab Drawing Station
Antioch, California, 94531
Anschutz Cancer Center Pavilion Pharmacy
Aurora, Colorado, 80045
Anschutz Inpatient Pavilion
Aurora, Colorado, 80045
University of Colorado Cancer Center, Anschutz Cancer Pavilion
Aurora, Colorado, 80045
University of Alabama at Birmingham
Birmingham, Alabama, 35233
University of Alabama at Birmingham,IDS Pharmacy
Birmingham, Alabama, 35249
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Charleston Hematology Oncology Associates, PA
Charleston, South Carolina, 29414
Carolinas Medical Center-Steelcreek
Charlotte, North Carolina, 28278
TriState Urologic Services PSC Inc., dba The Urology Group
Cincinnati, Ohio, 45212
Cleveland Clinic Taussig Cancer Institute
Cleveland, Ohio, 44195
Carolina Clinical Trials, LLC
Concord, North Carolina, 28025
Carolina Urology Partners, PLLC
Concord, North Carolina, 28025
Barnes-Jewish West County Hospital
Creve Coeur, Missouri, 63141
Urology Clinics of North Texas
Dallas, Texas, 75231
Texas Oncology - Baylor Charles A. Sammons Cancer Center
Dallas, Texas, 75246
Advanced Urology institute
Daytona Beach, Florida, 32114
The Urology Center of Colorado
Denver, Colorado, 80211
Duke University Medical Center
Durham, North Carolina, 27710
Investigational Chemotherapy Services
Durham, North Carolina, 27710
Minnesota Oncology Hematology, P.A.
Edina, Minnesota, 55435-2150
Kaiser Permanente Medical Center Lab Drawing Station
Fairfield, California, 94533-6901
Peace Harbor Hospital
Florence, Oregon, 97439
AccuMed Research Associates
Garden City, New York, 11530
Kaiser Permanente Medical Center Lab Drawing Station
Gilroy, California, 95020
Alliance Urology Specialists, PA
Greensboro, North Carolina, 27403
Hackensack University Medical Center
Hackensack, New Jersey, 07601
John Theurer Cancer Center at Hackensack University Medical Center
Hackensack, New Jersey, 07601
Virginia Oncology Associates
Hampton, Virginia, 23666
Texas Oncology-Memorial City
Houston, Texas, 77024
East Coast Institute for Research, LLC
Jacksonville, Florida, 32207
East Coast Institute for Research, LLC
Jacksonville, Florida, 32216
First Urology, PSC
Jeffersonville, Indiana, 47130
Lancaster Urology
Lancaster, Pennsylvania, 17604
Southern California Permanente Medical Group
Los Angeles, California, 90027
Tower Urology
Los Angeles, California, 90048
UCLA Clark Urology Clinic
Los Angeles, California, 90095
UCLA Department of Pharmaceutical Services
Los Angeles, California, 90095
University of Wisconsin Clinical Sciences Center
Madison, Wisconsin, 53792
Kaiser Permanente Medical Center Lab Drawing Station
Martinez, California, 94553
Metairie Oncologist, LLC
Metairie, Louisiana, 70006
Kaiser Permanente Medical Center Lab Drawing Station
Milpitas, California, 95035-5491
Kaiser Permanente Medical Center Lab Drawing Station
Modesto, California, 95356
Kaiser Permanente Medical Center Lab Drawing Station
Moutain View, California, 94041
Carolina Urologic Research Center
Myrtle Beach, South Carolina, 29572
Kaiser Permanente Medical Center Lab Drawing Station
Napa, California, 94558-3313
Specialists In Urology
Naples, Florida, 34102
Urology Associates P.C.
Nashville, Tennessee, 37209
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Ochsner Clinic Foundation
New Orleans, Louisiana, 70121
Virginia Oncology Associates
Norfolk, Virginia, 23502
Kaiser Permanente Medical Center
Oakland, California, 94611
GU Research network,LLC / Urology Cancer Center
Omaha, Nebraska, 68130
Jefferson Medical Oncology
Philadelphia, Pennsylvania, 19107
Jefferson Urology Associates
Philadelphia, Pennsylvania, 19107
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
UPMC Cancer Center Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Kaiser Permanente Medical Center Lab Drawing Station
Pleasanton, California, 94558
Premier Medical Group of the Hudson Valley PC
Poughkeepsie, New York, 12601
Kaiser Permanente Medical Center Lab Drawing Station
Redwood City, California, 94063
Kaiser Permanente Medical Center
Roseville, California, 95661
UC Davis Comprehensive Cancer Center
Sacramento, California, 95817
UC Davis Medical Center
Sacramento, California, 95817
Kaiser Permanente Medical Center
Sacramento, California, 95825
Salem Hospital
Salem, Oregon, 97301
Rowan Regional Medical Center
Salisbury, North Carolina, 28144
University of Utah/Huntsman Cancer Hospital
Salt Lake City, Utah, 84112
University of Utah/Huntsman Cancer Institute
Salt Lake City, Utah, 84112
Urology San Antonio Research
San Antonio, Texas, 78229
San Bernardino Urological Associates Medical Group
San Bernardino, California, 92404
Southern California Permanente Medical Group
San Diego, California, 92120
Kaiser Permanente Medical Center
San Francisco, California, 94115
Kaiser Permanente Medical Center
San Jose, California, 95119
Kaiser Permanente Medical Center
San Leandro, California, 94577
Southern California Permanente Medical Group
San Marcos, California, 92078
Kaiser Permanente Medical Center
Santa Clara, California, 95051
Desert Springs Cancer Care
Scottsdale, Arizona, 85255
Virginia Mason Medical Center
Seattle, Washington, 98101
Seattle Cancer Care Alliance
Seattle, Washington, 98109
University of Washington Medical Center
Seattle, Washington, 98195
Skyline Urology
Sherman Oaks, California, 91411
Regional Urology, LLC
Shreveport, Louisiana, 71106
Kaiser Permanente Medical Center
South San Francisco, California, 94080
Oregon Urology Institute
Springfield, Oregon, 97477
Sacred Heart Nuclear Medicine
Springfield, Oregon, 97477
Barnes-Jewish Hospital
St Louis, Missouri, 63110
Washington University Infusion Center Pharmacy
St Louis, Missouri, 63110
Washington University, School of Medicine, 7th Floor, Center for Advanced Medicine
St Louis, Missouri, 63110
Siteman Cancer Center - South County
St Louis, Missouri, 63129
Standford Health Care
Stanford, California, 94305
Mount Nittany Physician Group
State College, Pennsylvania, 16801
Mount Nittany Health
State College, Pennsylvania, 16803
Associated Medical Professionals of NY, PLLC
Syracuse, New York, 13210
Skyline Urology
Torrance, California, 90505
Chesapeake Urology Research Associates
Towson, Maryland, 21204
Michigan Institute of Urology
Troy, Michigan, 48084
Arizona Oncology Associates, PC - HOPE
Tucson, Arizona, 85704
Arizona Oncology Associates, PC - HOPE
Tucson, Arizona, 85710
Urological Associates of Southern Arizona, PC
Tucson, Arizona, 85715
Urological Associates of Southern Arizona, PC
Tucson, Arizona, 85741
Kaiser Permanente Medical Center
Vallejo, California, 94589
Urology of Virginia, PLLC.
Virginia Beach, Virginia, 23462
Kaiser Permanente Medical Center
Walnut Creek, California, 94596
George Washington University - Medical Faculty Associates
Washington D.C., District of Columbia, 20037
Wake Forest Baptist Health Urology
Winston-Salem, North Carolina, 27103
Wake Forest Baptist Health
Winston-Salem, North Carolina, 27157
Minnesota Oncology Hematology, P.A.
Woodbury, Minnesota, 55125
About this study
Official title: STRIVE: A MULTICENTER PHASE 2, RANDOMIZED, DOUBLE-BLIND, EFFICACY AND SAFETY STUDY OF ENZALUTAMIDE VS. BICALUTAMIDE IN MEN WITH PROSTATE CANCER WHO HAVE FAILED PRIMARY ANDROGEN DEPRIVATION THERAPY
The purpose of this study is to determine the safety and efficacy of enzalutamide vs bicalutamide in asymptomatic or mildly symptomatic patients with prostate cancer who have disease progression despite primary androgen deprivation therapy.
Read the detailed description
This study is a multicenter phase 2, randomized, double-blind, efficacy and safety study of enzalutamide (160 mg/day) vs. bicalutamide (50 mg/day) in patients with recurrent prostate cancer who have serologic and/or radiographic disease progression despite primary androgen deprivation therapy.
Throughout the study, safety and tolerability will be assessed by the recording of adverse events, monitoring of vital signs, physical examinations, and safety laboratory evaluations.
Following study unblinding, study patients receiving enzalutamide or bicalutamide at the time of unblinding and qualifying patients randomized to bicalutamide who discontinued prior to unblinding will be offered the opportunity to receive open label enzalutamide treatment.
- Conditions
- Prostate Cancer
- Being tested
- Enzalutamide, Bicalutamide
- Keywords
- prostate cancer, enzalutamide, MDV3100
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EnzalutamideDrug
Also called MDV3100, Xtandi
160 mg, daily, by mouth.
BicalutamideDrug
Also called Casodex
50 mg, daily, by mouth
| Study group | Role | What they receive |
|---|---|---|
| Enzalutamide | Experimental | Enzalutamide 160 mg/day orally Receives: Drug: Enzalutamide |
| Bicalutamide | Active comparator | 50 mg/day orally Receives: Drug: Bicalutamide |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression Free Survival (PFS)
PFS was defined as time from randomization to earliest objective evidence of prostate specific-antigen (PSA) progression, radiographic progression, or death on study. PSA progression was defined as ≥ 25% increase in PSA with an absolute increase ≥ 2 ng/mL above the nadir and was to be confirmed by a second consecutive assessment. Radiographic progression in bone was based on The Prostate Cancer Clinical Trials Working Group (PCWG2) guidelines defined as at least 2 new lesions on bone scan. Radiographic progression in soft tissue on Computerized Tomography/Magnetic Resonance Imaging (CT/MRI) was based on Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). CT/MRI and bone scans were read locally by the same radiologist (or nuclear medicine physician for interpretation of bone scans) whenever possible. Participants not known to have had a PFS event at the time of the analysis data cutoff were censored at the date of last assessment.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Secondary outcomes (6)
Time to PSA Progression
PSA progression was defined as ≥ 25% increase in PSA with an absolute increase ≥ 2 ng/mL above the nadir and was to be confirmed by a second consecutive assessment at least 3 weeks later. Participants not known to have had PSA progression were censored at the date of last PSA assessment.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Percentage of Participants With a PSA Response ≥ 50%
PSA response was defined as a reduction in PSA of at least 50% from baseline at any post baseline assessment confirmed by a second PSA assessment at least 3 weeks later.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Duration of Radiographic PFS
Duration of radiographic PFS was defined as the time from randomization to the earliest objective evidence of radiographic disease progression or death on study and was to be evaluated for participants with metastatic disease at study entry. Radiographic disease progression in bone was based on PCWG2 guidelines defined as at least 2 new lesions on bone scan. Radiographic disease progression in soft tissue on CT/MRI was based on RECIST 1.1. CT/MRI and bone scans were read locally by the same radiologist (or nuclear medicine physician for interpretation of bone scans) whenever possible. Participants not known to have had radiographic progression at the time of analysis data cutoff were censored at the date of last radiographic assessment.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Quality of Life: Time to Degradation of Functional Assessment of Cancer Therapy - Prostate (FACT-P)
The FACT-P is a multidimensional, self-reported quality of life instrument consisting of 27 core items that assess patient function in 4 domains: physical, social/family, emotional, and functional well-being, and supplemented by 12 site-specific items to assess for prostate-related symptoms. Each item is rated on a 0 to 4 Likert-type scale, and then combined to produce subscale scores for each domain, as well as a global quality of life score (0 to 156) with higher scores representing better quality of life. Time to degradation of FACT-P was defined as the time from randomization to first assessment with at least a 10-point decrease from baseline in the global FACT-P score for each participant. Participants with no score degradation at the time of analysis data cutoff were censored at the date of last assessment showing no degradation.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Best Overall Soft Tissue Response
Best overall soft tissue response is defined as partial response (PR) or complete response (CR) while on study treatment based on investigator assessment of target, nontarget, and new lesions using RECIST 1.1. Only participants in the metastatic population with measurable soft tissue disease (at least 1 target lesion identified per RECIST 1.1) at screening were included in the analysis. All percentages are based on number of participants with metastatic and measurable soft tissue disease at screening in each treatment group.
Measured: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Percentage of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
An AE was any untoward medical occurrence in a participant who received study treatment without regard to possibility of causal relationship. An SAE was an AE resulting in any of following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability or incapacity, congenital anomaly. A treatment emergent AE defined as an event that emerged during treatment period (From first dose of study drug until end of open label phase [up to maximum duration of 65 months]) that was absent before treatment, or worsened during treatment period relative to pre-treatment state. AE included both serious and non- SAE. Treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. An AE was considered related to study drug if event was assessed by investigator as probably or possibly related.
Measured: From first dose of study drug until the end of open label phase (up to maximum duration of 65 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2012 (estimated)
- Study startAug 2012
- Primary completionFeb 2015
- Study completionJan 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Prostate CancerStudies of the same condition, open and under way.
- More trials run by PfizerThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 396 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pfizer
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Astellas Pharma Inc, Medivation LLC, a wholly owned subsidiary of Pfizer Inc.
- Responsible party
- Sponsor
- Investigators
- Pfizer Pfizer CT.gov Call Center, Study director, Pfizer
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01664923
- Sponsor's protocol ID
- MDV3100-09
- Other IDs
- C3431014
- Acronym
- STRIVE
- Status last verified
- Jan 2019
- First submitted
- 10 Aug 2012
- Last updated
- 30 Jan 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Individual data sharing
- Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.
Publications
Penson DF, Armstrong AJ, Concepcion RS, Agarwal N, Olsson CA, Karsh LI, Dunshee CJ, Duggan W, Shen Q, Sugg J, Haas GP, Higano CS. Enzalutamide versus bicalutamide in patients with nonmetastatic castration-resistant prostate cancer: a prespecified subgroup analysis of the STRIVE trial. Prostate Cancer Prostatic Dis. 2022 Feb;25(2):363-365. doi: 10.1038/s41391-021-00465-7. Epub 2021 Oct 7.
PubMed 34621011Schultz NM, Shore ND, Chowdhury S, Klotz LH, Concepcion RS, Penson DF, Karsh LI, Yang H, Brown BA, Barlev A, Flanders SC. Number-needed-to-treat analysis of clinical progression in patients with metastatic castration-resistant prostate cancer in the STRIVE and TERRAIN trials. BMC Urol. 2018 Sep 6;18(1):77. doi: 10.1186/s12894-018-0387-7.
PubMed 30189902Penson DF, Armstrong AJ, Concepcion R, Agarwal N, Olsson C, Karsh L, Dunshee C, Wang F, Wu K, Krivoshik A, Phung D, Higano CS. Enzalutamide Versus Bicalutamide in Castration-Resistant Prostate Cancer: The STRIVE Trial. J Clin Oncol. 2016 Jun 20;34(18):2098-106. doi: 10.1200/JCO.2015.64.9285. Epub 2016 Jan 25.
PubMed 26811535
Study at a glance
From the registry record, last updated by the sponsor on 30 Jan 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- STRIVE: A MULTICENTER PHASE 2, RANDOMIZED, DOUBLE-BLIND, EFFICACY AND SAFETY STUDY OF ENZALUTAMIDE VS. BICALUTAMIDE IN MEN WITH PROSTATE CANCER WHO HAVE FAILED PRIMARY ANDROGEN DEPRIVATION THERAPY
- ClinicalTrials.gov ID
- NCT01664923
- Acronym / sponsor ID
- STRIVE / MDV3100-09
- Conditions
- Prostate Cancer
- Keywords
- prostate cancer, enzalutamide, MDV3100
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 396 participants (actual)
- Lead sponsor
- PfizerIndustry (pharma, biotech, devices)
- Collaborators
- Astellas Pharma Inc, Medivation LLC, a wholly owned subsidiary of Pfizer Inc.
- Study start
- Aug 2012 (actual)
- Primary completion
- Feb 2015 (actual)
- Study completion
- Jan 2018 (actual)
- First posted
- 14 Aug 2012 (estimated)
- Results
- Posted 23 May 2016
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine the safety and efficacy of enzalutamide vs bicalutamide in asymptomatic or mildly symptomatic patients with prostate cancer who have disease progression despite primary androgen deprivation therapy.
Detailed description
This study is a multicenter phase 2, randomized, double-blind, efficacy and safety study of enzalutamide (160 mg/day) vs. bicalutamide (50 mg/day) in patients with recurrent prostate cancer who have serologic and/or radiographic disease progression despite primary androgen deprivation therapy.
Throughout the study, safety and tolerability will be assessed by the recording of adverse events, monitoring of vital signs, physical examinations, and safety laboratory evaluations.
Following study unblinding, study patients receiving enzalutamide or bicalutamide at the time of unblinding and qualifying patients randomized to bicalutamide who discontinued prior to unblinding will be offered the opportunity to receive open label enzalutamide treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Enzalutamide | Experimental | Drug: EnzalutamideEnzalutamide 160 mg/day orally |
| Bicalutamide | Active comparator | Drug: Bicalutamide50 mg/day orally |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- Males age 18 or older;
- Histologically or cytologically confirmed adenocarcinoma of the prostate;
- Ongoing androgen deprivation therapy;
- Serum testosterone level ≤ 50 ng/dL (1.73 nmol/L) at the Screening visit;
- Progressive disease at study entry defined by prostate-specific antigen (PSA) progression and/or radiographic progression that occurred while the patient was on primary androgen deprivation therapy;
Key exclusion criteria (30 listed)
- Severe concurrent disease, infection, or co-morbidity;
- Known or suspected brain metastasis or active leptomeningeal disease;
- History of another invasive malignancy within the previous 5 years other than treated non-melanomatous skin cancer and American Joint Committee on Cancer (AJCC) Stage 0 or Stage 1 cancers that have a remote probability of recurrence;
- Absolute neutrophil count < 1,500/µL, or platelet count < 100,000/µL, or hemoglobin < 9 g/dL at the Screening visit;
- Total bilirubin, alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 times the upper limit of normal (ULN) at the Screening visit;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EnzalutamideAlso: MDV3100, Xtandi160 mg, daily, by mouth. | Drug | Enzalutamide |
| BicalutamideAlso: Casodex50 mg, daily, by mouth | Drug | Bicalutamide |
Primary outcome
Progression Free Survival (PFS)
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
PFS was defined as time from randomization to earliest objective evidence of prostate specific-antigen (PSA) progression, radiographic progression, or death on study. PSA progression was defined as ≥ 25% increase in PSA with an absolute increase ≥ 2 ng/mL above the nadir and was to be confirmed by a second consecutive assessment. Radiographic progression in bone was based on The Prostate Cancer Clinical Trials Working Group (PCWG2) guidelines defined as at least 2 new lesions on bone scan. Radiographic progression in soft tissue on Computerized Tomography/Magnetic Resonance Imaging (CT/MRI) was based on Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). CT/MRI and bone scans were read locally by the same radiologist (or nuclear medicine physician for interpretation of bone scans) whenever possible. Participants not known to have had a PFS event at the time of the analysis data cutoff were censored at the date of last assessment.
6 secondary outcomes
Time to PSA Progression
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Percentage of Participants With a PSA Response ≥ 50%
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Duration of Radiographic PFS
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Quality of Life: Time to Degradation of Functional Assessment of Cancer Therapy - Prostate (FACT-P)
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Best Overall Soft Tissue Response
Time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.
Percentage of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: From first dose of study drug until the end of open label phase (up to maximum duration of 65 months)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jan 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 34621011Penson DF, Armstrong AJ, Concepcion RS, Agarwal N, Olsson CA, Karsh LI, Dunshee CJ, Duggan W, Shen Q, Sugg J, Haas GP, Higano CS. Enzalutamide versus bicalutamide in patients with nonmetastatic castration-resistant prostate cancer: a prespecified subgroup analysis of the STRIVE trial. Prostate Cancer Prostatic Dis. 2022 Feb;25(2):363-365. doi: 10.1038/s41391-021-00465-7. Epub 2021 Oct 7.
- Derived from this study: PubMed 30189902Schultz NM, Shore ND, Chowdhury S, Klotz LH, Concepcion RS, Penson DF, Karsh LI, Yang H, Brown BA, Barlev A, Flanders SC. Number-needed-to-treat analysis of clinical progression in patients with metastatic castration-resistant prostate cancer in the STRIVE and TERRAIN trials. BMC Urol. 2018 Sep 6;18(1):77. doi: 10.1186/s12894-018-0387-7.
- Derived from this study: PubMed 26811535Penson DF, Armstrong AJ, Concepcion R, Agarwal N, Olsson C, Karsh L, Dunshee C, Wang F, Wu K, Krivoshik A, Phung D, Higano CS. Enzalutamide Versus Bicalutamide in Castration-Resistant Prostate Cancer: The STRIVE Trial. J Clin Oncol. 2016 Jun 20;34(18):2098-106. doi: 10.1200/JCO.2015.64.9285. Epub 2016 Jan 25.
- Individual participant dataSharing planned: Yes. Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Pfizer Pfizer CT.gov Call Center study director
Pfizer
109 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Enzalutamide and Bicalutamide in people with Prostate Cancer, run by Pfizer at 109 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 14 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 109 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 23 May 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression Free Survival (PFS) (time frame: From randomization until the data cut-off date of 09 February 2015, median duration of treatment was 14.7 months in the enzalutamide arm and 8.4 months in the bicalutamide arm.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01664923, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jan 2019.