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Prostate CancerPhase 4NCT02918968

Study on Enzalutamide and Flutamide in Patients With Castration Resistant Prostate Cancer

A Phase 4 study testing Enzalutamide, Flutamide and Androgen deprivation therapy in people with Prostate Cancer, run by Astellas Pharma Inc at 47 sites in Japan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study was to compare the efficacy and safety of the combination therapy with enzalutamide + androgen deprivation therapy (ADT) and the combination therapy with flutamide + ADT in patients with castration resistant prostate cancer who had relapsed during combined androgen blockade (CAB) therapy… Read more about this study

Who is it for?
Ages 20 years and older, men only
Conditions the study is for
Prostate Cancer
What is being tested?
Enzalutamide, Flutamide and Androgen deprivation therapy
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
206 participants
Where
47 sitesJapan
Study dates
2 Nov 2016to 27 Mar 2020
Phase
Phase 4
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 20 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject is diagnosed with histologically or cytologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation or small-cell histology.
  • Subject on continuous ADT with Gonadotropin Releasing Hormone (GnRH) agonist/antagonist or bilateral orchiectomy.
  • Serum testosterone level below the target level at screening visit.
  • Subject with asymptomatic or mildly symptomatic prostate cancer.
  • Subject has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Subject has progression of the disease as defined by rising PSA levels or progressive soft tissue or bony disease during CAB therapy in combination of bicalutamide and ADT.
  • A sexually active male subject and the subject's female partner who is of childbearing potential must use 2 acceptable birth control methods from screening to 3 months after the last dose of the study drug.
  • Subject must agree not to donate sperm from screening to 3 months after the last dose of the study drug.

Who cannot join

  • Subject with severe concurrent diseases, infections, or complications.
  • Subject with confirmed or suspected brain metastasis or active leptomeningeal metastasis.
  • Subject with a history of malignant tumor other than prostate cancer in the past 5 years.
  • Subject hypersensitive to the ingredients of enzalutamide capsules or flutamide tablets.
  • Subject with a history of convulsive attack, or prone to convulsive attack.
  • Subject with liver disorder such as viral hepatitis and hepatic cirrhosis, or subject with Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) at screening visit higher than the upper limit of normal.
  • Subject received treatment for prostate cancer with cytocidal chemotherapy that includes anti androgenic agents other than bicalutamide, abiraterone, or estramustine.

Trial locations and contacts

47 sites in 1 country.

47 sites in 1 country

Japan47 sites
  • Site JP00011

    Bunkyo-ku, Tokyo

  • Site JP00017

    Bunkyo-ku, Tokyo

  • Site JP00010

    Chiba

  • Site JP00053

    Chiba

  • Site JP00039

    Fukuoka

  • Site JP00040

    Fukuoka

  • Site JP00050

    Fukuoka

  • Site JP00054

    Hakodate, Hokkaido

  • Site JP00022

    Hamamatsu, Shizuoka

  • Site JP00028

    Hirakata, Osaka

  • Site JP00035

    Hiroshima

  • Site JP00051

    Iizuka, Fukuoka

  • Site JP00045

    Isesaki, Gunma

  • Site JP00046

    Kashihara, Nara

  • Site JP00009

    Kitaadachi-gun, Saitama

  • Site JP00013

    Koto-ku, Tokyo

  • Site JP00033

    Kurashiki, Okayama-ken

  • Site JP00026

    Kyoto

  • Site JP00005

    Maebashi, Gunma

  • Site JP00038

    Matsuyama, Ehime

  • Site JP00055

    Mito, Ibaraki

  • Site JP00006

    Nagano

  • Site JP00008

    Nagano

  • Site JP00041

    Nagasaki

  • Site JP00024

    Nagoya, Aichi-ken

  • Site JP00025

    Nagoya, Aichi-ken

  • Site JP00014

    Nakano-ku, Tokyo

  • Site JP00029

    Osaka

  • Site JP00031

    Osaka

  • Site JP00032

    Osaka

  • Site JP00043

    Ōta, Gunma

  • Site JP00042

    Saga

  • Site JP00019

    Sagamihara, Kanagawa

  • Site JP00001

    Sapporo, Hokkaido

  • Site JP00002

    Sapporo, Hokkaido

  • Site JP00048

    Sapporo, Hokkaido

  • Site JP00030

    Sayama, Osaka

  • Site JP00016

    Shinagawa-ku, Tokyo

  • Site JP00018

    Shinjuku-ku, Tokyo

  • Site JP00027

    Suita, Osaka

  • Site JP00037

    Tokushima

  • Site JP00052

    Toyama

  • Site JP00034

    Ube, Yamaguchi

  • Site JP00049

    Utsunomiya, Tochigi

  • Site JP00020

    Yokohama, Kanagawa

  • Site JP00021

    Yokohama, Kanagawa

  • Site JP00044

    Yokosuka, Kanagawa

Other trials in Japan

About this study

Official title: A Randomized Phase IV Study Comparing Enzalutamide Versus Flutamide in Castration-resistant Prostate Cancer (CRPC) Patients Who Have Failed Combined Androgen Blockade Therapy With Bicalutamide Plus Androgen Deprivation Therapy (ADT)

The objective of this study was to compare the efficacy and safety of the combination therapy with enzalutamide + androgen deprivation therapy (ADT) and the combination therapy with flutamide + ADT in patients with castration resistant prostate cancer who had relapsed during combined androgen blockade (CAB) therapy with bicalutamide and ADT. This study also investigated the order of alternative antiandrogen therapy (AAT) by changing the 1st line medication after relapse of prostate-specific antigen (PSA).

Conditions
Prostate Cancer
Being tested
Enzalutamide, Flutamide, Androgen deprivation therapy
Keywords
enzalutamide, Xtandi, Prostate Cancer
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 Xtandi, MDV3100

    Oral Capsule

  • FlutamideDrug

    Oral tablet

  • Androgen deprivation therapyOther

    All subjects must undergo continuous Androgen deprivation therapy with GnRH agonist/antagonist or bilateral orchiectomy during the study period.

Study groups in NCT02918968
Study groupRoleWhat they receive
Enzalutamide 160 mg 1st line AAT/Flutamide 375 mg 2nd line AATExperimentalParticipants received enzalutamide 160 mg capsules, orally once daily as 1st line of alternative antiandrogen therapy (AAT) until confirmed prostate-specific antigen (PSA) progression, other disease progression, or an intolerable adverse event. After confirmation of PSA progression, other disease progression, or an intolerable adverse event, participants received flutamide 125 mg tablets orally thrice daily after each meal as 2nd line of AAT. Treatment with each drug was continued until the participant met any of the discontinuation criteria or until 2 years from the enrollment of the last participant (approximately 38 months).
Receives: Drug: Enzalutamide; Drug: Flutamide; Other: Androgen deprivation therapy
Flutamide 375 mg 1st line AAT/Enzaltumide 160 mg 2nd line AATExperimentalParticipants received flutamide 125 mg tablets orally thrice daily after each meal as 1st line of AAT until confirmed PSA progression, other disease progression, or an intolerable adverse event. After confirmed PSA progression, other disease progression, or an intolerable adverse event. participants received enzalutamide 160 mg capsules orally once daily as 2nd line of AAT. Treatment with each drug was continued until the participant met any of the discontinuation criteria or until 2 years from the enrollment of the last participant (approximately 38 months).
Receives: Drug: Enzalutamide; Drug: Flutamide; Other: Androgen deprivation therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to PSA Progression With 1st Line AAT (TTPP1)

    TTPP1 was defined as the period from the date of randomization to the date of PSA progression in the 1st line AAT period. PSA progression was defined according to the consensus guidelines of prostate cancer clinical trials working group 2 (PCWG2). For participants with PSA declines at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir were documented, which was confirmed by a second consecutive value obtained 3 or more weeks later. For participants with no PSA decline at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the baseline were documented. Time to event analysis was performed using kaplan-meier (KM) estimates.

    Measured: From date of randomization to the date of PSA progression in the 1st line AAT period (Up to 38 months)

Secondary outcomes (7)
  1. Time to PSA Progression With 2nd Line AAT (TTPP2)

    TTPP2 was defined as the period from day 1 of the 2nd line AAT to the date of PSA progression with the 2nd line AAT. PSA progression was defined according to the consensus guidelines of PCWG2. For participants with PSA declines at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir were documented, which was confirmed by a second consecutive value obtained 3 or more weeks later. For participants with no PSA decline at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the baseline were documented. Time to event analysis was performed using kaplan-meier estimates.

    Measured: From date of randomization to the date of PSA progression in 2nd line AAT (Up to 38 months)

  2. Percentage of Participants Achieving at Least 50 or 90 Percent (%) Reduction From Baseline and Up To Week 38 in Prostate Specific Antigen (PSA) Response at 1st Line AAT

    PSA response was defined as PSA decreased by at least 50% or 90% from baseline when at least 3 weeks passed after the lowest PSA decreased by at least 50% or 90% from baseline in the 1st line AAT period after baseline.

    Data was reported per each disease stage (M0/N0, M0/N1, M1). 1) M0/N0: No distant metastasis and no lymph node metastasis. 2) M0/N1: Without distant metastasis, but with metastasis in lymph nodes distal to the aortic bifurcation. 3) M1: With distant metastasis (including metastasis in lymph nodes proximal to the aortic bifurcation).

    Measured: Baseline and at least 3 weeks after, the lowest PSA decreased by at least 50% or 90% from baseline (Up to 38 months)

  3. Percentage of Participants Achieving at Least 50 or 90 Percent (%) Reduction From Baseline to Week 13 in Prostate Specific Antigen (PSA) Response at 1st Line AAT

    PSA response was defined as the lowest PSA at week 13 decreased by at least 50% or 90% from baseline in the 1st line AAT period.

    Data was reported per each disease stage (M0/N0, M0/N1, M1). 1) M0/N0: No distant metastasis and no lymph node metastasis. 2) M0/N1: Without distant metastasis, but with metastasis in lymph nodes distal to the aortic bifurcation. 3) M1: With distant metastasis (including metastasis in lymph nodes proximal to the aortic bifurcation).

    Measured: Baseline and week 13

  4. Time to PSA Decrease by 50% From Baseline With 1st Line AAT

    Time to PSA decrease by 50% with 1st line AAT was defined as the period from the date of randomization to the day when the decrease of PSA from baseline by 50% is first identified. Time to event analysis was performed using kaplan-meier estimates.

    Data was reported per each disease stage (M0/N0, M0/N1, M1). 1) M0/N0: No distant metastasis and no lymph node metastasis. 2) M0/N1: Without distant metastasis, but with metastasis in lymph nodes distal to the aortic bifurcation. 3) M1: With distant metastasis (including metastasis in lymph nodes proximal to the aortic bifurcation).

    Measured: From date of randomization to the day when the decrease of PSA from baseline by 50% is first identified (Up to 38 months)

  5. Time to Treatment Failure of 1st Line AAT (TTF1)

    TTF1 was defined as the period from randomization to study drug discontinuation of 1st line AAT for any reason that includes disease progression, onset of adverse events (AEs), participants request, or death. Time to event analysis was performed using kaplan-meier estimates.

    Data was reported per each disease stage (M0/N0, M0/N1, M1). 1) M0/N0: No distant metastasis and no lymph node metastasis. 2) M0/N1: Without distant metastasis, but with metastasis in lymph nodes distal to the aortic bifurcation. 3) M1: With distant metastasis (including metastasis in lymph nodes proximal to the aortic bifurcation).

    Measured: From date of randomization to discontinuation of 1st line AAT (Up to 38 months)

  6. Time to Treatment Failure of 2nd Line AAT (TTF2)

    TTF2 was defined as the period from randomization to study drug discontinuation of 2nd line AAT for any reason that includes disease progression, onset of AEs, participants request, or death. Time to event analysis was performed using kaplan-meier estimates.

    Measured: From date of randomization to discontinuation of 2nd line AAT (Up to 38 months)

  7. Radiographic Progression-free Survival (rPFS)

    rPFS was defined as the period from randomization to the time when radiographic disease progression is observed or death of any cause during the study period, whichever occurs earlier. Time to event analysis was performed using kaplan-meier estimates.

    Data was reported per each disease stage (M0/N0, M0/N1, M1). 1) M0/N0: No distant metastasis and no lymph node metastasis. 2) M0/N1: Without distant metastasis, but with metastasis in lymph nodes distal to the aortic bifurcation. 3) M1: With distant metastasis (including metastasis in lymph nodes proximal to the aortic bifurcation).

    Measured: From date of randomization to the time when radiographic disease progression is observed or death of any cause (up to 38 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Sep 2016 (estimated)
  2. Study start2 Nov 2016
  3. Primary completion27 Mar 2020
  4. Study completion27 Mar 2020

Resources

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
206 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02918968
Sponsor's protocol ID
9785-MA-3051
Status last verified
Nov 2024
First submitted
27 Sep 2016
Last updated
9 Dec 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as products terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Enzalutamide, Flutamide and Androgen deprivation therapy in people with Prostate Cancer, run by Astellas Pharma Inc at 47 sites in Japan.

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 8 inclusion and 7 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 9 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 47 sites in Japan. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 21 May 2021). 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?

Time to PSA Progression With 1st Line AAT (TTPP1) (time frame: From date of randomization to the date of PSA progression in the 1st line AAT period (Up to 38 months)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Dec 2024.

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