A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-MutatedProstatic Neoplasms (mCSPC)
Niraparib+ Abiraterone acetate fixed dose combination (FDC): Participants will receive a FDC of Niraparib 200 mg + AA 1000 mg once daily.
Abiraterone acetate (AA): Participants will receive AA 1000 mg once daily.
Prednisone: Participants will receive prednisone 5 mg once daily.
Placebo FDC: Participants will receive matching placebo for Niraparib +AA FDC once daily.
Placebo AA: Participants will receive matching placebo for AA once daily.
Study summary
The purpose of the study is to determine if the combination of niraparib with Abiraterone Acetate (AA) plus prednisone compared with AA plus prednisone in participants with deleterious germline or somatic Homologous Recombination Repair (HRR) gene-mutated Metastatic Castration-Sensitive Prostate Cancer (mCSPC) provides superior efficacy in improving radiographic progression-free survival (rPFS).
Eligibility
Sex
MALE
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion criteria:
* Pathological diagnosis of prostate adenocarcinoma
* Must have appropriate deleterious homologous recombination repair (HRR) gene alteration
* Metastatic disease as documented by conventional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) (for soft tissue lesions) or 99mTc bone scan (for bone lesions). Participants with a single bone lesion on Technetium-99m (99mTc) bone scan with no other non-nodal metastatic disease must have confirmation of bone metastasis by CT or MRI. Participants with lymph node-only disease are not eligible
* Androgen deprivation therapy (either medical or surgical castration) must have been started \>=14 days prior to randomization and participants be willing to continue androgen deprivation therapy (ADT) through the treatment phase
* Other allowed prior therapy for metastatic castration-sensitive prostate cancer (mCSPC): (a) maximum of 1 course of radiation and 1 surgical intervention for symptomatic control of prostate cancer (example, uncontrolled pain, impending spinal cord compression or obstructive symptoms). Participants with radiation or surgical interventions to all known sites of metastatic disease will be excluded from trial participation. Radiation must be completed prior to randomization (b) Up to a maximum of 6 months of ADT prior to randomization; (c) Up to a maximum of 45 days of abiraterone acetate + prednisone (AA-P) prior to randomization (d) Up to a maximum of 2 weeks of ketoconazole for prostate cancer prior to randomization
Exclusion criteria:
* Prior treatment with a poly (adenosine diphosphate-ribose) polymerase inhibitor (PARP inhibitor)
* History of adrenal dysfunction
* Long-term use of systemically administered corticosteroids (greater than \[\>\] 5 milligrams \[mg\] of prednisone or the equivalent) during the study is not allowed. Short-term use (\<=4 weeks, including taper) and locally administered steroids (for example, inhaled, topical, ophthalmic, and intra-articular) are allowed, if clinically indicated
* History or current diagnosis of myelodysplastic syndrome (MDS)/ acute myeloid leukemia (AML)
Primary outcome measure(s)
Breast Cancer Gene (BRCA) Subgroup: Radiographic Progression-free Survival (rPFS) Assessed by Investigator — From date of randomization (Day -3 to Day 1) up to approximately 49 months rPFS: time interval from date of randomization to first date of radiographic progression as assessed by investigator or death due to any cause, whichever occurred first. rPFS was determined by: (1) progression of soft tissue lesions measured by computerized tomography (CT) or magnetic resonance imaging (MRI) per response evaluation criteria in solid tumors (RECIST) 1.1; (2) progression of bone lesions observed by bone scan per prostate cancer working group 3 (PCWG3) criteria: bone progression was confirmed by subsequent scan greater than or equal to (\>=) 6 weeks later. Week 8 scan was baseline to which all subsequent scans were compared to determine progression. A confirmatory scan with \>=2 new lesions indicated progression; A confirmatory scan not showing \>=2 new lesions means no progression. If Week 8 scan shows \<2 new bone lesions compared to baseline, first scan with \>=2 new lesions compared to Week 8 scan indicated progression, when confirmed by a subsequent scan \>=6 weeks later.
HRR Effector Subgroup: Radiographic Progression-free Survival (rPFS) Assessed by Investigator — From date of randomization (Day -3 to Day 1) up to approximately 49 months rPFS: time interval from date of randomization to first date of radiographic progression as assessed by investigator or death due to any cause, whichever occurred first. rPFS was determined by: (1) progression of soft tissue lesions measured by CT or MRI per RECIST 1.1; (2) progression of bone lesions observed by bone scan per PCWG3 criteria: bone progression was confirmed by subsequent scan \>= 6 weeks later. Week 8 scan was baseline to which all subsequent scans were compared to determine progression. A confirmatory scan with \>=2 new lesions indicated progression; A confirmatory scan not showing \>=2 new lesions means no progression. If Week 8 scan shows \<2 new bone lesions compared to baseline, first scan with \>=2 new lesions compared to Week 8 scan indicated progression, when confirmed by a subsequent scan \>=6 weeks later.
All HRR: Radiographic Progression-free Survival (rPFS) Assessed by Investigator — From date of randomization (Day -3 to Day 1) up to approximately 49 months rPFS: time interval from date of randomization to first date of radiographic progression as assessed by investigator or death due to any cause, whichever occurred first. rPFS was determined by: (1) progression of soft tissue lesions measured by CT or MRI per RECIST 1.1; (2) progression of bone lesions observed by bone scan per PCWG3 criteria: bone progression was confirmed by subsequent scan \>= 6 weeks later. Week 8 scan was baseline to which all subsequent scans were compared to determine progression. A confirmatory scan with \>=2 new lesions indicated progression; A confirmatory scan not showing \>=2 new lesions means no progression. If Week 8 scan shows \<2 new bone lesions compared to baseline, first scan with \>=2 new lesions compared to Week 8 scan indicated progression, when confirmed by a subsequent scan \>=6 weeks later.
Trial sites (387)
Facility
City
Region
Status
Urology Centers Of Alabama
Homewood
Alabama
Mayo Clinic Arizona
Phoenix
Arizona
Urological Associates of Southern Arizona, P.C.
Tucson
Arizona
Greater Los Angeles VA Healthcare System
Los Angeles
California
University of California Irvine Medical Center Chao Family Comprehensive Cancer Center
Orange
California
San Bernardino Urological Associates
San Bernardino
California
University of San Francisco California
San Francisco
California
Rocky Mountain Cancer Centers
Colorado Springs
Colorado
AdventHealth Medical Group Urology of Denver
Denver
Colorado
Colorado Clinical Research
Lakewood
Colorado
Eastern Connecticut Hematology & Oncology Assoc.
Norwich
Connecticut
Advanced Urology Institute
Daytona Beach
Florida
Holy Cross Hospital - Michael and Dianne Bienes Comprehensive Cancer Center
Fort Lauderdale
Florida
University of Florida Health Jacksonville
Jacksonville
Florida
Cancer Specialists of North Florida
Jacksonville
Florida
Urology of Indiana
Greenwood
Indiana
First Urology
Jeffersonville
Indiana
Ochsner Clinic Foundation
New Orleans
Louisiana
Baltimore VA Medical Center
Baltimore
Maryland
Maryland Oncology Hematology, PA
Columbia
Maryland
Chesapeake Urology Associates
Towson
Maryland
Michigan Institute of Urology
Troy
Michigan
Mosaic Life Care
Saint Joseph
Missouri
St. Louis VA Medical Center
St Louis
Missouri
GU Research Network
Omaha
Nebraska
New York Oncology Hematology
Albany
New York
Manhattan VAMC
New York
New York
Mount Sinai
New York
New York
Memorial Sloan Kettering Cancer Center
New York
New York
Associated Medical Professionals
Syracuse
New York
Montefiore Medical Center
The Bronx
New York
Durham VAMC
Durham
North Carolina
Stephenson Cancer Center
Oklahoma City
Oklahoma
VA Portland Health Care System
Portland
Oregon
Oregon Oncology Specialists
Salem
Oregon
Keystone Urology Specialists
Lancaster
Pennsylvania
Philadelphia VA Medical Center
Philadelphia
Pennsylvania
University of Pennsylvania
Philadelphia
Pennsylvania
University of Pittsburgh Medical Center (UPMC)
Pittsburgh
Pennsylvania
Ralph H. Johnson Veterans Affairs Medical Center
Charleston
South Carolina
+ 347 more sites — see the full list on the official registry below.
Official registry record
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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