A Study of Niraparib Combination Therapies for the Treatment of Metastatic Castration-Resistant Prostate Cancer (QUEST)
A Phase 1b-2 Study of Niraparib Combination Therapies for the Treatment of Metastatic Castration-Resistant Prostate Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Aalst, Belgium, 9300
- OLV Ziekenhuis Aalst
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Antwerp, Belgium, 2020
- ZNA Middelheim
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Brussels, Belgium, 1070
- ULB Hopital Erasme
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Ghent, Belgium, 9000
- Universitair Ziekenhuis Gent
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Kortrijk, Belgium, 8500
- AZ Groeninge
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Liège, Belgium, B-4000
- Centre Hospitalier Universitaire de Liege Domaine Universitaire du Sart Tilman
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Alberta
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Calgary, Alberta, Canada, T2V 1P9
- Southern Alberta Institute of Urology / Prostate Cancer Centre
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British Columbia
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Vancouver, British Columbia, Canada, V5Z4E6
- British Columbia Cancer Agency
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Ontario
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Toronto, Ontario, Canada, M5G2M9
- Princess Margaret Cancer Centre University Health Network
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Quebec
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Montreal, Quebec, Canada, H2X 0A9
- Centre de recherche du CHUM
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Beer Yaakov, Israel, 60930
- Asaf Harofe Medical Center
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Beersheba, Israel, 85101
- Soroka Hospital
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Haifa, Israel, 31096
- Rambam Medical Center
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Petah Tikva, Israel, 49100
- Rabin Medical Center
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Ramat Gan, Israel, 52621
- Sheba Medical Center Tel Hashomer
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Florence, Italy, 50134
- Azienda Ospedaliera Universitaria Careggi di Firenze
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Lecce, Italy, 73100
- Azienda Ospedaliera ''Vito Fazzi''
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Milan, Italy, 20162
- Asst Grande Ospedale Metropolitano Niguarda
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Naples, Italy, 80131
- IRCCS-Fondazione Pascale
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Province of Macerata, Italy, 62100
- UOC Oncologia Ospedale Provinciale di Macerata
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Barcelona, Spain, 8035
- Hospital Vall D'Hebron
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Barcelona, Spain, 08025
- Hosp. de La Santa Creu I Sant Pau
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Madrid, Spain, 28006
- Hosp. Univ. de La Princesa
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Madrid, Spain, 28040
- Hosp Univ Fund Jimenez Diaz
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Madrid, Spain, 28050
- Hosp Univ Hm Sanchinarro
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Málaga, Spain, 29010
- Hosp Virgen de La Victoria
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Bath, United Kingdom, BA1 3NG
- Royal United Hospital
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London, United Kingdom, WC1E 6BT
- University College London Hospitals
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Southampton, United Kingdom, SO16 6YD
- Southampton General Hospital
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Sutton, United Kingdom, SM2 5PT
- The Royal Marsden NHS Trust Sutton
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Truro, United Kingdom, TR1 3LJ
- Royal Cornwall Hospitals NHS Trust - Royal Cornwall Hospital
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Arizona
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Tucson, Arizona, United States, 85741
- Urological Associates of Southern Arizona, P.C.
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Colorado
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Denver, Colorado, United States, 80211
- The Urology Center of Colorado
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Florida
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Jacksonville, Florida, United States, 32224
- Mayo Clinic - Division Of Hematology/oncology
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Indiana
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Jeffersonville, Indiana, United States, 47130
- First Urology, PSC
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Maryland
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Towson, Maryland, United States, 21204
- Chesapeake Urology Research Associates
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Michigan
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Troy, Michigan, United States, 48084
- Michigan Institute of Urology
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New York
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Albany, New York, United States, 12208
- New York Oncology Hematology
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Harrison, New York, United States, 10604
- Memorial Sloan Kettering Cancer Center 1
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19107
- Thomas Jefferson University
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Pittsburgh, Pennsylvania, United States, 15232
- University of Pittsburgh Medical Center (UPMC)
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South Carolina
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Charleston, South Carolina, United States, 29425
- MUSC-Hollings Cancer Center
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Myrtle Beach, South Carolina, United States, 29572
- Carolina Urologic Research Center
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Tennessee
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Nashville, Tennessee, United States, 37209
- Urology Associates
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Texas
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Houston, Texas, United States, 77030
- The University of Texas MD Anderson Cancer Center
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Houston, Texas, United States, 77027
- Houston Metro Urology
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Utah
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Salt Lake City, Utah, United States, 84106
- Utah Cancer Specialists
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Virginia
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Virginia Beach, Virginia, United States, 23462
- Urology of Virginia, PLCC
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Wisconsin
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Madison, Wisconsin, United States, 5379200
- University of Wisconsin Carbone Cancer Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria for Combination 3:
- Diagnosed with mCRPC, who in the opinion of the investigator may benefit from treatment in Combination 3 of this study
- Able to continue gonadotropin releasing hormone analogue (GnRHa) therapy during the study if not surgically castrate (that is, subjects who has not undergone bilateral orchiectomy).
- Eastern Cooperative Oncology Group Performance Status (ECOG PS) of less than or equal to (<=) 1
- Toxicity associated with prior chemotherapy or radiotherapy has resolved to Grade <= 1 (except alopecia or Grade <= 2 neuropathy) at screening
- Participant must agree not to donate sperm while on study treatment, and for 3 months following the last dose of study treatment
Exclusion Criteria:
- History or current diagnosis of myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML)
- Active malignancies (that is, progressing or requiring treatment change in the last 24 months) other than the disease being treated under study. The only allowed exceptions are: non-muscle invasive bladder cancer; skin cancer (non-melanoma or melanoma); breast cancer; malignancy that is considered cured with minimal risk of recurrence
- Active infection requiring systemic therapy
- Allergies, hypersensitivity, or intolerance to niraparib or the corresponding excipients
Combination 3:
- Symptomatic brain metastases
- Prior disease progression during combination treatment with AA and poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitor (PARPi). Prior discontinuation of treatment with AA or PARPi due to AA- or PARPi-related toxicity
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Combination 1:Dose Selection: Niraparib + cetrelimab (Part 1)
Dose regimen 1: The participants will receive niraparib 200 milligram (mg) orally once daily in combination with cetrelimab 240 mg intravenously (IV) once every 2 weeks.
Dose regimen 2: The participants will receive niraparib 200 mg orally once daily in combination with cetrelimab 480 mg IV once every 4 weeks in 28-day treatment cycles until disease progression, unacceptable toxicity, death, or the sponsor terminates the study.
The safety evaluation team (SET) will determine if an additional cohort is necessary, based on the data from dose regimens 1 and 2. Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
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Participants will receive niraparib 200 mg orally.
Participants will receive cetrelimab 240 mg IV every 2 weeks.
Other Names:
Participants will receive cetrelimab 480 mg IV every 4 weeks.
Other Names:
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Experimental: Combination 1:Dose Expansion: Niraparib + cetrelimab (Part 2)
Participants will be assigned to either Cohort 1A (Biomarker [BM] positive [+]) or Cohort 1B (BM negative [-]) and will receive established RP2D of cetrelimab and niraparib, in Part 2 until disease progression, unacceptable toxicity, death, or the sponsor terminates the study.
A futility analysis will be performed for the Cohort 1B after 10 BM- participants are enrolled in Part 2. This cohort will be closed if the response is less than predetermined response rate as outlined in the protocol.
Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
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Participants will receive niraparib 200 mg orally.
Participants will receive cetrelimab 480 mg IV every 4 weeks.
Other Names:
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Experimental: Combination 2: Dose Expansion: Niraparib + AA-P (Part 2)
Participants will be assigned to one of 4 cohorts based on biomarker status - Cohort 2A (BRCA biallelic loss), 2B (other DRD biallelic loss), 2C (BRCA monoallelic loss), or 2D (other DRD monoallelic loss), and will receive niraparib 200 mg once daily in combination with abiraterone acetate 1000 mg (4*250 mg) plus 10 mg prednisone (5 mg twice daily) throughout treatment phase.
Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
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Participants will receive niraparib 200 mg orally.
Participants will receive AA 1000 mg orally.
Participants will receive prednisone 5 mg orally.
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Experimental: Combination 3: Niraparib + AA-P
Participants will be assigned to one of three cohorts to receive AA-P with or without niraparib.
Participants in the Treatment Phase of this combination will be offered the option to enter the Long-term Extension Phase of the study.
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Participants will receive niraparib 200 mg orally.
Participants will receive AA 1000 mg orally.
Participants will receive prednisone 5 mg orally.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Combination 1: Part 1: Number of Participants With Specified Toxicity
Time Frame: Cycle 1 (28 days)
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Number of participants with specified toxicity during Cycle 1 was reported.
Only toxicities that occurred during safety evaluation period(defined as first 28 days of treatment-Cycle 1 of Part 1) was used for analysis of specified toxicities and for dose reduction decisions.
Toxicities were graded for severity as per NCI-CTCAE, version 4.03.
Safety evaluation criteria were: Any Grade(G) >=3 non-hematological toxicity without anorexia, or constipation, fatigue improved to G<=2 in <7 days, vomiting and diarrhea resolved in <=3 days, laboratory abnormalities with hospitalization, tumor flare improved to G<=2 in <=7 days, elevation in AST/ALT for <=7 days and G3 hypertension controlled by medical therapy; any treatment-related(TR)G4 or G>=3 thrombocytopenia required platelet transfusion; Any TR G4 neutropenia >=7 days or G3 or 4 neutropenia with infection/fever >38.5 degrees Celsius; Any TR SAE or intolerable toxicity.
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Cycle 1 (28 days)
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Combination 1: Part 2: Objective Response Rate (ORR)
Time Frame: Up to 37 months
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ORR of soft tissue (visceral or nodal disease) was defined as percentage of participants with measurable disease who achieved a best response of either complete response (CR) or partial response (PR) as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 with no evidence of bone progression according to prostate cancer working group 3 (PCWG3) criteria.
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Up to 37 months
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Combination 2: Composite Response Rate (RR)
Time Frame: Up to 31 months
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Composite response rate was defined as the percentage of participants who had a composite response which is defined as one of the following PCWG3 criteria: Objective response (percentage of participants with measurable disease who achieved a best response of either CR or PR as assessed by RECIST 1.1 with no evidence of bone progression according to PCWG3 criteria) (confirmed per RECIST 1.1), or; circulating tumor cells (CTC) response: defined as CTC=0 per 7.5 milliliters (mL) of blood at 8 weeks for participants who had CTC greater than or equal to (>=) 1 at baseline or CTC less than (<) 5 per 7.5 mL with CTC >=5 at baseline, confirmed by a second consecutive value obtained 4 or more weeks later, or prostate-specific antigen (PSA) declined of >=50 percentage (%), measured twice 3 to 4 weeks apart.
This outcome measure was analyzed for specified arms only as pre-planned in the protocol.
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Up to 31 months
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Combination 1: Part 2: Number of Participants With Adverse Events (AEs)
Time Frame: Up to 37 months
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AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product.
An AE does not necessarily have a causal relationship with the treatment.
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Up to 37 months
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Combination 2: Number of Participants With Adverse Events (AEs)
Time Frame: Up to 31 months
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AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product.
An AE does not necessarily have a causal relationship with the treatment.
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Up to 31 months
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Combination 1: Part 2: Number of Participants With Adverse Events (AEs) of Grade >=3 Severity
Time Frame: Up to 37 months
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AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product.
An AE does not necessarily have a causal relationship with the treatment.
An assessment of severity grade was made using the National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) as Grade 1 (mild): awareness of symptoms that are easily tolerated, causing minimal discomfort and not interfering with everyday activities; Grade 2 (moderate): sufficient discomfort is present to cause interference with normal activity; Grade 3 (severe): extreme distress, causing significant impairment of functioning or incapacitation, prevents normal everyday activities; Grade 4 (Life-threatening): urgent intervention indicated; and Grade 5 (death).
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Up to 37 months
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Combination 2: Number of Participants With Adverse Events (AEs) of Grade >=3 Severity
Time Frame: Up to 31 months
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AE was defined as an any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product.
An AE does not necessarily have a causal relationship with the treatment.
An assessment of severity grade was made using the NCI-CTCAE as Grade 1 (mild): awareness of symptoms that are easily tolerated, causing minimal discomfort and not interfering with everyday activities; Grade 2 (moderate): sufficient discomfort is present to cause interference with normal activity; Grade 3 (severe): extreme distress, causing significant impairment of functioning or incapacitation, prevents normal everyday activities; Grade 4 (Life-threatening): urgent intervention indicated; and Grade 5 (death).
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Up to 31 months
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Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib and Abiraterone Acetate After a Single Dose
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Cmax is defined as maximum observed plasma concentration of niraparib and abiraterone acetate (AA) after a single dose.
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Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib Normalized by the Dose(Niraparib) (Cmax/Dose) of Niraparib Administered With AA After a Single Dose
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Cmax/dose of niraparib was defined as maximum observed plasma concentration of niraparib Cmax normalized by the dose of niraparib administered with AA after a single dose.
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Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Area Under the Plasma Concentration-Time Curve From Time Zero to 168 Hours (AUC [0-168hr]) of Niraparib Administered With AA After a Single Dose
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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AUC(0-168 hours) was defined as area under the plasma concentration-time curve from time zero to 168 hours of Niraparib administered with AA After a single dose.
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Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Area Under the Plasma Concentration-Time Curve for Niraparib From Time Zero to 168 Hours (AUC [0-168 Hours]/Dose) of Niraparib Administered With AA After a Single Dose
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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AUC0(168 hours)/dose was defined as area under the plasma concentration-time curve for niraparib from time 0 to 168 hours of niraparib administered with AA after a single dose.
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Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Combination 1: Parts 1 and 2: Plasma Concentrations of Niraparib
Time Frame: Day 1
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Day 1
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Combination 1: Parts 1 and 2: Maximum Observed Plasma Concentration (Cmax) of Niraparib
Time Frame: Day 1
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Day 1
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Combination 1: Parts 1 and 2: Time to Reach the Maximum Plasma Concentration (Tmax) of Niraparib
Time Frame: Day 1
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Day 1
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Combination 1: Parts 1 and 2: Minimum Observed (Predose) Concentration Following Multiple Dosing (Ctrough) of Niraparib
Time Frame: Day 1
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Day 1
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Combination 1: Parts 1 and 2: Number of Participants With Anti-drug Antibodies of Niraparib
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 1: Part 2 and Combination 2: Circulating Tumor Cells (CTC) Response
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 1: Part 2: Composite Response Rate
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 2: Objective Response Rate (ORR)
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 1: Part 2 and Combination 2: Duration of Objective Response
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 1: Part 2 and Combination 2: Overall Survival
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 3: Cmax of Niraparib and Abiraterone Acetate After a Single Dose For Low-strength FDC
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
|
Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
|
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Combination 3: Maximum Observed Plasma Concentration (Cmax) of Niraparib Normalized by the Dose(Niraparib) (Cmax/Dose) of Niraparib Administered With AA After a Single Dose for Low-strength FDC
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
|
Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Area Under the Plasma Concentration-Time Curve From Time Zero to 168 Hours (AUC [0-168hr]) of Niraparib Administered With AA After a Single Dose For Low-strength FDC
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
|
Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Area Under the Plasma Concentration-Time Curve for Niraparib From Time Zero to 168 Hours (AUC [0-168 Hours]/Dose) of Niraparib Administered With AA After a Single Dose For Low-strength FDC
Time Frame: Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
|
Pre-dose, 30 min, 1 hour (hr), 1.5 hr, 2hr, 3 hr, 4 hr, 6 hr, 8 hr, 10 hr, 24 hr, 48 hr, 72 hr, and 168 hr post dose on Day 1
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Combination 3: Number of Participants With Adverse Events
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Combination 3: Number of Participants With Clinical Laboratory Parameters
Time Frame: From baseline up to end of study (6 years 10 months)
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From baseline up to end of study (6 years 10 months)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Janssen Research & Development, LLC Clinical Trial, Janssen Research & Development, LLC
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Genital Neoplasms, Male
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Genital Diseases, Male
- Prostatic Diseases
- Male Urogenital Diseases
- Prostatic Neoplasms
- Prostatic Neoplasms, Castration-Resistant
- Polycyclic Compounds
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Pregnadienediols
- Androstenes
- Androstanes
- Abiraterone Acetate
- Prednisone
- niraparib
Other Study ID Numbers
Other Study ID Numbers
- CR108406
- 64091742PCR2002 (Other Identifier: Janssen Research & Development, LLC)
- 2017-003552-23 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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