- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02257736
An Efficacy and Safety Study of Apalutamide (JNJ-56021927) in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone in Participants With Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer (mCRPC)
March 26, 2024 updated by: Aragon Pharmaceuticals, Inc.
A Phase 3 Randomized, Placebo-controlled Double-blind Study of JNJ-56021927 in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone in Subjects With Chemotherapy-naive Metastatic Castration-resistant Prostate Cancer (mCRPC)
The purpose of this study is to compare the radiographic progression-free survival (rPFS) of apalutamide in combination with abiraterone acetate (AA) plus prednisone or prednisolone (AAP) and AAP in participants with chemotherapy-naive (participants who did not receive any chemotherapy [treatment of cancer using drugs]) metastatic castration-resistant prostate cancer (mCRPC) (cancer of prostate gland [gland that makes fluid that aids movement of sperm]).
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
This is a randomized (study drug assigned by chance), double-blind (neither the Investigator nor the participant know the treatment) placebo-controlled and multicenter (when more than 1 hospital or medical school team work on a medical research study) study to determine if participants with chemotherapy-naive mCRPC will benefit from the addition of apalutamide to AAP compared with AAP alone.
The study consists of 3 phases: Screening phase; Treatment phase, and Follow-up phase.
At the final analysis, the study will be unblinded.
After the Independent Data Monitoring Committee (IDMC) review and the sponsor's subsequent decision participants will be offered to receive treatment either in the Open-Label Extension Phase or the Long-Term Extension Phase of study.
Participants' safety will be monitored throughout the study.
Study Type
Interventional
Enrollment (Actual)
982
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Ciudad Automoma Buenos Aires, Argentina
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Ciudad de Buenos Aires, Argentina
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Cordoba, Argentina
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La Rioja, Argentina
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Mendoza, Argentina
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Rosario, Argentina
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Adelaide, Australia
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Ashford, Australia
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Camperdown, Australia
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Herston, Australia
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Liverpool, Australia
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Malvern, Australia
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Melbourne, Australia
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Southport, Australia
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Wahroonga, Australia
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West Heidelberg, Australia
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Woolloongabba, Australia
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Antwerpen, Belgium
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Bruxelles, Belgium
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Gent, Belgium
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Gosselies, Belgium
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Leuven, Belgium
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Liege, Belgium
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Namur, Belgium
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Ottignies, Belgium
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Roeselare, Belgium
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Sint-Niklaas, Belgium
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Barretos, Brazil
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Ijui, Brazil
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Natal, Brazil
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Porto Alegre, Brazil
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Sao Jose do Rio Preto, Brazil
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Sao Paulo, Brazil
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Quebec, Canada
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British Columbia
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Abbotsford, British Columbia, Canada
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Kelowna, British Columbia, Canada
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Vancouver, British Columbia, Canada
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Nova Scotia
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Halifax, Nova Scotia, Canada
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Ontario
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Barrie, Ontario, Canada
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London, Ontario, Canada
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Oakville, Ontario, Canada
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Toronto, Ontario, Canada
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Weston, Ontario, Canada
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Quebec
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Montreal, Quebec, Canada
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Sherbrooke, Quebec, Canada
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Angers Cedex 9, France
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Caen Cedex 05, France
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Dijon Cedex, France
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Le Mans Cedex 2, France
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Lyon, France
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Lyon cedex 03, France
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Montpellier, France
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Paris Cedex 15, France
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Saint Herblain, France
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Toulouse Cedex 9, France
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Berlin, Germany
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Dresden, Germany
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Freiburg, Germany
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Hamburg, Germany
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Heidelberg, Germany
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Muenster, Germany
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Nuertingen, Germany
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Wuppertal, Germany
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Fukuoka-shi, Japan
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Kanazawa, Japan
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Kashiwa, Japan
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Kita-Gun, Japan
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Kumamoto, Japan
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Kurume, Japan
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Matsuyama-Shi, Japan
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Miyazaki, Japan
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Nagasaki, Japan
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Osaka, Japan
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Osaka-Sayama, Japan
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Sakura, Japan
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Sapporo, Japan
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Ube, Japan
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Yokohama, Japan
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Goyang-Si, Korea, Republic of
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Seongnam, Korea, Republic of
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Seoul, Korea, Republic of
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Chihuahua, Mexico
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Cuernavaca, Mexico
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Culiacan, Mexico
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Mexico, Mexico
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Oaxaca, Mexico
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Zapopan, Mexico
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Amsterdam, Netherlands
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Amsterdam Zuidoost, Netherlands
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Blaricum, Netherlands
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Den Haag, Netherlands
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Dordrecht, Netherlands
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Groningen, Netherlands
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Heerlen, Netherlands
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Nieuwegein, Netherlands
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Nijmegen, Netherlands
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Rotterdam, Netherlands
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Kursk, Russian Federation
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Moscow, Russian Federation
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Omsk, Russian Federation
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Pyatigorsk, Russian Federation
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Rostov-on-Don, Russian Federation
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Saint Petersburg, Russian Federation
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Saint-Petersburg, Russian Federation
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Saint-Petersburg,, Russian Federation
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Ufa, Russian Federation
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Bloemfontein, South Africa
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Cape Town, South Africa
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Johannesburg, South Africa
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Pretoria, South Africa
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Alcorcon, Spain
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Barcelona, Spain
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Cadiz, Spain
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Cordoba, Spain
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Madrid, Spain
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San Sebastián de los Reyes, Spain
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Valencia, Spain
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Ayr, United Kingdom
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Belfast, United Kingdom
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Birmingham, United Kingdom
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Edinburgh, United Kingdom
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Glasgow, United Kingdom
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London, United Kingdom
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Manchester, United Kingdom
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Plymouth, United Kingdom
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Preston, United Kingdom
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Stevenage, United Kingdom
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Sutton, United Kingdom
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Westcliff on Sea, United Kingdom
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Wirral, United Kingdom
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Arizona
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Phoenix, Arizona, United States
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California
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La Mesa, California, United States
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Los Angeles, California, United States
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Modesto, California, United States
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San Diego, California, United States
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San Francisco, California, United States
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Santa Barbara, California, United States
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Colorado
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Aurora, Colorado, United States
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Denver, Colorado, United States
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Florida
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Jensen Beach, Florida, United States
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Lakeland, Florida, United States
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New Port Richey, Florida, United States
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Ocala, Florida, United States
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Georgia
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Atlanta, Georgia, United States
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Illinois
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Melrose, Illinois, United States
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Niles, Illinois, United States
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Louisiana
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Marrero, Louisiana, United States
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New Orleans, Louisiana, United States
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Shreveport, Louisiana, United States
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Maine
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Auburn, Maine, United States
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Maryland
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Baltimore, Maryland, United States
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Missouri
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Saint Louis, Missouri, United States
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Nebraska
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Omaha, Nebraska, United States
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Nevada
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Las Vegas, Nevada, United States
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New York
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Albany, New York, United States
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Bronx, New York, United States
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Johnson City, New York, United States
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New York, New York, United States
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Poughkeepsie, New York, United States
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Syracuse, New York, United States
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Ohio
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Columbus, Ohio, United States
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Oregon
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Tualatin, Oregon, United States
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Pennsylvania
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Lancaster, Pennsylvania, United States
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Pittsburgh, Pennsylvania, United States
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South Carolina
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Charleston, South Carolina, United States
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Myrtle Beach, South Carolina, United States
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Tennessee
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Nashville, Tennessee, United States
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Texas
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Austin, Texas, United States
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Houston, Texas, United States
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Virginia
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Norfolk, Virginia, United States
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Richmond, Virginia, United States
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Washington
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Auburn, Washington, United States
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Seattle, Washington, United States
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Spokane, Washington, United States
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Wenatchee, Washington, United States
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Wisconsin
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Madison, Wisconsin, United States
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Adenocarcinoma of the prostate
- Metastatic disease as documented by technetium-99m (99mTc) bone scan or metastatic lesions by computed tomography (CT) or magnetic resonance imaging (MRI) scans (visceral or lymph node disease). If lymph node metastasis is the only evidence of metastasis, it must be greater than or equal to (>=) 2 centimeter (cm) in the longest diameter
- Castration-resistant prostate cancer demonstrated during continuous androgen deprivation therapy (ADT), defined as 3 rises of PSA, at least 1 week apart with the last androgen deprivation therapy (PSA) >= 2 nanogram per milliliters (ng/mL)
- Participants who received a first generation anti-androgen (eg, bicalutamide, flutamide, nilutamide) must have at least a 6-week washout prior to randomization and must show continuing disease (PSA) progression (an increase in PSA) after the washout period
- Prostate cancer progression documented by prostate-specific antigen (PSA) according to the Prostate Cancer Clinical Trials Working Group (PCWG2) or radiographic progression of soft tissue according to modified Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST) modified based on PCWG2, or radiographic progression of bone according to PCWG2
- Participants who cross-over from Prednisone alone to open-label apalutamide plus AAP should still be in the double-blind phase of the study, should be receiving AAP alone and should have ECOG 0-1-2.
Exclusion Criteria:
- Small cell or neuroendocrine carcinoma of the prostate
- Known brain metastases
- Prior chemotherapy for prostate cancer, except if administered in the adjuvant/neoadjuvant setting
- Previously treated with ketoconazole for prostate cancer for greater than 7 days
- Therapies that must be discontinued or substituted at least 4 weeks prior to randomization include the following: a) Medications known to lower the seizure threshold, b) Herbal and non-herbal products that may decrease PSA levels (example [eg], saw palmetto, pomegranate) or c) Any investigational agent
- At Screening need for parenteral or oral opioid analgesics (eg, codeine, dextropropoxyphene)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Group 1: AAP and apalutamide
Participants will receive apalutamide 240 milligram (mg) (4*60 mg tablets) and abiraterone acetate (AA) 1000 mg (4*250 mg tablets) once daily on an empty stomach and 5 mg prednisone (P), AAP, twice daily, until disease progression, unacceptable toxicity or end of treatment, whichever occurs first.
After unblinding participants will be offered further treatment as defined in the Open-Label Extension (OLE) or Long-Term Extension (LTE) phase (AAP + open label apalutamide or AAP alone).
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Participants will receive 240 mg (4*60 mg tablets) of apalutamide once daily orally.
Participants will receive 1000 mg (4*250 mg tablets) of abiraterone acetate (AA) once daily orally.
Other Names:
Participants will receive 5 mg tablet of prednisone twice daily orally.
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Placebo Comparator: Group 2: AAP and Placebo
Participants will receive matching Placebo of apalutamide and abiraterone acetate (AA) 1000 mg (4*250 mg tablets) once daily on an empty stomach and 5 mg prednisone (P), AAP, twice daily until disease progression, unacceptable toxicity or end of treatment, whichever occurs first.
After unblinding participants will be offered further treatment as defined in the OLE or LTE phase (AAP + open label apalutamide or AAP alone).
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Participants will receive 1000 mg (4*250 mg tablets) of abiraterone acetate (AA) once daily orally.
Other Names:
Participants will receive 5 mg tablet of prednisone twice daily orally.
Participants will receive matching placebo to apalutamide once daily orally.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Radiographic Progression-free Survival (rPFS)
Time Frame: Up to 3 years and 4 months
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The rPFS was defined as the time from randomization to the occurrence of one of the following: 1) a participant was considered to have progressed by bone scan if - a) the first bone scan with greater than or equal to (>=) 2 new lesions compared to baseline was observed in less than (<) 12 weeks from randomization and was confirmed by a second bone scan taken >=6 weeks later showing >=2 additional new lesions (a total of >=4 new lesions compared to baseline), b) the first bone scan with >=2 new lesions compared to baseline was observed in >=12 weeks from randomization and the new lesions were verified on the next bone scan >=6 weeks later (a total of >=2 new lesions compared to baseline); 2) progression of soft tissue lesions measured by computerized tomography (CT) or magnetic resonance imaging (MRI) as per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1.
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Up to 3 years and 4 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Overall Survival (OS)
Time Frame: Up to 5 years and 10 months
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The OS was defined as the time from randomization to date of death from any cause.
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Up to 5 years and 10 months
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Time to Chronic Opioid Use
Time Frame: Up to 5 years and 10 months
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Time to chronic opioid use was defined as the time from date of randomization to the first date of opioid use.
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Up to 5 years and 10 months
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Time to Initiation of Cytotoxic Chemotherapy
Time Frame: Up to 5 years and 10 months
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Time to initiation of cytotoxic chemotherapy was defined as the time from date of randomization to the date of initiation of cytotoxic chemotherapy.
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Up to 5 years and 10 months
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Time to Pain Progression
Time Frame: Up to 5 years and 10 months
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Time to pain progression: time from randomization to first date that participant either experienced an increase by 2 points from baseline in Brief Pain Inventory Short Form (BPI-SF) worst pain intensity item (item 3) or Case Report Form (CRF) pain, observed at 2 consecutive evaluations >=4 wks apart, or initiation of chronic opioids as defined in time to chronic opioid use, whichever occurred first.
BPI-SF is a self-administered questionnaire developed to assess severity of pain and impact of pain on daily functions.
Item 3(worst pain intensity) asks participants to rate worst pain in prior 7-days on a 0-10 numeric rating scale, where "0" indicates "No pain" and "10" indicates "Pain as bad as you can imagine."
A lower score is better.CRF pain refers to participant's response to global pain assessment "How would you rate your pain over the past 7 days?"with a scale of 0("No pain") to 10("Pain as bad as you can imagine"),that is systematically reported and recorded on the eCRF.
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Up to 5 years and 10 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Janssen Research & Development, LLC Clinical Trial, Janssen Research & Development, LLC
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 26, 2014
Primary Completion (Actual)
March 19, 2018
Study Completion (Estimated)
December 31, 2025
Study Registration Dates
First Submitted
October 2, 2014
First Submitted That Met QC Criteria
October 2, 2014
First Posted (Estimated)
October 6, 2014
Study Record Updates
Last Update Posted (Actual)
March 28, 2024
Last Update Submitted That Met QC Criteria
March 26, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Genital Neoplasms, Male
- Prostatic Diseases
- Urogenital Diseases
- Male Urogenital Diseases
- Genital Diseases, Male
- Genital Diseases
- Prostatic Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Cytochrome P-450 Enzyme Inhibitors
- Hormone Antagonists
- Steroid Synthesis Inhibitors
- Prednisone
- Abiraterone Acetate
Other Study ID Numbers
- CR105505
- 56021927PCR3001 (Other Identifier: Janssen Research & Development, LLC)
- 2014-001718-25 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
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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