Japanese Research for Patients With Non-metastatic Castration Resistant Prostate Cancer - Enzalutamide (JCASTRE-Zero)

The purpose of this study is to investigate the efficacy and safety of enzalutamide in patients with non-metastatic castration resistant prostate cancer. The total duration of the study will be 5 years. All patients will receive enzalutamide 160 mg (four 40 mg capsules) orally once daily. The treatment will be started at Visit 0 within one week after enrollment. Visit 1 is at 2 weeks after the treatment started; clinical assessments are conducted on adverse events and the Japanese version of the Functional Assessment of Cancer Therapy-Prostate (FACT-P) scales. Patients who are considered to be adequate by the investigator can continue the treatment with 12-week cycle visit (counted from initial dose) until patients meet withdrawal criteria. Patients will be followed up at 2 and 3 years after enrollment and at 3 years after the last participant enrollment. The end of the study is defined as follow-up assessment date at 3 years after the last participant enrollment. Patients will primarily be assessed by prostate-specific antigen (PSA) progression-free survival (PFS).

Study Overview

• Status: Completed
• Conditions: Prostate Cancer
• Intervention / Treatment: Drug: Enzalutamide

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Japan
  • Kagawa-prefecture
    • Kita-gun, Kagawa-prefecture, Japan, 761-0793
      • Kagawa University Faculty of Medicine
  • Miyazaki-prefecture
    • Miyazaki-city, Miyazaki-prefecture, Japan, 889-1692
      • University of Miyazaki Faculty of Medicine
  • Tokyo
    • Meguro-ku, Tokyo, Japan, 152-8902
      • Tokyo Medical Center
    • Minato-ku, Tokyo, Japan, 105-8461
      • The Jikei university school of medicin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

1. Patients with histologically or cytologically confirmed prostate cancer
2. Patients with history of radical prostatectomy or radiation therapy for radical treatment
3. Patients who receive continuous androgen deprivation therapy using both gonadotropin-releasing hormone (GnRH) agonist and antagonist, or using surgical castration
4. Patients with serum testosterone 1.73 nmol/L (0.50 ng/dL) or less
5. Patients with history of bicalutamide or flutamide at any time after first recurrence confirmed since radical treatment completed
6. Patients with 3 increased PSA test results which measured consecutively at least one week apart during androgen deprivation therapy
7. Patients with serum PSA 1 micrograms/L (1 ng/mL) or more
8. Patients with no confirmed remote metastasis after diagnosis of prostate cancer (excluding lymph nodes metastasis with a minor axis of less than 15 mm which considered to be nonmeasurable in the Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1)
9. Patients with asymptomatic prostate cancer
10. Patients with the Eastern Cooperative Oncology Group (ECOG) performance status 0-1
11. Patients with life expectancy of at least 12 months
12. Patients who have signed written informed consent to participate in this study

Exclusion Criteria:

1. Patients with history of any chemotherapy (including estramustine phosphate sodium hydrate (JAN)) or treatment with enzalutamide or abiraterone acetate
2. Patients with history of steroid usage as treatment for prostate cancer
3. Patients with history of 5-alpha-reductase inhibitor, estrogen or steroidal antiandrogen within past 4 weeks prior to initial administration of enzalutamide
4. Patients with history of malignant tumor other than prostate cancer within past 3 years
5. Patients with history of seizure or predisposing disease of seizure
6. Patients with severe liver dysfunction
7. Patients with a previous history of hypersensitivity to any component of drugs which will be administered in this study
8. Patients who considered to be inappropriate for the study participation by the investigator.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Enzalutamide Group

Drug: Enzalutamide; All patients will receive enzalutamide 160 mg (four 40 mg capsules) orally once daily. The treatment will be started at Visit 0 within one week after enrollment. Visit 1 is at 2 weeks after the treatment started; clinical assessments are conducted on adverse events and the Japanese version of the Functional Assessment of Cancer Therapy-Prostate (FACT-P) scales. Patients who are considered to be adequate by the investigator can continue the treatment with 12-week cycle visit (counted from initial dose) until patients meet withdrawal criteria. Patients will be followed up at 2 and 3 years after enrollment and at 3 years after the last participant enrollment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PSA-progression-free survival (PSA-PFS)	Prostate specific antigen (PSA) progression-free survival is defined as time from date of initial dose until the date of first confirmed PSA progression (an increase in PSA of >= 25% and >= 2 ng/ml above the nadir after initial dose) or date of death from any cause, whichever comes first.	6 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall survival (OS)	OS is defined as time from date of initial dose until date of death from any cause.	6 years
Progression-free survival (PFS)	PFS is defined as time from date of initial dose until the date of first confirmed progression or date of death from any cause, whichever comes first.	6 years
Metastasis free survival (MFS)	MFS is defined as time from date of initial dose until the date of first metastasis which confirmed by computed tomography (CT) and bone scintigraphy.	6 years
Time-to-PSA-progression (TTPP)	TTPP is defined as time from date of initial dose until the date of first confirmed PSA progression (an increase in PSA of >= 25% and >= 2 ng/ml above the nadir after initial dose).	6 years
PSA response rate	PSA response rate is defined as ratio of patients who have an decrease in PSA of >= 50% above baseline, compared to PSA levels at week 2, every 12 weeks for up to 5 years after initial dose.	At week 2, and every 12 weeks for up to 6 years after initial dose
Time to first use of chemotherapy (TFC)	TFC is defined as time from date of initial dose until the date of first additional chemotherapy started for prostate cancer.	6 years
QOL assessment using Japanese version of the FACT-P scales	Quality of life (QOL) is assessed on both total scores and each domain scores using Japanese version of the Functional Assessment of Cancer Therapy-Prostate (FACT-P) scales at baseline, week 2, week 60, withdrawal of treatment and at the end of treatment for up to 5 years.	Baseline, week 2, week 60, at withdrawal of treatment and at end of treatment for up to 6 years
Medication adherence (dosage)	Medication adherence is assessed in dosage of enzalutamide.	6 years
Medication adherence (duration)	Medication adherence is assessed in duration of enzalutamide.	6 years
Medication adherence (ratio)	Medication adherence is assessed in dosage rate of enzalutamide which is classfied into 3 categories: 1) >=80%, 2) >= 50% to < 80%, and 3) < 50%.	6 years
Safety assessment on the incidence and severity of adverse events using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0		6 years

Collaborators and Investigators

• Sponsor: Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan
• Collaborators: Kagawa University
• Investigators: Principal Investigator: Mikio Sugimoto, MD, Ph.D., Kagawa University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2015
• Primary Completion (Actual): March 31, 2020
• Study Completion (Actual): March 31, 2021

Study Registration Dates

• First Submitted: October 23, 2015
• First Submitted That Met QC Criteria: October 26, 2015
• First Posted (Estimate): October 27, 2015

Study Record Updates

• Last Update Posted (Actual): May 25, 2022
• Last Update Submitted That Met QC Criteria: May 24, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Genital Neoplasms, Male; Prostatic Diseases; Prostatic Neoplasms
• Other Study ID Numbers: TRIGU1506; UMIN000018964 (Registry Identifier: UMIN-CTR)