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The purpose of this study is to assess the efficacy of a PARP inhibitor, Pamiparib, in metastatic castration-resistant prostate cancer patients with homologous recombination deficiency or BRCA 1 or 2 somatic/germline mutation.
This is a single arm, open-label, single center, phase II trial, assessing the efficacy of a PARP inhibitor, Pamiparib, in 50 progressing metastatic castration-resistant prostate cancer patients with at least one line of androgen deprivation therapy or chemotherapy at the metastatic setting, and homologous recombination deficiency or BRCA 1 or 2 somatic or germline mutation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pamiparib | Experimental | Tablets 20mg per os : 40 mg / bid every day in continuous. Patients will be treated with Pamiparib. Cycles are defined in 28-day periods. Disease response will be assessed every 8 weeks (RECIST 1.1). Safety will be assessed continuously. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pamiparib | Drug | 40 mg bid per os , 28 day cycle, number of cycles: until progression or unacceptable toxicity develops. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Radiologic Progression-free Survival (rPFS) | Radiologic progression-free survival will be assessed from the time of the first dose to radiologic disease progression or death from any cause, whichever comes first. | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | Proportion of patients in complete remission (CR) plus partial remission (PR) | From enrollment to primary completion of study (up to approximately 3 years) |
| Duration of Response (DOR) |
| Measure | Description | Time Frame |
|---|---|---|
| rPFS stratified by baseline HRD score (HRD score threshold is defined as 9) | The rPFS is defined as the duration from Pamiparib initiation to radiologic disease progression or death from any cause, whichever comes first. | 3 years |
| OS stratified by baseline HRD score (HRD score threshold is defined as 9) |
Inclusion Criteria:
≥18 years old, male
Have a histologically or cytologically confirmed adenocarcinoma or poorly differentiated carcinoma without neuroendocrine differentiation of the prostate. Mixed histology is accepted, except for small cell carcinoma.
Have a deleterious mutation in BRCA1/2 , or HRD score ≥ 9.
Eastern Cooperative Oncology Group (ECOG) performance status ≤1
BPI<4
Metastatic Castration-resistant Prostate Cancer (mCRPC): Presence of measurable target lesion according to RECIST criteria v1.1
Male subject has been surgically or medically sterilized and has serum testosterone level ≤1.73nmol/L.
Unsterilized male subject uses an acceptable method of contraception (defined as a barrier method with spermicide) to prevent pregnancy during the duration of the study and for 6 months after the last dose of Pamiparib.
Experienced disease progression after having received at least 1 prior next-generation androgen receptor-targeted therapies, for metastatic castration-resistant disease.
Capable of swallowing the whole capsule.
Subjects must have normal organ and bone marrow function at baseline, as defined below:
Hemoglobin ≥ 9.0 g/dL at least 28 days after transfusion . Absolute neutrophil count ≥ 1.5 × 10^9/L. Platelet count ≥ 100 × 10^9/L. Total bilirubin ≤ 1.5 × the upper limit of normal (ULN) specified. Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase/alanine aminotransferase (ALT) serum glutamic pyruvic transaminase) ≤ 3 × the specified ULN, unless liver metastases are present, in which case it must be ≤ 5 × ULN.
Agree to sign informed consent form
Agree not to participate in other interventional trials during this trial.
Exclusion Criteria:
Subjects should not enter the study if any of the following exclusion criteria are fulfilled:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fangjian Zhou, M.D. | Contact | 020-87343656 | zhoufj@sysucc.org.cn | |
| Yonghong Li, M.D. | Contact | 020-87343656 | liyongh@sysucc.org.cn |
| Name | Affiliation | Role |
|---|---|---|
| Fangjian Zhou, M.D. | Sun Yat-sen University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sun Yat-sen University Cancer Center | Recruiting | Guangzhou | Guangdong | 510060 | China |
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| ID | Term |
|---|---|
| C000707927 | pamiparib |
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Time from the start of the first assessment of the tumor as CR or PR to the first assessment of PD (Progressive Disease) or death from any cause.
| From enrollment to primary completion of study (up to approximately 3 years) |
| Time to Response (TTR) | Time from initiation of treatment to first assessment of tumor as CR or PR. | From enrollment to primary completion of study (up to approximately 3 years) |
| Clinical Benefit Rate | according to RECIST, is either complete response (CR), partial response (PR) or stable disease (SD) lasting for at least 16 weeks | 3 years |
| Prostate Specific Antigen (PSA) Response Rate | Proportion of patients with a 50% decrease in PSA from baseline | From enrollment to primary completion of study (up to approximately 3 years) |
| Time to PSA Progression | Time from initiation of treatment to two consecutive 50% PSA increases from baseline level | From enrollment to primary completion of study (up to approximately 3 years) |
| Overall Survival (OS) | Time between the start of treatment and death from any cause | From enrollment to primary completion of study (up to approximately 3 years) |
| Adverse events | Adverse events are graded according to the CTCAE V4.03 | 3 years |
The OS is defined as the duration from Pamiparib initiation to any death. |
| 3 years |