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Taxane efficacy in metastatic prostate cancer is modest due to resistance development. Several clinical phase III studies in metastatic castration-naïve prostate cancer (mCNPC) patients have shown that adding an androgen receptor signalling inhibitor (ARSi) to patients receiving a taxane and androgen deprivation therapy (ADT) improves survival endpoints. Adding ARSi darolutamide to docetaxel+ADT in mCNPC patients resulted in a robust OS benefit (HR 0.68). Importantly, the combination of a taxane and darolutamide is not prone to a drug-drug interaction, while there is a detrimental CYP3A4 inducing effect in the case of enzalutamide, resulting in a significant and clinically relevant reduction of cabazitaxel plasma concentrations. The investigators have previously reported preclinical data showing that addition of an androgen receptor signaling inhibitor (ARSi) improves cabazitaxel efficacy, even in metastatic castration-resistant prostate cancer (mCRPC). As treatment options for mCRPC) patients are scarce and patients often develop drug resistance relatively early, a new treatment regimen for this population to delay drug resistance is highly desired. The investigators propose a randomized phase II trial to investigate the efficacy of docetaxel or cabazitaxel plus darolutamide compared to docetaxel or cabazitaxel monotherapy in men with metastatic CRPC, who have progressed on an ARSI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Docetaxel or cabazitaxel (SOC) | Active Comparator |
| |
| Docetaxel or cabazitaxel with darolutamide | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Darolutamide | Drug | Darolutamide 600 mg b.i.d. until the end of the last taxane cycle |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progression free survival | progression free survival, which is defined as time from randomization to radiologic, biochemical or pain progression or death from any cause, whichever occurs first, according to PCWG3 | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival | Overall survival, defined as time from randomization to death from any cause. | From date of randomization until the date of death from any cause |
| Time to progression | Time to progression, defined as time from randomization to radiologic, biochemical or pain progression, whichever occurs first. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tanja van Dijk | Contact | 0031107040704 | interne.oncologie@erasmusmc.nl |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Erasmus MC Cancer Institute | Recruiting | Rotterdam | 3015GD | Netherlands |
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| ID | Term |
|---|---|
| C000607739 | darolutamide |
| D000077143 | Docetaxel |
| C552428 | cabazitaxel |
| ID | Term |
|---|---|
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
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| Docetaxel or cabazitaxel | Drug | Docetaxel or cabazitaxel Q3W |
|
| From date of randomization until the date of first documented progression |
| Time to PSA progression | Time to PSA progression, defined as time from randomization to biochemical progression. | From date of randomization until the date of first documented PSA progression |
| D006844 |
| Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D004224 | Diterpenes |
| D013729 | Terpenes |