Phase 3 Study of Xaluritamig vs Cabazitaxel or Second Androgen Receptor-Directed Therapy in Participants With Progressive Metastatic Castration-Resistant Prostate Cancer (XALute)

Brief Summary
The main objective of the study is to compare overall survival in participants receiving xaluritamig versus investigator's choice (cabazitaxel or second androgen receptor-directed therapy \[ARDT\]).
Brief Title
Phase 3 Study of Xaluritamig vs Cabazitaxel or Second Androgen Receptor-Directed Therapy in Participants With Progressive Metastatic Castration-Resistant Prostate Cancer (XALute)
Categories
Central Contacts
Central Contact Role
Contact
Central Contact Phone
866-572-6436
Central Contact Email
medinfo@amgen.com
Completion Date
Completion Date Type
Estimated
Conditions
Metastatic Castration-resistant Prostate Cancer
Eligibility Criteria
Inclusion Criteria:

* Participant has provided informed consent prior to initiation of any study-specific activities/procedures.
* Age ≥ 18 years (or ≥ legal age within the country if it is older than 18 years) at the time of signing the informed consent.
* Participant must have histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate. Mixed histologies (eg, adenocarcinoma with neuroendocrine component) are not permitted.
* mCRPC with ≥ 1 metastatic lesion that is present on baseline computed tomography (CT), magnetic resonance imaging (MRI), or bone scan imaging obtained within 28 days prior to enrollment.
* Evidence of progressive disease, defined as 1 or more PCWG3 criteria:

* Serum PSA progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL.
* Soft-tissue progression defined as an increase ≥ 20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions or unequivocal progression of existing non-target lesions.
* Progression of bone disease: defined by the appearance of at least 2 new bone lesion(s) by bone scan (as per the 2+2 PCWG3 criteria).
* Participants must have had a prior orchiectomy and/or ongoing androgen-deprivation therapy and a castrate level of serum testosterone (\< 50 ng/dL or \< 1.7 nmol/L).
* Prior progression on at least one ARDT (enzalutamide, abiraterone, apalutamide, darolutamide).
* Prior treatment with only one taxane therapy in the mCRPC setting. Note: Prior treatment with docetaxel in the metastatic hormone-sensitive prostate cancer (mHSPC) setting is permitted; however, participants must have also received one, and only one, taxane therapy in the mCRPC setting.
* Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1.
* Adequate organ function.
* Life expectancy of ≥ 12 weeks per the treating physician's assessment.

Key Exclusion Criteria:

Prior \& Concomitant Therapy:

* Prior six transmembrane epithelial antigen of the prostate 1 (STEAP1)-targeted therapy.
* Any anticancer therapy, immunotherapy, or investigational agent within 4 weeks prior to the first dose of study treatment, not including androgen receptor pathway inhibitors (ARPIs) (abiraterone, enzalutamide, darolutamide, apalutamide): minimum washout of 2 weeks prior to the first dose of study treatment and androgen suppression therapy (eg, luteinizing hormone-releasing hormone/gonadotropin-releasing hormone \[LHRH/GnRH\] analogue \[agonist/antagonist\]).
* Prior Prostate-Specific Membrane Antigen (PSMA) radioligand therapy (RLT) within 3 months of the first dose of study treatment unless participants received \< 2 cycles of therapy.
* Prior palliative radiotherapy within 2 weeks of first dose of study treatment. Participants must have recovered from all radiation-related toxicities.
* Concurrent cytotoxic chemotherapy, ARDT, immunotherapy, radioligand therapy, PARP inhibitor, biological therapy, investigational therapy. Note: Prior treatment with a PARP inhibitor is permitted as long as not within 4 weeks before first dose of study treatment.
* Prior radionuclide therapy (Radium-223) within 2 months of first dose of study treatment.
* Treatment with live and live-attenuated vaccines within 4 weeks before the first dose of study treatment.

Disease Related:

* Participants with a history of central nervous system (CNS) metastasis. Note: Participants with treated, asymptomatic, and clinically stable dural metastases are eligible.
* Unresolved toxicities from prior anti-tumor therapy not having resolved to CTCAE version 5.0 events grade above 1 or baseline, with the exception of alopecia or toxicities that are stable and well controlled AND there is an agreement to allow inclusion by both the investigator and the sponsor.
Inclusion Criteria
Inclusion Criteria:

* Participant has provided informed consent prior to initiation of any study-specific activities/procedures.
* Age ≥ 18 years (or ≥ legal age within the country if it is older than 18 years) at the time of signing the informed consent.
* Participant must have histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate. Mixed histologies (eg, adenocarcinoma with neuroendocrine component) are not permitted.
* mCRPC with ≥ 1 metastatic lesion that is present on baseline computed tomography (CT), magnetic resonance imaging (MRI), or bone scan imaging obtained within 28 days prior to enrollment.
* Evidence of progressive disease, defined as 1 or more PCWG3 criteria:

* Serum PSA progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL.
* Soft-tissue progression defined as an increase ≥ 20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions or unequivocal progression of existing non-target lesions.
* Progression of bone disease: defined by the appearance of at least 2 new bone lesion(s) by bone scan (as per the 2+2 PCWG3 criteria).
* Participants must have had a prior orchiectomy and/or ongoing androgen-deprivation therapy and a castrate level of serum testosterone (\< 50 ng/dL or \< 1.7 nmol/L).
* Prior progression on at least one ARDT (enzalutamide, abiraterone, apalutamide, darolutamide).
* Prior treatment with only one taxane therapy in the mCRPC setting. Note: Prior treatment with docetaxel in the metastatic hormone-sensitive prostate cancer (mHSPC) setting is permitted; however, participants must have also received one, and only one, taxane therapy in the mCRPC setting.
* Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1.
* Adequate organ function.
* Life expectancy of ≥ 12 weeks per the treating physician's assessment.

Gender
Male
Gender Based
false
Keywords
Oncology
Xaluritamig
Cabazitaxel
Prostate cancer
Abiraterone
Enzalutamide
Healthy Volunteers
No
Last Update Submit Date
Minimum Age
18 Years
NCT Id
NCT06691984
Org Class
Industry
Org Full Name
Amgen
Org Study Id
20230005
Overall Status
Recruiting
Phases
Phase 3
Primary Completion Date
Primary Completion Date Type
Estimated
Official Title
A Phase 3, Open-label, Multicenter, Randomized Study of Xaluritamig vs Cabazitaxel or Second Androgen Receptor-Directed Therapy in Subjects With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Chemotherapy
Primary Outcomes
Outcome Measure
Overall Survival (OS)
Outcome Time Frame
Up to approximately 53 months
Secondary Ids
Secondary Id
2024-513968-25
Secondary Outcomes
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Radiographic Progression-free Survival (rPFS) per Prostate Cancer Working Group 3 (PCWG3)-modified Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 as Assessed by Blinded Independent Central Review (BICR)
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Objective Response Rate per Modified RECIST v1.1 as Assessed by BICR
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Duration of Response (DOR) per Modified RECIST v1.1 as Assessed by BICR
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Disease Control Rate per Modified RECIST v1.1 as Assessed by BICR
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Response (TTR) per Modified RECIST v1.1 as Assessed by BICR
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to First Symptomatic Skeletal Events (SSE)
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Number of Participants Experiencing Treatment-emergent Adverse Events (TEAEs)
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from Baseline in Brief Pain Inventory - Short Form (BPI-SF) Worst Pain Score
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from Baseline in BPI-SF Pain Intensity Scale Score
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from Baseline in BPI-SF Pain Interference Scale Score
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from baseline in the European Quality of Life 5 Domain 5 Level Scale (EQ-5D-5L) Utility Score
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from baseline in the EQ-5D-5L Visual Analogue Scale (VAS)
Outcome Time Frame
Baseline and approximately 53 months
Outcome Measure
Change from Baseline in Functional Assessment of Cancer Therapy - Prostate (FACT-P) Total Score and Subscale Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Worsening in BPI-SF Worst Pain Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Worsening in BPI-SF Pain Intensity Scale Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Worsening in BPI-SF Pain Interference Scale Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Worsening in FACT-P Total Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Pain Improvement in Participants with Moderate/Severe Pain at Baseline
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Pain Improvement after Worsening in BPI-SF Pain Intensity Scale Score
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Pain Improvement after Worsening in BPI-SF Pain Interference Scale
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Number of Patient-Reported Symptomatic AEs per Patient-reported Outcome - Common Terminology Criteria for Adverse Events (PRO-CTCAE) Item Library
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Patient-Reported Summary Scores for Overall Bother of Side Effects per FACT-P
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Percentage of Participants Achieving a ≥50% Reduction in Prostate-specific Antigen (PSA) (PSA50)
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Percentage of Participants Achieving a ≥90% Reduction in PSA (PSA90)
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Maximum Serum Concentration (Cmax) of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Time to Cmax (Tmax) of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Minimum Serum Concentration (Cmin) of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Area Under the Concentration-time Curve (AUC) of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Accumulation Following Multiple Dosing of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Half-life (t1/2) of Xaluritamig
Outcome Time Frame
Up to approximately 53 months
Outcome Measure
Number of Participants with Anti-xaluritamig Antibody
Start Date
Start Date Type
Actual
Status Verified Date
First Submit Date
First Submit QC Date
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
999
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Benjamin Gartrell
Investigator Email
bgartrel@montefiore.org
Investigator Phone
718-405-8404
Investigator Department
Medicine
Investigator Division
Oncology
Investigator Sponsor Organization
External
Study Department
Oncology (Medical/Hematologic)
Study Division
Medical and Hematologic Oncology
Categories Mesh Debug
Cancer --- NEOPLASMS
Prostate Cancer --- PROSTATIC NEOPLASMS
Prostate Cancer --- GENITAL NEOPLASMS, MALE
Prostate Cancer --- UROGENITAL NEOPLASMS
Cancer --- NEOPLASMS BY SITE
Prostate Cancer --- PROSTATIC DISEASES
MeSH Terms
NEOPLASMS
PROSTATIC NEOPLASMS
GENITAL NEOPLASMS, MALE
UROGENITAL NEOPLASMS
NEOPLASMS BY SITE
GENITAL DISEASES, MALE
GENITAL DISEASES
UROGENITAL DISEASES
PROSTATIC DISEASES
MALE UROGENITAL DISEASES
ABIRATERONE
ENZALUTAMIDE
CABAZITAXEL