Prostate Cancer
Conditions
Keywords
Progressive Metastatic Prostate Cancer
Brief summary
The purpose of this study is to determine the benefit of enzalutamide versus placebo as assessed by overall survival and progression-free survival in patients with progressive metastatic prostate cancer who have failed androgen deprivation therapy but not yet received chemotherapy.
Interventions
Participants received enzalutamide 160 mg, administered as four 40-mg capsules, once per day by mouth. Study drug treatment continued until disease progression (evidence of radiographic progression, a skeletal-related event, or clinical progression) and the initiation of a cytotoxic chemotherapy or an investigational agent, unacceptable toxicity, or withdrawal.
Participants received placebo, administered as four capsules, once per day by mouth. Study drug treatment continued until disease progression (evidence of radiographic progression, a skeletal-related event, or clinical progression) and the initiation of a cytotoxic chemotherapy or an investigational agent, unacceptable toxicity, or withdrawal.
Sponsors
Study design
Eligibility
Inclusion criteria
Randomized, Double Blind Treatment Period: Inclusion Criteria: * Histologically confirmed adenocarcinoma of the prostate without neuroendocrine differentiation or small cell features * Ongoing androgen deprivation therapy with a GnRH analogue or bilateral orchiectomy * Progressive disease despite androgen deprivation therapy as defined by rising PSA levels or progressive soft tissue or bony disease * No prior treatment with cytotoxic chemotherapy * Asymptomatic or mildly symptomatic from prostate cancer
Exclusion criteria
* Severe concurrent disease, infection, or co-morbidity that, in the judgment of the Investigator, would make the patient inappropriate for enrollment * Known or suspected brain metastasis or active leptomeningeal disease * History of another malignancy within the previous 5 years other than curatively treated non-melanomatous skin cancer Open-Label Treatment Period: The following inclusion criteria apply to patients receiving enzalutamide or placebo during double-blind treatment. Eligible patients must meet all inclusion criteria. * Received randomized double-blind treatment in PREVAIL; * Open-label day 1 visit is within 6 months after this amendment is approved and becomes effective at the study site; * Is willing to maintain androgen deprivation therapy with a gonadotropin-releasing hormone (GnRH) agonist/antagonist or has had a bilateral orchiectomy; The
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Progression-free Survival (rPFS) | During study period (up to 20 months) | Radiographic progression-free survival was defined as the time from randomization to the first objective evidence of radiographic disease progression assessed by independent central radiology review or death due to any cause within 168 days after treatment discontinuation, whichever was first. Radiographic disease progression was evaluated by CT scan or MRI and radionuclide bone scans at regularly scheduled visits. Radiographic disease progression in bone required a confirmatory scan. Radiographic disease progression in soft tissue did not require a confirmatory scan for purposes of analysis. Radiographic disease progression was evaluated by independent central radiology review using RECIST 1.1 for soft tissue disease and PCWG2 guidelines for bone disease. Patients who did not reach the endpoint were censored at their last assessment. |
| Overall Survival | During study period (up to 3 years) | Overall survival was defined as the time from randomization to death due to any cause. For patients who were alive at the time of the analysis data cutoff, overall survival was censored at the last date the patient was known to be alive or analysis data cutoff date, whichever was first. This included patients who were known to have died after the data analysis cutoff date. Patients with no post-baseline survival information were censored on the date of randomization. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Initiation of Cytotoxic Chemotherapy | During study period (up to 3 years) | The time to initiation of cytotoxic chemotherapy is defined as the time from randomization to the date of initiation of cytotoxic chemotherapy for the treatment of prostate cancer for each patient. For patients who did not start cytotoxic chemotherapy at the time of the analysis data cutoff, time to initiation of cytotoxic chemotherapy was censored at the date of last assessment where no cytotoxic chemotherapy was indicated or at the analysis data cutoff date, whichever was first. Time to initiation of cytotoxic chemotherapy for patients with no postbaseline assessments was censored on the date of randomization. |
| Time to Prostate-specific Antigen (PSA) Progression | During study period (up to 3 years) | Time to PSA progression was defined as the time from randomization to date of first confirmed observation of PSA progression for each patient. For patients with PSA declines at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir was documented, and confirmed 3 or more weeks later. For patients with no PSA decline at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above baseline was documented, and confirmed 3 or more weeks later. For patients who did not have confirmed PSA progression at the time of the analysis data cutoff, time to PSA progression was censored at the date of the last PSA assessment showing no evidence of confirmed PSA progression or the analysis data cutoff date, whichever was first. Time to PSA progression for patients with no postbaseline assessments was censored on the date of randomization. |
| Time to First Skeletal-related Event | During study period (up to 3 years) | Time to first skeletal-related event was defined as the time from randomization to the date of the first occurrence of a skeletal-related event for each patient. A skeletal-related event was defined as radiation therapy or surgery to bone for prostate cancer, pathological bone fracture, spinal cord compression, or initiation/change in antineoplastic therapy to treat bone pain from prostate cancer. Skeletal-related events were recorded at each scheduled and unscheduled study visit and during long-term follow-up if a skeletal-related event was not documented previously. Patients who did not have a skeletal-related event at the time of the analysis data cutoff were censored at the date of last assessment indicating no evidence of skeletal-related event. Patients with no postbaseline assessments were censored on the date of randomization. |
| Percentage of Patients With Prostate Specific Antigen (PSA) Response ≥ 50% | During study period (up to 3 years) | PSA response was defined as a ≥ 50% reduction in PSA from baseline to the lowest postbaseline PSA value and required confirmation by a consecutive assessment at least 3 weeks later. Patients were evaluable for PSA response rate if a patient had a PSA level measured at baseline and at least one postbaseline assessment. |
| Best Overall Soft Tissue Response | During study period (up to 3 years) | The best overall soft tissue objective response is defined as partial response \[PR\] or complete response \[CR\] while on study treatment based on investigator assessments of target, nontarget, and new lesions using RECIST 1.1. Soft tissue was assessed by CT or MRI at regularly scheduled visits. Only patients with measurable soft tissue disease (ie, at least 1 target lesion identified per RECIST 1.1) at screening are included in this analysis. All percentages are based on number of participants with measurable soft tissue disease at screening in each treatment group. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Treatment-Emergent Adverse Events (AEs) Greater Than or Equal to (>=) Grade 3, Based on National Cancer Institute Common Terminology Criteria for AEs (CTCAE), Version 4.0 | Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years) | An AE is any untoward medical occurrence in participant who received study drug without regard to possibility of causal relationship. As per NCI CTCAE, Grade 3 events =medically significant but not immediately life-threatening, unacceptable or intolerable events, significantly interrupting usual daily activity, require systemic drug therapy/other treatment, Grade 4 events =participant to be in imminent danger of death. Grade 5 events =death. A treatment-emergent AE (TEAE) was defined as an AE that occurred from the date and time of the first dose of study drug up to a maximum duration of 6.5 years. Number of participants with AEs of any of the Grade 3 or above (Grade 4, 5) were reported. |
| Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years) | An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug and up to a maximum of 6.5 years that were absent before treatment or that worsened relative to pretreatment state. AEs included both serious and non-serious AEs. |
| Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years) | Treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug and up to a maximum duration of 6.5 years that were absent before treatment or that worsened relative to pre-treatment state. Relatedness to study drug was assessed by the investigator. |
Countries
Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, Lithuania, Netherlands, Poland, Russia, Singapore, Slovakia, South Korea, Spain, Sweden, United Kingdom, United States
Participant flow
Pre-assignment details
Following the independent data monitoring committee's recommendation, a protocol amendment was implemented for double-blind phase to be proceeded to open-label phase, which allowed previously placebo treated participants who had not received commercial enzalutamide the opportunity, to receive open-label access to enzalutamide.
Participants by arm
| Arm | Count |
|---|---|
| Enzalutamide Participants received enzalutamide 160 mg, administered as four 40-mg capsules, once per day by mouth. | 872 |
| Placebo Participants received placebo, administered as four capsules, once per day by mouth. | 845 |
| Total | 1,717 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Double-blind | Death | 699 | 550 | 0 |
| Double-blind | Lost to Follow-up | 8 | 4 | 0 |
| Double-blind | Other | 7 | 0 | 0 |
| Double-blind | Sponsor decision | 142 | 38 | 0 |
| Double-blind | Withdrawal by Subject | 16 | 19 | 0 |
| Open-label | Death | 0 | 0 | 166 |
| Open-label | Lost to Follow-up | 0 | 0 | 5 |
| Open-label | Other | 0 | 0 | 3 |
| Open-label | Sponsor decision | 0 | 0 | 53 |
| Open-label | Withdrawal by Subject | 0 | 0 | 7 |
Baseline characteristics
| Characteristic | Total | Enzalutamide | Placebo |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 1359 Participants | 693 Participants | 666 Participants |
| Age, Categorical Between 18 and 65 years | 358 Participants | 179 Participants | 179 Participants |
| Age, Continuous | 71.3 years STANDARD_DEVIATION 8.47 | 71.3 years STANDARD_DEVIATION 8.51 | 71.2 years STANDARD_DEVIATION 8.42 |
| Region of Enrollment Australia | 232 count of participants | 116 count of participants | 116 count of participants |
| Region of Enrollment Austria | 18 count of participants | 9 count of participants | 9 count of participants |
| Region of Enrollment Belgium | 57 count of participants | 28 count of participants | 29 count of participants |
| Region of Enrollment Canada | 179 count of participants | 91 count of participants | 88 count of participants |
| Region of Enrollment Denmark | 87 count of participants | 43 count of participants | 44 count of participants |
| Region of Enrollment Finland | 33 count of participants | 18 count of participants | 15 count of participants |
| Region of Enrollment France | 175 count of participants | 85 count of participants | 90 count of participants |
| Region of Enrollment Germany | 83 count of participants | 41 count of participants | 42 count of participants |
| Region of Enrollment Israel | 25 count of participants | 14 count of participants | 11 count of participants |
| Region of Enrollment Italy | 30 count of participants | 15 count of participants | 15 count of participants |
| Region of Enrollment Japan | 61 count of participants | 28 count of participants | 33 count of participants |
| Region of Enrollment Korea, Republic of | 78 count of participants | 40 count of participants | 38 count of participants |
| Region of Enrollment Lithuania | 14 count of participants | 8 count of participants | 6 count of participants |
| Region of Enrollment Netherlands | 28 count of participants | 15 count of participants | 13 count of participants |
| Region of Enrollment Poland | 39 count of participants | 21 count of participants | 18 count of participants |
| Region of Enrollment Russian Federation | 22 count of participants | 12 count of participants | 10 count of participants |
| Region of Enrollment Singapore | 9 count of participants | 5 count of participants | 4 count of participants |
| Region of Enrollment Slovakia | 27 count of participants | 13 count of participants | 14 count of participants |
| Region of Enrollment Spain | 81 count of participants | 44 count of participants | 37 count of participants |
| Region of Enrollment Sweden | 39 count of participants | 21 count of participants | 18 count of participants |
| Region of Enrollment United Kingdom | 153 count of participants | 78 count of participants | 75 count of participants |
| Region of Enrollment United States | 247 count of participants | 127 count of participants | 120 count of participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 1717 Participants | 872 Participants | 845 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 699 / 871 | 550 / 844 | 166 / 234 |
| other Total, other adverse events | 814 / 871 | 723 / 844 | 180 / 234 |
| serious Total, serious adverse events | 384 / 871 | 229 / 844 | 104 / 234 |
Outcome results
Overall Survival
Overall survival was defined as the time from randomization to death due to any cause. For patients who were alive at the time of the analysis data cutoff, overall survival was censored at the last date the patient was known to be alive or analysis data cutoff date, whichever was first. This included patients who were known to have died after the data analysis cutoff date. Patients with no post-baseline survival information were censored on the date of randomization.
Time frame: During study period (up to 3 years)
Population: Intent to Treat (ITT) - All patients randomly assigned to treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Overall Survival | 32.4 months |
| Placebo | Overall Survival | 30.2 months |
Radiographic Progression-free Survival (rPFS)
Radiographic progression-free survival was defined as the time from randomization to the first objective evidence of radiographic disease progression assessed by independent central radiology review or death due to any cause within 168 days after treatment discontinuation, whichever was first. Radiographic disease progression was evaluated by CT scan or MRI and radionuclide bone scans at regularly scheduled visits. Radiographic disease progression in bone required a confirmatory scan. Radiographic disease progression in soft tissue did not require a confirmatory scan for purposes of analysis. Radiographic disease progression was evaluated by independent central radiology review using RECIST 1.1 for soft tissue disease and PCWG2 guidelines for bone disease. Patients who did not reach the endpoint were censored at their last assessment.
Time frame: During study period (up to 20 months)
Population: Intent to Treat (ITT) - All patients randomly assigned to treatment excluding 84 patients who were not randomized before the radiographic Progression-free Survival data cutoff date of 06 May 2012.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Radiographic Progression-free Survival (rPFS) | NA months |
| Placebo | Radiographic Progression-free Survival (rPFS) | 3.9 months |
Best Overall Soft Tissue Response
The best overall soft tissue objective response is defined as partial response \[PR\] or complete response \[CR\] while on study treatment based on investigator assessments of target, nontarget, and new lesions using RECIST 1.1. Soft tissue was assessed by CT or MRI at regularly scheduled visits. Only patients with measurable soft tissue disease (ie, at least 1 target lesion identified per RECIST 1.1) at screening are included in this analysis. All percentages are based on number of participants with measurable soft tissue disease at screening in each treatment group.
Time frame: During study period (up to 3 years)
Population: Intent to treat (ITT) population With Measurable Disease - All participants who were randomly assigned to treatment and had at least one target lesion at screening.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzalutamide | Best Overall Soft Tissue Response | 58.8 Percentage of participants |
| Placebo | Best Overall Soft Tissue Response | 5.0 Percentage of participants |
Percentage of Patients With Prostate Specific Antigen (PSA) Response ≥ 50%
PSA response was defined as a ≥ 50% reduction in PSA from baseline to the lowest postbaseline PSA value and required confirmation by a consecutive assessment at least 3 weeks later. Patients were evaluable for PSA response rate if a patient had a PSA level measured at baseline and at least one postbaseline assessment.
Time frame: During study period (up to 3 years)
Population: Evaluable intent to treat (ITT) population - All patients randomly assigned to treatment with PSA values at baseline and at least one postbaseline assessment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzalutamide | Percentage of Patients With Prostate Specific Antigen (PSA) Response ≥ 50% | 78 Percentage of Participants |
| Placebo | Percentage of Patients With Prostate Specific Antigen (PSA) Response ≥ 50% | 3.5 Percentage of Participants |
Time to First Skeletal-related Event
Time to first skeletal-related event was defined as the time from randomization to the date of the first occurrence of a skeletal-related event for each patient. A skeletal-related event was defined as radiation therapy or surgery to bone for prostate cancer, pathological bone fracture, spinal cord compression, or initiation/change in antineoplastic therapy to treat bone pain from prostate cancer. Skeletal-related events were recorded at each scheduled and unscheduled study visit and during long-term follow-up if a skeletal-related event was not documented previously. Patients who did not have a skeletal-related event at the time of the analysis data cutoff were censored at the date of last assessment indicating no evidence of skeletal-related event. Patients with no postbaseline assessments were censored on the date of randomization.
Time frame: During study period (up to 3 years)
Population: Intent to Treat (ITT) - All patients randomly assigned to treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to First Skeletal-related Event | 31.1 months |
| Placebo | Time to First Skeletal-related Event | 31.3 months |
Time to Initiation of Cytotoxic Chemotherapy
The time to initiation of cytotoxic chemotherapy is defined as the time from randomization to the date of initiation of cytotoxic chemotherapy for the treatment of prostate cancer for each patient. For patients who did not start cytotoxic chemotherapy at the time of the analysis data cutoff, time to initiation of cytotoxic chemotherapy was censored at the date of last assessment where no cytotoxic chemotherapy was indicated or at the analysis data cutoff date, whichever was first. Time to initiation of cytotoxic chemotherapy for patients with no postbaseline assessments was censored on the date of randomization.
Time frame: During study period (up to 3 years)
Population: Intent to Treat (ITT) - All patients randomly assigned to treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to Initiation of Cytotoxic Chemotherapy | 28.0 months |
| Placebo | Time to Initiation of Cytotoxic Chemotherapy | 10.8 months |
Time to Prostate-specific Antigen (PSA) Progression
Time to PSA progression was defined as the time from randomization to date of first confirmed observation of PSA progression for each patient. For patients with PSA declines at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir was documented, and confirmed 3 or more weeks later. For patients with no PSA decline at week 13, the PSA progression date was defined as the date that a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above baseline was documented, and confirmed 3 or more weeks later. For patients who did not have confirmed PSA progression at the time of the analysis data cutoff, time to PSA progression was censored at the date of the last PSA assessment showing no evidence of confirmed PSA progression or the analysis data cutoff date, whichever was first. Time to PSA progression for patients with no postbaseline assessments was censored on the date of randomization.
Time frame: During study period (up to 3 years)
Population: Intent to Treat (ITT) - All patients randomized.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to Prostate-specific Antigen (PSA) Progression | 11.2 months |
| Placebo | Time to Prostate-specific Antigen (PSA) Progression | 2.8 months |
Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug and up to a maximum of 6.5 years that were absent before treatment or that worsened relative to pretreatment state. AEs included both serious and non-serious AEs.
Time frame: Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years)
Population: The safety analysis set included all randomized participants who received at least 1 dose or partial dose of study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 857 Participants |
| Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 384 Participants |
| Placebo | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 791 Participants |
| Placebo | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 229 Participants |
| Placebo Participants Crossover to Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 212 Participants |
| Placebo Participants Crossover to Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 104 Participants |
Number of Participants With Treatment-Emergent Adverse Events (AEs) Greater Than or Equal to (>=) Grade 3, Based on National Cancer Institute Common Terminology Criteria for AEs (CTCAE), Version 4.0
An AE is any untoward medical occurrence in participant who received study drug without regard to possibility of causal relationship. As per NCI CTCAE, Grade 3 events =medically significant but not immediately life-threatening, unacceptable or intolerable events, significantly interrupting usual daily activity, require systemic drug therapy/other treatment, Grade 4 events =participant to be in imminent danger of death. Grade 5 events =death. A treatment-emergent AE (TEAE) was defined as an AE that occurred from the date and time of the first dose of study drug up to a maximum duration of 6.5 years. Number of participants with AEs of any of the Grade 3 or above (Grade 4, 5) were reported.
Time frame: Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years)
Population: The safety analysis set included all randomized participants who received at least 1 dose or partial dose of study drug.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) Greater Than or Equal to (>=) Grade 3, Based on National Cancer Institute Common Terminology Criteria for AEs (CTCAE), Version 4.0 | 465 Participants |
| Placebo | Number of Participants With Treatment-Emergent Adverse Events (AEs) Greater Than or Equal to (>=) Grade 3, Based on National Cancer Institute Common Terminology Criteria for AEs (CTCAE), Version 4.0 | 318 Participants |
| Placebo Participants Crossover to Enzalutamide | Number of Participants With Treatment-Emergent Adverse Events (AEs) Greater Than or Equal to (>=) Grade 3, Based on National Cancer Institute Common Terminology Criteria for AEs (CTCAE), Version 4.0 | 129 Participants |
Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs)
Treatment-related AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug and up to a maximum duration of 6.5 years that were absent before treatment or that worsened relative to pre-treatment state. Relatedness to study drug was assessed by the investigator.
Time frame: Baseline to discontinuation from the study or death, whichever occurred first (maximum duration of 6.5 years)
Population: The safety analysis set included all randomized participants who received at least 1 dose or partial dose of study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Enzalutamide | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 579 Participants |
| Enzalutamide | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 38 Participants |
| Placebo | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 423 Participants |
| Placebo | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 22 Participants |
| Placebo Participants Crossover to Enzalutamide | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | AEs | 119 Participants |
| Placebo Participants Crossover to Enzalutamide | Number of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) | SAEs | 14 Participants |