Progressive Metastatic Prostate Cancer
Conditions
Keywords
Enzalutamide, Androgen receptor, Prostate cancer, Xtandi
Brief summary
Purpose of the study was to assess the effect of enzalutamide on time to Prostate Specific Antigen (PSA) progression as compared to placebo in chemotherapy naïve participants with progressive metastatic prostate cancer who have failed androgen deprivation therapy.
Detailed description
The study was a multinational Phase 3, randomized, double-blind, placebo-controlled efficacy and safety study of oral enzalutamide (formerly MDV3100) in asymptomatic or mildly symptomatic participants with progressive metastatic prostate cancer who have disease progression despite androgen deprivation therapy. In order to join the study, participants could not have been previously treated with cytotoxic chemotherapy. Approximately 30 Chinese participants were allocated to the pharmacokinetic (PK) cohort. Participants in the PK cohort were required to be hospitalized from Day 1 before the randomization date to at least the completion of all the assessments planned on Day 3. All participants in the PK cohort underwent blood sampling for the PK analysis. Data reported in the results section was based on data cutoff dates of 20 Sept 2015 for efficacy and safety data and 20 Jan 2016 for PK outcome measures. The study completed double-blind period and is now in the open-label period.
Interventions
Oral
Oral
Sponsors
Study design
Eligibility
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 bone 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 * History of seizure including febrile seizure or any condition that may predispose to seizure (e.g., prior stroke, brain arteriovenous malformation, head trauma with loss of consciousness requiring hospitalization).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to Prostate-specific Antigen (PSA) Progression | From the date of randomization to PSA progression median follow-up time is 6.47 months for enzalutamide and 2.99 months for placebo | The time to Prostate Specific Antigen (PSA) progression was defined as the time from randomization to the PSA progression. The PSA progression was defined according to the consensus guidelines of Prostate Cancer Clinical Trials Working Group 2 (PCWG2).For participants with PSA decline at Week 13, the PSA progression date was defined as a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir, which would be confirmed by a second consecutive value obtained 3 or more weeks later. For participants with no PSA decline at Week 13, the PSA progression date was defined as the date when a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the baseline was documented, which was confirmed by a second consecutive value 3 or more weeks later. Time to PSA progression was estimated using the Kaplan-Meier method. Participants without confirmed PSA progression were censored. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility Assessment | From the date of randomization to the rPFS event (deaths from any cause and radiographic disease progression) median follow-up time is 5.55 months for enzalutamide and 3.71 months for placebo | Duration of Radiographic Progression-free Survival (rPFS) was defined as the time from randomization to the rPFS event (deaths from any cause and radiographic disease progression). Radiographic disease progression is defined by RECIST 1.1 for soft tissue disease, or PCWG2 for bone lesions. If a participant met the criteria for more than 1 censoring rule, they were censored with the earliest censoring date. The radiographic progression date was the first date when progression definition was met, not confirmed. |
| Time to First Skeletal-Related Event | From the date of randomization to the first skeletal-related event median follow-up time is 7.39 months for enzalutamide and 5.29 months for placebo | Time to first skeletal-related event (SRE) was defined as the time from randomization to the first skeletal-related event, defined as radiation therapy or surgery to bone, pathologic bone fracture, spinal cord compression, or change of anti-neoplastic therapy to treat bone pain. Participants who have not had a SRE at the time of the analysis were censored at their last assessment indicating no evidence of SRE. |
| Time to Initiation of Cytotoxic Chemotherapy | From the date of randomization to initiation of cytotoxic chemotherapy median follow-up time is 7.39 months for enzalutamide and 5.19 months for placebo | Time to initiation of cytotoxic chemotherapy was defined as the time from randomization to initiation of cytotoxic chemotherapy. It included only therapies for prostate cancer. When multiple cytotoxic chemotherapies were initiated, the first chemotherapy was used to determine the time to event. Participants who did not start cytotoxic chemotherapy at the time of analysis data cutoff were censored at the date of their last assessment indicating no evidence of cytotoxic chemotherapy usage. |
| Number of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline) | From baseline to the lowest post-baseline PSA result median treatment duration is 6.60 months for enzalutamide and 3.70 months for placebo | Best PSA response was defined as as ≥50% reductions in PSA level from baseline to the lowest post-baseline PSA result as determined by the central laboratory, with a consecutive assessment conducted at least 3 weeks later to confirm the PSA response. Only participants who had both baseline and post-baseline assessments were included in the analysis. |
| Best Overall Soft Tissue Response | From the date of randomization median treatment duration is 6.60 months for enzalutamide and 3.70 months for placebo | Participants with measurable soft tissue disease at screening visit (i.e., at least one target lesion per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1) who have an objective response (complete response (CR) or partial response (PR)) during the study were included in the best overall soft tissue response assessment. The best overall soft tissue response was based on the investigator assessment using RECIST 1.1. CR was defined as complete resolution of all attributable clinical symptoms and physical findings. PR was defined as partial resolution of at Least some of the clinical symptoms and physical findings. |
| Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85 | — |
| Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85 | — |
| Duration of Overall Survival | From the date of randomization to deaths from any cause median follow-up time is 42.32 months for enzalutamide and 26.81 months for placebo | Duration of overall survival was defined as the time from the randomization to deaths from any cause. For participants who were alive at the time of the data analysis, overall survival time was censored to the last know date the participants were known to be alive. |
| Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85 | N is the number of participants with available data at this time point. |
| Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization up to Days 2, 3, 8, 22, 29, 43, 57, 85, 86, 113, 141 and 169 | N is the number of participants with available data at this time point. |
| Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only) | From the date of randomization up to Multiple Dosing Day 85 | — |
| Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization up to Multiple Dosing Day 85 | — |
| AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization up to Multiple Dosing Day 85 | — |
| Number of Participants With Adverse Events (AE) | From first dose on Day 1 until 28 days after the last dose of study drug, or one day before the date of initiation of cytotoxic chemotherapy or an investigational agent for treatment of prostate cancer, whichever comes first, up to 123 months and 24 days | An AE was defined as any untoward medical occurrence, temporally associated with use of medicinal product, whether considered related to medicinal product. AE could therefore be any unfavorable & unintended sign, symptom, or disease temporally associated with use of a medicinal product. An AE was considered serious if, results in death; is life-threatening; results in persistent disability; results in congenital anomaly; requires inpatient hospitalization; or leads to prolongation of hospitalization; other medically important events. TEAE was defined as AE occurring from time of study drug administration on Day 1 until follow-up visit (28 days after last dose, or one day before date of initiation of cytotoxic chemotherapy or an investigational agent, whichever comes first). AEs were graded using National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Life-threatening; Grade 5 = Fatal. |
| AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85 | — |
Countries
China, Hong Kong, South Korea, Taiwan
Participant flow
Recruitment details
The study population consisted of men with asymptomatic or mildly symptomatic progressive metastatic prostate cancer, who had failed androgen deprivation therapy, and have not been treated with cytotoxic chemotherapy. Participants from 46 study sites in 4 countries (China, Korea, Taiwan and Hong Kong) were randomized for the study.
Pre-assignment details
Participants who met inclusion criteria and none of the exclusion criteria were enrolled in the study.
Participants by arm
| Arm | Count |
|---|---|
| Enzalutamide Participants received 160 mg of enzalutamide orally once a day during double blind period until PSA progression and radiographic disease progression were centrally confirmed and 1 of the following 2 events became applicable to the participants: (1) initiation of cytotoxic chemotherapy or (2) initiation of an investigational agent for treatment of prostate cancer (up to 29.4 months). Eligible participants who received enzalutamide during double blind and who provided consent to take part in open-label period continued to receive 160 mg of enzalutamide in open-label period orally once a day until PSA progression and radiographic disease progression were centrally confirmed and 1 of the following 2 events became applicable to the participants: (1) initiation of cytotoxic chemotherapy or (2) initiation of an investigational agent for treatment of prostate cancer (up to 54.3 months). | 202 |
| Placebo Participants received enzalutamide matching placebo orally once a day during double-blind period until PSA progression and radiographic disease progression were centrally confirmed and 1 of the following 2 events became applicable to the participants: (1) initiation of cytotoxic chemotherapy or (2) initiation of an investigational agent for treatment of prostate cancer (up to 18.6 months). Eligible participants who received enzalutamide matching placebo during double-blind period and who provided consent to take part in open-label period, received 160 mg of enzalutamide orally once a day during open-label period until PSA progression and radiographic disease progression were centrally confirmed and 1 of the following 2 events became applicable to the participants: (1) initiation of cytotoxic chemotherapy or (2) initiation of an investigational agent for treatment of prostate cancer (up to 53.8 months). | 193 |
| Total | 395 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Double-blind Period (up to 29.4 Months) | Adverse Event | 16 | 15 | 0 |
| Double-blind Period (up to 29.4 Months) | Death | 6 | 4 | 0 |
| Double-blind Period (up to 29.4 Months) | Lost to Follow-up | 1 | 0 | 0 |
| Double-blind Period (up to 29.4 Months) | Miscellaneous | 30 | 66 | 0 |
| Double-blind Period (up to 29.4 Months) | Progressive Disease | 38 | 51 | 0 |
| Double-blind Period (up to 29.4 Months) | Protocol Deviation | 0 | 2 | 0 |
| Double-blind Period (up to 29.4 Months) | Withdrawal by Subject | 27 | 54 | 0 |
| Open-label Period (up to 54.3 Months) | Adverse Event | 6 | 0 | 6 |
| Open-label Period (up to 54.3 Months) | Death | 6 | 0 | 5 |
| Open-label Period (up to 54.3 Months) | Lost to Follow-up | 4 | 0 | 2 |
| Open-label Period (up to 54.3 Months) | Miscellaneous | 28 | 0 | 16 |
| Open-label Period (up to 54.3 Months) | Progressive Disease | 20 | 0 | 12 |
| Open-label Period (up to 54.3 Months) | Protocol Deviation | 2 | 0 | 0 |
| Open-label Period (up to 54.3 Months) | Withdrawal by Subject | 19 | 0 | 10 |
Baseline characteristics
| Characteristic | Enzalutamide | Placebo | Total |
|---|---|---|---|
| Age, Continuous | 71.6 Years STANDARD_DEVIATION 8.1 | 71 Years STANDARD_DEVIATION 8.7 | 71.3 Years STANDARD_DEVIATION 8.4 |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 202 Participants | 193 Participants | 395 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 202 Participants | 193 Participants | 395 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 85 / 202 | 57 / 193 | 21 / 51 |
| other Total, other adverse events | 169 / 202 | 125 / 193 | 31 / 51 |
| serious Total, serious adverse events | 87 / 202 | 57 / 193 | 24 / 51 |
Outcome results
Time to Prostate-specific Antigen (PSA) Progression
The time to Prostate Specific Antigen (PSA) progression was defined as the time from randomization to the PSA progression. The PSA progression was defined according to the consensus guidelines of Prostate Cancer Clinical Trials Working Group 2 (PCWG2).For participants with PSA decline at Week 13, the PSA progression date was defined as a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir, which would be confirmed by a second consecutive value obtained 3 or more weeks later. For participants with no PSA decline at Week 13, the PSA progression date was defined as the date when a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the baseline was documented, which was confirmed by a second consecutive value 3 or more weeks later. Time to PSA progression was estimated using the Kaplan-Meier method. Participants without confirmed PSA progression were censored.
Time frame: From the date of randomization to PSA progression median follow-up time is 6.47 months for enzalutamide and 2.99 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to Prostate-specific Antigen (PSA) Progression | 8.31 Months |
| Placebo | Time to Prostate-specific Antigen (PSA) Progression | 2.86 Months |
Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only)
Time frame: From the date of randomization up to Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Enzalutamide | Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only) | 0.387 L/h | Standard Error 0.0774 |
| Placebo | Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only) | NA L/h | — |
| M2- N-Desmethyl Enzalutamide | Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only) | NA L/h | — |
| Enzalutamide Plus M2 | Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only) | NA L/h | — |
AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2
Time frame: From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point. Number of participants analyzed is the number of participants with available data at this time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Enzalutamide | AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 43.1 μg*h/mL | Standard Deviation 9.64 |
| Placebo | AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 1.81 μg*h/mL | Standard Deviation 0.972 |
| M2- N-Desmethyl Enzalutamide | AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 2.17 μg*h/mL | Standard Deviation 1.3 |
| Enzalutamide Plus M2 | AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 45.3 μg*h/mL | Standard Deviation 10.1 |
AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2
Time frame: From the date of randomization up to Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Enzalutamide | AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 427 μg*h/mL | Standard Deviation 79.8 |
| Placebo | AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 149 μg*h/mL | Standard Deviation 74.1 |
| M2- N-Desmethyl Enzalutamide | AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 308 μg*h/mL | Standard Deviation 68.2 |
| Enzalutamide Plus M2 | AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 735 μg*h/mL | Standard Deviation 109 |
Best Overall Soft Tissue Response
Participants with measurable soft tissue disease at screening visit (i.e., at least one target lesion per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1) who have an objective response (complete response (CR) or partial response (PR)) during the study were included in the best overall soft tissue response assessment. The best overall soft tissue response was based on the investigator assessment using RECIST 1.1. CR was defined as complete resolution of all attributable clinical symptoms and physical findings. PR was defined as partial resolution of at Least some of the clinical symptoms and physical findings.
Time frame: From the date of randomization median treatment duration is 6.60 months for enzalutamide and 3.70 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzalutamide | Best Overall Soft Tissue Response | 18 Participants |
| Placebo | Best Overall Soft Tissue Response | 1 Participants |
Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2
N is the number of participants with available data at this time point.
Time frame: From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Enzalutamide | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 1.65 μg/mL | Standard Deviation 0.343 |
| Enzalutamide | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 17.6 μg/mL | Standard Deviation 3.09 |
| Placebo | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 6.09 μg/mL | Standard Deviation 3.07 |
| Placebo | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.111 μg/mL | Standard Deviation 0.0801 |
| M2- N-Desmethyl Enzalutamide | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.164 μg/mL | Standard Deviation 0.0942 |
| M2- N-Desmethyl Enzalutamide | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 13.7 μg/mL | Standard Deviation 2.91 |
| Enzalutamide Plus M2 | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 1.82 μg/mL | Standard Deviation 0.363 |
| Enzalutamide Plus M2 | Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 31.2 μg/mL | Standard Deviation 4 |
Duration of Overall Survival
Duration of overall survival was defined as the time from the randomization to deaths from any cause. For participants who were alive at the time of the data analysis, overall survival time was censored to the last know date the participants were known to be alive.
Time frame: From the date of randomization to deaths from any cause median follow-up time is 42.32 months for enzalutamide and 26.81 months for placebo
Population: ITT population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Duration of Overall Survival | 39.06 Months |
| Placebo | Duration of Overall Survival | 27.10 Months |
Duration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility Assessment
Duration of Radiographic Progression-free Survival (rPFS) was defined as the time from randomization to the rPFS event (deaths from any cause and radiographic disease progression). Radiographic disease progression is defined by RECIST 1.1 for soft tissue disease, or PCWG2 for bone lesions. If a participant met the criteria for more than 1 censoring rule, they were censored with the earliest censoring date. The radiographic progression date was the first date when progression definition was met, not confirmed.
Time frame: From the date of randomization to the rPFS event (deaths from any cause and radiographic disease progression) median follow-up time is 5.55 months for enzalutamide and 3.71 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Duration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility Assessment | NA Months |
| Placebo | Duration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility Assessment | 5.29 Months |
Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2
Time frame: From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Enzalutamide | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 3.92 micrograms/milliliter (μg/mL) | Standard Deviation 1.37 |
| Enzalutamide | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 20.0 micrograms/milliliter (μg/mL) | Standard Deviation 3.22 |
| Placebo | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 14.0 micrograms/milliliter (μg/mL) | Standard Deviation 23.5 |
| Placebo | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.112 micrograms/milliliter (μg/mL) | Standard Deviation 0.0794 |
| M2- N-Desmethyl Enzalutamide | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.175 micrograms/milliliter (μg/mL) | Standard Deviation 0.0921 |
| M2- N-Desmethyl Enzalutamide | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 15.2 micrograms/milliliter (μg/mL) | Standard Deviation 3.44 |
| Enzalutamide Plus M2 | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 3.94 micrograms/milliliter (μg/mL) | Standard Deviation 1.34 |
| Enzalutamide Plus M2 | Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 34.2 micrograms/milliliter (μg/mL) | Standard Deviation 4.98 |
Number of Participants With Adverse Events (AE)
An AE was defined as any untoward medical occurrence, temporally associated with use of medicinal product, whether considered related to medicinal product. AE could therefore be any unfavorable & unintended sign, symptom, or disease temporally associated with use of a medicinal product. An AE was considered serious if, results in death; is life-threatening; results in persistent disability; results in congenital anomaly; requires inpatient hospitalization; or leads to prolongation of hospitalization; other medically important events. TEAE was defined as AE occurring from time of study drug administration on Day 1 until follow-up visit (28 days after last dose, or one day before date of initiation of cytotoxic chemotherapy or an investigational agent, whichever comes first). AEs were graded using National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03, where Grade 1 = Mild; Grade 2 = Moderate; Grade 3 = Severe; Grade 4 = Life-threatening; Grade 5 = Fatal.
Time frame: From first dose on Day 1 until 28 days after the last dose of study drug, or one day before the date of initiation of cytotoxic chemotherapy or an investigational agent for treatment of prostate cancer, whichever comes first, up to 123 months and 24 days
Population: Safety Analysis Set consisted of all randomized participants who received at least 1 dose of study drug.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Enzalutamide | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE Related to Study Drug | 26 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Reduction of Study Drug | 4 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | Treatment Emergent Adverse Events (TEAEs) | 190 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Related to Study Drug | 102 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Interruption of Study Drug | 28 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Death | 24 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE That Was Primary Reason for Treatment Discontinuation | 32 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | Serious TEAE | 87 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | Serious TEAE Related to Study Drug | 14 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Study Drug Discontinuation | 49 Participants |
| Enzalutamide | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE | 98 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Interruption of Study Drug | 16 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE Leading to Death | 7 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | Serious TEAE | 57 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE That Was Primary Reason for Treatment Discontinuation | 33 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE Leading to Study Drug Discontinuation | 42 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Reduction of Study Drug | 3 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | TEAE Related to Study Drug | 59 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE Related to Study Drug | 13 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | Serious TEAE Related to Study Drug | 7 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | Treatment Emergent Adverse Events (TEAEs) | 166 Participants |
| Placebo | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE | 66 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | Treatment Emergent Adverse Events (TEAEs) | 47 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE Related to Study Drug | 5 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE That Was Primary Reason for Treatment Discontinuation | 7 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Death | 7 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | Serious TEAE Related to Study Drug | 3 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | Serious TEAE | 24 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Interruption of Study Drug | 7 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Dose Reduction of Study Drug | 2 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | Grade 3 or Higher TEAE | 28 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Related to Study Drug | 13 Participants |
| M2- N-Desmethyl Enzalutamide | Number of Participants With Adverse Events (AE) | TEAE Leading to Study Drug Discontinuation | 12 Participants |
Number of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline)
Best PSA response was defined as as ≥50% reductions in PSA level from baseline to the lowest post-baseline PSA result as determined by the central laboratory, with a consecutive assessment conducted at least 3 weeks later to confirm the PSA response. Only participants who had both baseline and post-baseline assessments were included in the analysis.
Time frame: From baseline to the lowest post-baseline PSA result median treatment duration is 6.60 months for enzalutamide and 3.70 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Enzalutamide | Number of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline) | 120 Participants |
| Placebo | Number of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline) | 15 Participants |
Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2
N is the number of participants with available data at this time point.
Time frame: From the date of randomization up to Days 2, 3, 8, 22, 29, 43, 57, 85, 86, 113, 141 and 169
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at least 1 time point.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 113 predose | 17.5 μg/mL | Standard Deviation 4.14 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 169 predose | 17.2 μg/mL | Standard Deviation 5.55 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 predose | 17.9 μg/mL | Standard Deviation 3.19 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 2 predose | 1.65 μg/mL | Standard Deviation 0.343 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 86 predose | 17.6 μg/mL | Standard Deviation 3.09 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 8 predose | 9.39 μg/mL | Standard Deviation 2.07 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 22 predose | 17.6 μg/mL | Standard Deviation 2.37 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 3 predose | 3.29 μg/mL | Standard Deviation 1.16 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 141 predose | 17.3 μg/mL | Standard Deviation 3.73 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 29 predose | 19.6 μg/mL | Standard Deviation 4 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 43 predose | 17.0 μg/mL | Standard Deviation 4.13 |
| Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 57 predose | 17.8 μg/mL | Standard Deviation 3.09 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 3 predose | 0.302 μg/mL | Standard Deviation 0.256 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 57 predose | 18.4 μg/mL | Standard Deviation 28.2 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 22 predose | 6.09 μg/mL | Standard Deviation 8.26 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 86 predose | 6.09 μg/mL | Standard Deviation 3.07 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 113 predose | 17.5 μg/mL | Standard Deviation 33.1 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 predose | 6.33 μg/mL | Standard Deviation 2.95 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 2 predose | 0.111 μg/mL | Standard Deviation 0.0801 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 43 predose | 12.5 μg/mL | Standard Deviation 22.1 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 29 predose | 8.16 μg/mL | Standard Deviation 12.5 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 8 predose | 1.21 μg/mL | Standard Deviation 0.923 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 169 predose | 5.09 μg/mL | Standard Deviation 2.27 |
| Placebo | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 141 predose | 5.52 μg/mL | Standard Deviation 2.1 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 predose | 14.9 μg/mL | Standard Deviation 3.67 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 2 predose | 0.164 μg/mL | Standard Deviation 0.0942 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 3 predose | 0.367 μg/mL | Standard Deviation 0.188 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 8 predose | 1.94 μg/mL | Standard Deviation 0.983 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 22 predose | 8.34 μg/mL | Standard Deviation 2.74 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 29 predose | 10.9 μg/mL | Standard Deviation 3.72 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 43 predose | 14.0 μg/mL | Standard Deviation 3.99 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 57 predose | 14.7 μg/mL | Standard Deviation 3.88 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 86 predose | 13.7 μg/mL | Standard Deviation 2.91 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 113 predose | 15.0 μg/mL | Standard Deviation 3.21 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 141 predose | 14.3 μg/mL | Standard Deviation 3.9 |
| M2- N-Desmethyl Enzalutamide | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 169 predose | 14.0 μg/mL | Standard Deviation 4.8 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 43 predose | 31.0 μg/mL | Standard Deviation 5.82 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 29 predose | 30.5 μg/mL | Standard Deviation 5.47 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 2 predose | 1.82 μg/mL | Standard Deviation 0.363 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 113 predose | 32.5 μg/mL | Standard Deviation 3.72 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 22 predose | 25.9 μg/mL | Standard Deviation 3.25 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 8 predose | 11.3 μg/mL | Standard Deviation 2.62 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 169 predose | 31.2 μg/mL | Standard Deviation 5.02 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 141 predose | 31.6 μg/mL | Standard Deviation 4.7 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 predose | 32.8 μg/mL | Standard Deviation 5.1 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 57 predose | 32.5 μg/mL | Standard Deviation 4.57 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 3 predose | 3.66 μg/mL | Standard Deviation 1.24 |
| Enzalutamide Plus M2 | Observed Plasma Concentration in Predose Samples Obtained During Multiple-dose Administration of Minimum Concentration (Plasma Concentration at Pre Dose) (Cmin) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 86 predose | 31.2 μg/mL | Standard Deviation 4 |
Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2
Time frame: From the date of randomization up to Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Enzalutamide | Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 1.15 Ratio | Standard Deviation 0.11 |
| Placebo | Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 1.19 Ratio | Standard Deviation 0.364 |
| M2- N-Desmethyl Enzalutamide | Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 1.09 Ratio | Standard Deviation 0.0897 |
| Enzalutamide Plus M2 | Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M2 | 1.08 Ratio | Standard Deviation 0.0581 |
Time to First Skeletal-Related Event
Time to first skeletal-related event (SRE) was defined as the time from randomization to the first skeletal-related event, defined as radiation therapy or surgery to bone, pathologic bone fracture, spinal cord compression, or change of anti-neoplastic therapy to treat bone pain. Participants who have not had a SRE at the time of the analysis were censored at their last assessment indicating no evidence of SRE.
Time frame: From the date of randomization to the first skeletal-related event median follow-up time is 7.39 months for enzalutamide and 5.29 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to First Skeletal-Related Event | NA Months |
| Placebo | Time to First Skeletal-Related Event | NA Months |
Time to Initiation of Cytotoxic Chemotherapy
Time to initiation of cytotoxic chemotherapy was defined as the time from randomization to initiation of cytotoxic chemotherapy. It included only therapies for prostate cancer. When multiple cytotoxic chemotherapies were initiated, the first chemotherapy was used to determine the time to event. Participants who did not start cytotoxic chemotherapy at the time of analysis data cutoff were censored at the date of their last assessment indicating no evidence of cytotoxic chemotherapy usage.
Time frame: From the date of randomization to initiation of cytotoxic chemotherapy median follow-up time is 7.39 months for enzalutamide and 5.19 months for placebo
Population: ITT population with available data.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Enzalutamide | Time to Initiation of Cytotoxic Chemotherapy | NA Months |
| Placebo | Time to Initiation of Cytotoxic Chemotherapy | 13.93 Months |
Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2
Time frame: From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85
Population: The Pharmacokinetic Analysis Set (PKAS) population consisted of all participants who received at least 1 dose of study drug and who provided blood samples for drug concentrations at at least 1 time point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Enzalutamide | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.975 hour |
| Enzalutamide | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 1.00 hour |
| Placebo | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 1.02 hour |
| Placebo | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 24.0 hour |
| M2- N-Desmethyl Enzalutamide | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 24.0 hour |
| M2- N-Desmethyl Enzalutamide | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 0 hour |
| Enzalutamide Plus M2 | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 1 | 0.975 hour |
| Enzalutamide Plus M2 | Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2 | Day 85 | 0.250 hour |