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An Asian Study to Evaluate Efficacy and Safety of Oral Enzalutamide in Progressive Metastatic Prostate Cancer Participants

Asian Multinational Phase 3, Randomized, Double-Blind, Placebo-Controlled Efficacy and Safety Study of Oral Enzalutamide in Chemotherapy Naïve Subjects With Progressive Metastatic Prostate Cancer Who Have Failed Androgen Deprivation Therapy

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02294461
Enrollment
395
Registered
2014-11-19
Start date
2014-04-23
Completion date
2024-07-17
Last updated
2025-10-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Progressive Metastatic Prostate Cancer

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

DRUGEnzalutamide

Oral

DRUGPlacebo

Oral

Sponsors

Astellas Pharma Inc
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
Time to Prostate-specific Antigen (PSA) ProgressionFrom the date of randomization to PSA progression median follow-up time is 6.47 months for enzalutamide and 2.99 months for placeboThe 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

MeasureTime frameDescription
Duration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility AssessmentFrom 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 placeboDuration 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 EventFrom 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 placeboTime 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 ChemotherapyFrom the date of randomization to initiation of cytotoxic chemotherapy median follow-up time is 7.39 months for enzalutamide and 5.19 months for placeboTime 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 placeboBest 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 ResponseFrom the date of randomization median treatment duration is 6.60 months for enzalutamide and 3.70 months for placeboParticipants 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 M2From 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 M2From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85
Duration of Overall SurvivalFrom the date of randomization to deaths from any cause median follow-up time is 42.32 months for enzalutamide and 26.81 months for placeboDuration 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 M2From the date of randomization, Single Dosing Day 1 and Multiple Dosing Day 85N 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 M2From the date of randomization up to Days 2, 3, 8, 22, 29, 43, 57, 85, 86, 113, 141 and 169N 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 M2From 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 M2From 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 daysAn 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 M2From 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

ArmCount
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
Total395

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Double-blind Period (up to 29.4 Months)Adverse Event16150
Double-blind Period (up to 29.4 Months)Death640
Double-blind Period (up to 29.4 Months)Lost to Follow-up100
Double-blind Period (up to 29.4 Months)Miscellaneous30660
Double-blind Period (up to 29.4 Months)Progressive Disease38510
Double-blind Period (up to 29.4 Months)Protocol Deviation020
Double-blind Period (up to 29.4 Months)Withdrawal by Subject27540
Open-label Period (up to 54.3 Months)Adverse Event606
Open-label Period (up to 54.3 Months)Death605
Open-label Period (up to 54.3 Months)Lost to Follow-up402
Open-label Period (up to 54.3 Months)Miscellaneous28016
Open-label Period (up to 54.3 Months)Progressive Disease20012
Open-label Period (up to 54.3 Months)Protocol Deviation200
Open-label Period (up to 54.3 Months)Withdrawal by Subject19010

Baseline characteristics

CharacteristicEnzalutamidePlaceboTotal
Age, Continuous71.6 Years
STANDARD_DEVIATION 8.1
71 Years
STANDARD_DEVIATION 8.7
71.3 Years
STANDARD_DEVIATION 8.4
Race and Ethnicity Not Collected0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
202 Participants193 Participants395 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants
Sex: Female, Male
Male
202 Participants193 Participants395 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
85 / 20257 / 19321 / 51
other
Total, other adverse events
169 / 202125 / 19331 / 51
serious
Total, serious adverse events
87 / 20257 / 19324 / 51

Outcome results

Primary

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.

ArmMeasureValue (MEDIAN)
EnzalutamideTime to Prostate-specific Antigen (PSA) Progression8.31 Months
PlaceboTime to Prostate-specific Antigen (PSA) Progression2.86 Months
Comparison: P-value is based on an unstratified log-rank test. Hazard ratio calculated using unstratified Cox Proportional Hazards model with treatment as the only covariate for enzalutamide group versus placebo group.p-value: <0.000195% CI: [0.27, 0.52]Hazard Ratio
Secondary

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.

ArmMeasureValue (MEAN)Dispersion
EnzalutamideApparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only)0.387 L/hStandard Error 0.0774
PlaceboApparent 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 EnzalutamideApparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only)NA L/h
Enzalutamide Plus M2Apparent Total Systemic Clearance After Multiple Dosing (CL/F) Enzalutamide, M1,M2 and Enzalutamide Plus M2 (For Unchanged Enzalutamide Only)NA L/h
Secondary

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.

ArmMeasureValue (MEAN)Dispersion
EnzalutamideAUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M243.1 μg*h/mLStandard Deviation 9.64
PlaceboAUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M21.81 μg*h/mLStandard Deviation 0.972
M2- N-Desmethyl EnzalutamideAUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M22.17 μg*h/mLStandard Deviation 1.3
Enzalutamide Plus M2AUC From the Time of Dosing to 24 h After Dosing (AUC24h) Enzalutamide, M1,M2 and Enzalutamide Plus M245.3 μg*h/mLStandard Deviation 10.1
Secondary

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.

ArmMeasureValue (MEAN)Dispersion
EnzalutamideAUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2427 μg*h/mLStandard Deviation 79.8
PlaceboAUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2149 μg*h/mLStandard Deviation 74.1
M2- N-Desmethyl EnzalutamideAUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2308 μg*h/mLStandard Deviation 68.2
Enzalutamide Plus M2AUC From the Time of Dosing to the Start of the Next Dosing Interval (AUCtau) Enzalutamide, M1,M2 and Enzalutamide Plus M2735 μg*h/mLStandard Deviation 109
Secondary

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.

ArmMeasureValue (NUMBER)
EnzalutamideBest Overall Soft Tissue Response18 Participants
PlaceboBest Overall Soft Tissue Response1 Participants
Comparison: When deriving the response category, it was based on the target, non-target and new lesions without confirming CR, PR, and Progressive disease (PD). Participants with no post baseline assessment were included in the category of Nonevaluable (NE). The best overall soft tissue objective response was defined as PR or CR based on the investigator assessments of target, non-target and new lesions while on the study treatment.p-value: <0.000195% CI: [14.7, 37.4]Unstratified Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureGroupValue (MEAN)Dispersion
EnzalutamideConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 11.65 μg/mLStandard Deviation 0.343
EnzalutamideConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8517.6 μg/mLStandard Deviation 3.09
PlaceboConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 856.09 μg/mLStandard Deviation 3.07
PlaceboConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.111 μg/mLStandard Deviation 0.0801
M2- N-Desmethyl EnzalutamideConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.164 μg/mLStandard Deviation 0.0942
M2- N-Desmethyl EnzalutamideConcentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8513.7 μg/mLStandard Deviation 2.91
Enzalutamide Plus M2Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 11.82 μg/mLStandard Deviation 0.363
Enzalutamide Plus M2Concentration 24 h After Dosing (C24h) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8531.2 μg/mLStandard Deviation 4
Secondary

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

ArmMeasureValue (MEDIAN)
EnzalutamideDuration of Overall Survival39.06 Months
PlaceboDuration of Overall Survival27.10 Months
Comparison: Participants who were not known to have had died at the analysis date were censored at date last known alive. Hazard ratio calculated using unstratified Cox Proportional Hazards model with treatment as the only covariate for enzalutamide group versus placebo group.p-value: 0.020895% CI: [0.51, 0.95]Unstratified log-rank test
Secondary

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.

ArmMeasureValue (MEDIAN)
EnzalutamideDuration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility AssessmentNA Months
PlaceboDuration of Radiographic Progression-free Survival (rPFS) Based on Independent Central Review Facility Assessment5.29 Months
Comparison: Participants who were not known to have had an rPFS event were censored at the date of the last assessment showing no objective evidence of rPFS prior to scan modality change, new antineoplastic treatment, initiation of radiation therapy for prostate cancer, skeletal-related event (SRE) and 2 or more consecutive missed tumor assessments. Hazard ratio calculated using unstratified Cox Proportional Hazards model with treatment as the only covariate for enzalutamide.p-value: <0.000195% CI: [0.2, 0.46]Unstratified log-rank test
Secondary

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.

ArmMeasureGroupValue (MEAN)Dispersion
EnzalutamideMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 13.92 micrograms/milliliter (μg/mL)Standard Deviation 1.37
EnzalutamideMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8520.0 micrograms/milliliter (μg/mL)Standard Deviation 3.22
PlaceboMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8514.0 micrograms/milliliter (μg/mL)Standard Deviation 23.5
PlaceboMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.112 micrograms/milliliter (μg/mL)Standard Deviation 0.0794
M2- N-Desmethyl EnzalutamideMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.175 micrograms/milliliter (μg/mL)Standard Deviation 0.0921
M2- N-Desmethyl EnzalutamideMaximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8515.2 micrograms/milliliter (μg/mL)Standard Deviation 3.44
Enzalutamide Plus M2Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 13.94 micrograms/milliliter (μg/mL)Standard Deviation 1.34
Enzalutamide Plus M2Maximum Observed Plasma Concentration During the First 24 Hours After Dosing (Cmax) Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 8534.2 micrograms/milliliter (μg/mL)Standard Deviation 4.98
Secondary

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.

ArmMeasureGroupValue (NUMBER)
EnzalutamideNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE Related to Study Drug26 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Reduction of Study Drug4 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)Treatment Emergent Adverse Events (TEAEs)190 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Related to Study Drug102 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Interruption of Study Drug28 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Death24 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE That Was Primary Reason for Treatment Discontinuation32 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)Serious TEAE87 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)Serious TEAE Related to Study Drug14 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Study Drug Discontinuation49 Participants
EnzalutamideNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE98 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Interruption of Study Drug16 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE Leading to Death7 Participants
PlaceboNumber of Participants With Adverse Events (AE)Serious TEAE57 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE That Was Primary Reason for Treatment Discontinuation33 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE Leading to Study Drug Discontinuation42 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Reduction of Study Drug3 Participants
PlaceboNumber of Participants With Adverse Events (AE)TEAE Related to Study Drug59 Participants
PlaceboNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE Related to Study Drug13 Participants
PlaceboNumber of Participants With Adverse Events (AE)Serious TEAE Related to Study Drug7 Participants
PlaceboNumber of Participants With Adverse Events (AE)Treatment Emergent Adverse Events (TEAEs)166 Participants
PlaceboNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE66 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)Treatment Emergent Adverse Events (TEAEs)47 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE Related to Study Drug5 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE That Was Primary Reason for Treatment Discontinuation7 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Death7 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)Serious TEAE Related to Study Drug3 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)Serious TEAE24 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Interruption of Study Drug7 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Dose Reduction of Study Drug2 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)Grade 3 or Higher TEAE28 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Related to Study Drug13 Participants
M2- N-Desmethyl EnzalutamideNumber of Participants With Adverse Events (AE)TEAE Leading to Study Drug Discontinuation12 Participants
Secondary

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.

ArmMeasureValue (NUMBER)
EnzalutamideNumber of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline)120 Participants
PlaceboNumber of Participants With Confirmed Best PSA Response (≥50% Decrease From Baseline)15 Participants
p-value: <0.000195% CI: [47.4, 64.2]Unstratified Cochran-Mantel-Haenszel %
Secondary

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.

ArmMeasureGroupValue (MEAN)Dispersion
EnzalutamideObserved 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 M2Day 113 predose17.5 μg/mLStandard Deviation 4.14
EnzalutamideObserved 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 M2Day 169 predose17.2 μg/mLStandard Deviation 5.55
EnzalutamideObserved 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 M2Day 85 predose17.9 μg/mLStandard Deviation 3.19
EnzalutamideObserved 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 M2Day 2 predose1.65 μg/mLStandard Deviation 0.343
EnzalutamideObserved 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 M2Day 86 predose17.6 μg/mLStandard Deviation 3.09
EnzalutamideObserved 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 M2Day 8 predose9.39 μg/mLStandard Deviation 2.07
EnzalutamideObserved 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 M2Day 22 predose17.6 μg/mLStandard Deviation 2.37
EnzalutamideObserved 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 M2Day 3 predose3.29 μg/mLStandard Deviation 1.16
EnzalutamideObserved 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 M2Day 141 predose17.3 μg/mLStandard Deviation 3.73
EnzalutamideObserved 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 M2Day 29 predose19.6 μg/mLStandard Deviation 4
EnzalutamideObserved 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 M2Day 43 predose17.0 μg/mLStandard Deviation 4.13
EnzalutamideObserved 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 M2Day 57 predose17.8 μg/mLStandard Deviation 3.09
PlaceboObserved 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 M2Day 3 predose0.302 μg/mLStandard Deviation 0.256
PlaceboObserved 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 M2Day 57 predose18.4 μg/mLStandard Deviation 28.2
PlaceboObserved 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 M2Day 22 predose6.09 μg/mLStandard Deviation 8.26
PlaceboObserved 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 M2Day 86 predose6.09 μg/mLStandard Deviation 3.07
PlaceboObserved 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 M2Day 113 predose17.5 μg/mLStandard Deviation 33.1
PlaceboObserved 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 M2Day 85 predose6.33 μg/mLStandard Deviation 2.95
PlaceboObserved 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 M2Day 2 predose0.111 μg/mLStandard Deviation 0.0801
PlaceboObserved 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 M2Day 43 predose12.5 μg/mLStandard Deviation 22.1
PlaceboObserved 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 M2Day 29 predose8.16 μg/mLStandard Deviation 12.5
PlaceboObserved 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 M2Day 8 predose1.21 μg/mLStandard Deviation 0.923
PlaceboObserved 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 M2Day 169 predose5.09 μg/mLStandard Deviation 2.27
PlaceboObserved 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 M2Day 141 predose5.52 μg/mLStandard Deviation 2.1
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 85 predose14.9 μg/mLStandard Deviation 3.67
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 2 predose0.164 μg/mLStandard Deviation 0.0942
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 3 predose0.367 μg/mLStandard Deviation 0.188
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 8 predose1.94 μg/mLStandard Deviation 0.983
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 22 predose8.34 μg/mLStandard Deviation 2.74
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 29 predose10.9 μg/mLStandard Deviation 3.72
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 43 predose14.0 μg/mLStandard Deviation 3.99
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 57 predose14.7 μg/mLStandard Deviation 3.88
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 86 predose13.7 μg/mLStandard Deviation 2.91
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 113 predose15.0 μg/mLStandard Deviation 3.21
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 141 predose14.3 μg/mLStandard Deviation 3.9
M2- N-Desmethyl EnzalutamideObserved 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 M2Day 169 predose14.0 μg/mLStandard Deviation 4.8
Enzalutamide Plus M2Observed 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 M2Day 43 predose31.0 μg/mLStandard Deviation 5.82
Enzalutamide Plus M2Observed 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 M2Day 29 predose30.5 μg/mLStandard Deviation 5.47
Enzalutamide Plus M2Observed 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 M2Day 2 predose1.82 μg/mLStandard Deviation 0.363
Enzalutamide Plus M2Observed 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 M2Day 113 predose32.5 μg/mLStandard Deviation 3.72
Enzalutamide Plus M2Observed 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 M2Day 22 predose25.9 μg/mLStandard Deviation 3.25
Enzalutamide Plus M2Observed 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 M2Day 8 predose11.3 μg/mLStandard Deviation 2.62
Enzalutamide Plus M2Observed 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 M2Day 169 predose31.2 μg/mLStandard Deviation 5.02
Enzalutamide Plus M2Observed 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 M2Day 141 predose31.6 μg/mLStandard Deviation 4.7
Enzalutamide Plus M2Observed 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 M2Day 85 predose32.8 μg/mLStandard Deviation 5.1
Enzalutamide Plus M2Observed 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 M2Day 57 predose32.5 μg/mLStandard Deviation 4.57
Enzalutamide Plus M2Observed 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 M2Day 3 predose3.66 μg/mLStandard Deviation 1.24
Enzalutamide Plus M2Observed 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 M2Day 86 predose31.2 μg/mLStandard Deviation 4
Secondary

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.

ArmMeasureValue (MEAN)Dispersion
EnzalutamidePeak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M21.15 RatioStandard Deviation 0.11
PlaceboPeak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M21.19 RatioStandard Deviation 0.364
M2- N-Desmethyl EnzalutamidePeak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M21.09 RatioStandard Deviation 0.0897
Enzalutamide Plus M2Peak-Trough Ratio (PTR) Enzalutamide, M1,M2 and Enzalutamide Plus M21.08 RatioStandard Deviation 0.0581
Secondary

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.

ArmMeasureValue (MEDIAN)
EnzalutamideTime to First Skeletal-Related EventNA Months
PlaceboTime to First Skeletal-Related EventNA Months
Comparison: Participants who did not have an SRE were censored at the date of the last assessment indicating no evidence of SRE. Hazard ratio calculated using unstratified Cox Proportional Hazards model with treatment as the only covariate for enzalutamide group versus placebo group.p-value: 0.250195% CI: [0.21, 1.52]Unstratified log-rank test
Secondary

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.

ArmMeasureValue (MEDIAN)
EnzalutamideTime to Initiation of Cytotoxic ChemotherapyNA Months
PlaceboTime to Initiation of Cytotoxic Chemotherapy13.93 Months
Comparison: Participants who did not start cytotoxic chemotherapy were censored at the date of the last assessment indicating no evidence of cytotoxic chemotherapy usage. Hazard ratio calculated using unstratified Cox Proportional Hazards model with treatment as the only covariate for enzalutamide group versus placebo group.p-value: 0.00295% CI: [0.12, 0.66]Unstratified log-rank test
Secondary

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.

ArmMeasureGroupValue (MEDIAN)
EnzalutamideTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.975 hour
EnzalutamideTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 851.00 hour
PlaceboTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 851.02 hour
PlaceboTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 124.0 hour
M2- N-Desmethyl EnzalutamideTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 124.0 hour
M2- N-Desmethyl EnzalutamideTime to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 850 hour
Enzalutamide Plus M2Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 10.975 hour
Enzalutamide Plus M2Time to Maximum Concentration (Tmax) of Enzalutamide, M1,M2 and Enzalutamide Plus M2Day 850.250 hour

Source: ClinicalTrials.gov · Data processed: Feb 21, 2026