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Apalutamide and Leuprolide in Intermediate and High-risk Prostate Cancer

The Association Between HSD3B1 Genotype and Steroid Metabolism in Normal and Prostate Cancer Tissue of Men With Intermediate and High-risk Prostate Cancer Undergoing Radical Prostatectomy After Treatment With Apalutamide and Leuprolide

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02770391
Enrollment
54
Registered
2016-05-12
Start date
2016-10-17
Completion date
2020-04-29
Last updated
2022-06-21

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

Conditions

Prostate Cancer

Keywords

HSD3B1 Genotype, Steroid Metabolism, High-risk Prostate Cancer, Apalutamide, ARN-509

Brief summary

This is a research study to test an investigational drug (Not FDA approved), Apalutamide given in combination with Leuprolide acetate (FDA approved) in men diagnosed with high-risk prostate cancer who have already selected to have surgery to remove their prostate gland as part of their treatment plan. The main purpose of this study is to determine how tumors make androgens (male hormones), which makes these tumors more aggressive and resistant to hormonal therapy and how a short period of treatment with Apalutamide and leuprolide acetate prior to surgery can affect the production of these hormones in normal and malignant prostate tissue.

Detailed description

Primary Objective: To evaluate the differential effect of neo-adjuvant leuprolide and Apalutamide on dihydrotestosterone (DHT) concentration in benign prostate tissue based on HSD3B1 genotype. Secondary Objective(s): To evaluate the differential effect of neoadjuvant leuprolide and Apalutamide on other androgen (testosterone (T), dehydroepiandrosterone (DHEA), androstenediol, 5α-androstanedione (5α-dione), androstenedione (AD), androsterone and 5α-androstanediol) concentrations in benign and malignant prostate tissue based on HSD3B1 genotype. To compare the level of DHT, T, DHEA, androstenediol, 5α-dione, AD, androsterone and 5α-androstanediol between normal and malignant prostate tissue after neoadjuvant treatment with leuprolide and Apalutamide To determine the safety of the combination of Leuprolide and Apalutamide administered prior to radical prostatectomy To evaluate prostatic specific antigen (PSA), FKBP5, TMPRSS2, EZH2, H3K27 and UBE2C tissue expression (via immunohistochemistry (IHC) and quantitative polymerase chain reaction (qPCR)) in benign and malignant prostate tissue after treatment with Leuprolide and Apalutamide.

Interventions

DRUGLeuprolide acetate

Leuprolide acetate, Intramuscular injection - 7.5 mg, one time dose on day (-28) ± 3

DRUGApalutamide

Apalutamide, PO, 240 mg daily, starting day (-28) ± 3 until the day before radical prostatectomy. Apalutamide will be initiated the same day patients receive their leuprolide acetate injection.

PROCEDURERadical prostatectomy

Sponsors

Case Comprehensive Cancer Center
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Adenocarcinoma of the prostate with histological or cytological confirmation without neuroendocrine differentiation or small cell histology and with G 4+3 or higher, and PSA ≥ 10, and ≥T2b, for whom radical prostatectomy has been recommended and who choose to undergo radical prostatectomy. * A minimum tissue requirement of ≥3 core biopsies with tumor involvement and at least 50% tumor involvement in one of the core biopsies is required. * Have an Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 * Hemoglobin of ≥ 10 g/dL, independent of transfusion and/or growth factors within 3 months prior to randomization * Platelet count of ≥ 100k/mL independent of transfusion and/or growth factors within 3 months prior to randomization * Serum albumin ≥3.0 g/dL * Serum creatinine \< 2.0 times the upper limit of normal (ULN) {or a calculated creatinine clearance ≥ 60 mL/min} * Serum potassium ≥3.5 mmol/L * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) \< 2.5 x ULN * Total serum bilirubin levels \< 1.5 x ULN (Note: In subjects with Gilbert's syndrome, if total bilirubin is \>1.5 × ULN, measure direct and indirect bilirubin and if direct bilirubin is ≤1.5 × ULN, subject may be eligible) * Be capable of swallowing study agents whole as a tablet * Be willing/able to adhere to the prohibitions and restrictions specified in this protocol * Have signed an informed consent document indicating that the subject understands the purpose of and procedures required for the study and are willing to participate in the study. * Medications known to lower the seizure threshold must be discontinued or substituted at least 4 weeks prior to study entry. * Agrees to use a condom (even men with vasectomies) and another effective method of birth control if he is having sex with a woman of childbearing potential or agrees to use a condom if he is having sex with a woman who is pregnant while on study drug and for 3 months following the last dose of study drug. Must also agree not to donate sperm during the study and for 3 months following the last dose of study drug.

Exclusion criteria

* The use of any prior hormones including luteinizing hormone-releasing hormone (LHRH) agonists , LHRH antagonists, antiandrogens such as bicalutamide, flutamide and nilutamide, and/or the use of 5-alpha reductase inhibitors, prostate cancer (PC) Spes (or PC-x product), Megestrol Acetate, or estrogen containing nutriceuticals within 6 months of study treatment initiation. * Prior radiation therapy, immunotherapy, chemotherapy or other investigational therapy given for prostate cancer. * Currently active second malignancy other than non-melanoma skin cancers or non-muscle invasive transitional cell carcinoma of bladder. Patients are not considered to have a currently active malignancy if they have completed therapy and are now considered (by their physician) to be at less than 30% risk for relapse. * History of seizure or condition that may pre-dispose to seizure (including but not limited to prior stroke, transient ischemic attack, loss of consciousness within 1 year prior to randomization, brain arteriovenous malformation; or intracranial masses such as schwannomas and meningiomas that are causing edema or mass effect) * Current systemic steroid therapy (inhaled or topical steroids are also not allowed) * Have received treatment with any form of therapy with CYP17 inhibitory activity such as ketoconazole, aminoglutethimide, or an antiandrogen such as bicalutamide within 6 months of study treatment initiation. * Use of herbal products that may have hormonal anti-prostate cancer activity and/or are known to decrease PSA levels (e.g., saw palmetto) or systemic corticosteroids within 6 months of enrollment * Active infection (eg, human immunodeficiency virus \[HIV\] or viral hepatitis) * Have uncontrolled hypertension;subjects with a history of hypertension are permitted in the study provided their blood pressure is controlled by anti-hypertensive therapy, at the discretion of the treating physician * Have a known history of pituitary or adrenal dysfunction * Have clinically significant heart disease as evidenced by severe or unstable angina, myocardial infarction, symptomatic congestive heart failure, arterial or venous thromboembolic events (e.g., pulmonary embolism, cerebrovascular accident including transient ischemic attacks), or clinically significant ventricular arrhythmias within 6 months prior to randomization * Have a history of gastric bypass surgery or severe malabsorption that may interfere with the absorption of the study agents * Be taking or require the use of prohibited medications as listed * Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements

Design outcomes

Primary

MeasureTime frameDescription
Dihydrotestosterone (DHT) Concentration in Benign Prostate Tissue After a Combination Drug Treatment Based on Genotype StatusUp to 28 DaysTo evaluate the differential effect of neo-adjuvant leuprolide and ARN-509 on dihydrotestosterone (DHT) concentration in benign prostate tissue based on HSD3B1 genotype.
Dihydrotestosterone (DHT) Concentration in Malignant Prostate Tissue After a Combination Drug Treatment Based on Genotype StatusUp to 28 DaysTo evaluate the differential effect of neo-adjuvant leuprolide and ARN-509 on dihydrotestosterone (DHT) concentration in malignant prostate tissue based on HSD3B1 genotype.

Secondary

MeasureTime frameDescription
To Compare the Level of DHT, T, DHEA, Androstenediol, 5alpha-dione, AD, Androsterone and 5alpha-androstanediol Between Normal and Malignant Prostate Tissue After Neoadjuvant Leuprolide and ARN-509.Up to 28 DaysTo compare the level of DHT, T, DHEA, androstenediol, 5alpha-dione, AD, androsterone and 5alpha-androstanediol between normal and malignant prostate tissue after neoadjuvant leuprolide and ARN-509.
PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C tissue expression (via IHC) in malignant prostate tissue after treatment with Leuprolide and Apalutamide.
Other Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate the differential effect of neoadjuvant leuprolide and ARN-509 on other androgens (testosterone (T), dehydroepiandrosterone (DHEA), androstenediol, 5?-androstanedione (5?-dione), androstenedione (AD), androsterone and 5?-androstanediol) concentration in benign prostate tissue based on HSD3B1 genotype.
PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Benign Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27 and UBE2C tissue expression (via IHC) in benign prostate tissue after treatment with Leuprolide and Apalutamide.
PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Benign Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27 and UBE2C tissue expression (via qPCR) in benign prostate tissue after treatment with Leuprolide and Apalutamide.
PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C tissue expression (via qPCR) in malignant prostate tissue after treatment with Leuprolide and Apalutamide.
Other Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.Up to 28 DaysTo evaluate the effect of neoadjuvant ARN-509 on other androgens (DHT, T, DHEA, androstenediol, 5?-dione, AD, androsterone and 5?-androstanediol) concentration in malignant prostate tissue after neoadjuvant leuprolide and ARN-509.

Countries

United States

Participant flow

Participants by arm

ArmCount
Apalutamide + Leuprolide Acetate
All participating patients will receive a single dose of leuprolide 7.5 mg intramuscularly (IM) in addition to Apalutamide 240 mg orally daily for four weeks prior to radical prostatectomy (RP). Treatment will be started on day (-28) ± 3 from the scheduled RP date to minimize the variability of treatment duration. Apalutamide may be continued up to and including the day before Leuprolide acetate: Leuprolide acetate, Intramuscular injection - 7.5 mg, one time dose on day (-28) ± 3 Apalutamide: Apalutamide, PO, 240 mg daily, starting day (-28) ± 3 until the day before radical prostatectomy. Apalutamide will be initiated the same day patients receive their leuprolide acetate injection. Radical prostatectomy
54
Total54

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyLost to Follow-up2
Overall StudySurgery delayed unevaluable2
Overall StudyTreatment discontinued due to treatment inturruption1
Overall StudyWithdrawal by Subject1

Baseline characteristics

CharacteristicApalutamide + Leuprolide Acetate
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
28 Participants
Age, Categorical
Between 18 and 65 years
26 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
53 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
1 Participants
Race (NIH/OMB)
Black or African American
5 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
Race (NIH/OMB)
White
46 Participants
Sex: Female, Male
Female
0 Participants
Sex: Female, Male
Male
54 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 54
other
Total, other adverse events
47 / 54
serious
Total, serious adverse events
1 / 54

Outcome results

Primary

Dihydrotestosterone (DHT) Concentration in Benign Prostate Tissue After a Combination Drug Treatment Based on Genotype Status

To evaluate the differential effect of neo-adjuvant leuprolide and ARN-509 on dihydrotestosterone (DHT) concentration in benign prostate tissue based on HSD3B1 genotype.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue each gave two samples

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Benign Prostate Tissue After a Combination Drug Treatment Based on Genotype Statushomozygous (1245A)9.066 nMStandard Error 7.775
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Benign Prostate Tissue After a Combination Drug Treatment Based on Genotype Statusheterozygous (1254C)5.917 nMStandard Error 3.458
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Benign Prostate Tissue After a Combination Drug Treatment Based on Genotype Statushomozygous (1245C)9.345 nMStandard Error 5.607
Primary

Dihydrotestosterone (DHT) Concentration in Malignant Prostate Tissue After a Combination Drug Treatment Based on Genotype Status

To evaluate the differential effect of neo-adjuvant leuprolide and ARN-509 on dihydrotestosterone (DHT) concentration in malignant prostate tissue based on HSD3B1 genotype.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue each gave two samples

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Malignant Prostate Tissue After a Combination Drug Treatment Based on Genotype Statushomozygous (1245A)8.855 nMStandard Error 7.4847
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Malignant Prostate Tissue After a Combination Drug Treatment Based on Genotype Statusheterozygous (1254C)5.238 nMStandard Error 3.822
Apalutamide + Leuprolide AcetateDihydrotestosterone (DHT) Concentration in Malignant Prostate Tissue After a Combination Drug Treatment Based on Genotype Statushomozygous (1245C)2.622 nMStandard Error 1.53
Secondary

Other Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate the differential effect of neoadjuvant leuprolide and ARN-509 on other androgens (testosterone (T), dehydroepiandrosterone (DHEA), androstenediol, 5?-androstanedione (5?-dione), androstenedione (AD), androsterone and 5?-androstanediol) concentration in benign prostate tissue based on HSD3B1 genotype.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue gave two samples

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT homozygous(1245A)9.066 nMStandard Error 7.775
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T homozygous(1245A)6.901 nMStandard Error 2.372
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHEA homozygous(1245A)46.110 nMStandard Error 82.578
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD homozygous(1245A)8.394 nMStandard Error 2.168
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT heterozygous5.917 nMStandard Error 3.458
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T heterozygous4.929 nMStandard Error 1.285
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHEA heterozygous18.5788 nMStandard Error 13.02
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD heterozygous6.083 nMStandard Error 2.5522
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT homozygous (1245C)9.345 nMStandard Error 5.607
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T homozygous (1245C)4.704 nMStandard Error 4.166
Apalutamide + Leuprolide AcetateOther Androgens Concentration in Benign Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD homozygous (1245C)8.303 nMStandard Error 2.841
Secondary

Other Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate the effect of neoadjuvant ARN-509 on other androgens (DHT, T, DHEA, androstenediol, 5?-dione, AD, androsterone and 5?-androstanediol) concentration in malignant prostate tissue after neoadjuvant leuprolide and ARN-509.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue gave two samples

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT heterozygous5.238 nMStandard Error 3.822
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT homozygous (1245A)8.855 nMStandard Error 7.4847
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T homozygous (1245A)5.691 nMStandard Error 2.531
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHEA homozygous (1245A)22.941 nMStandard Error 11.523
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD homozygous (1245A)7.974 nMStandard Error 4.005
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T heterozygous5.719 nMStandard Error 3.513
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHEA heterozygous24.543 nMStandard Error 16.779
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD heterozygous8.593 nMStandard Error 3.736
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHT homozygous (1245C)2.622 nMStandard Error 1.53
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.T homozygous (1245C)4.489 nMStandard Error 1.197
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.DHEA homozygous (1245C)1.421 nMStandard Error 0
Apalutamide + Leuprolide AcetateOther Androgens (DHT, T, DHEA, Androstenediol, 5α-dione, AD, Androsterone and 5α-androstanediol) Concentration in Malignant Prostate Tissue After Neo-adjuvant Leuprolide and Apalutamide Based on Genotype Status.AD homozygous (1245C)6.959 nMStandard Error 3.956
Secondary

PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Benign Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27 and UBE2C tissue expression (via IHC) in benign prostate tissue after treatment with Leuprolide and Apalutamide.

Time frame: Up to 28 Days

Population: Insufficient tissue

Secondary

PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C tissue expression (via IHC) in malignant prostate tissue after treatment with Leuprolide and Apalutamide.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue for PSA and H3K27 were Analyzed. Two samples collected per participant. There was insufficient tissue for TMPRSS2, EZH2, H3K27, and UBE2C expression.

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA Homozygous (1245A)1.15 nMStandard Error 0.662
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.H3K27 Homozygous (1245A)1.619 nMStandard Error 0.882
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA heterozygous1.393 nMStandard Error 0.786
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.H3K27 heterozygous1.633 nMStandard Error 0.89
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA Homozygous (1245C)1.375 nMStandard Error 1.5
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via IHC) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.H3K27 Homozygous (1245C)0.744 nMStandard Error 0.756
Secondary

PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Benign Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27 and UBE2C tissue expression (via qPCR) in benign prostate tissue after treatment with Leuprolide and Apalutamide.

Time frame: Up to 28 Days

Population: Insufficient Tissue

Secondary

PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.

To evaluate PSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C tissue expression (via qPCR) in malignant prostate tissue after treatment with Leuprolide and Apalutamide.

Time frame: Up to 28 Days

Population: Participants with sufficient tissue for PSA, FKBP5, TMPRSS2 were analyzed. Two samples were collected from each participant. There was insufficient tissues for the EZH2, H3K27, and UBE2C expression.

ArmMeasureGroupValue (MEAN)Dispersion
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA homozygous (1245A)1.474 nMStandard Error 1.488
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.FKBP5 homozygous (1245A)1.304 nMStandard Error 0.874
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.TMPRSS2 homozygous (1245A)1.603 nMStandard Error 1.071
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA heterozygous1.127 nMStandard Error 1.109
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.FKBP5 heterozygous1.127 nMStandard Error 1.109
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.TMPRSS2 heterozygous1.742 nMStandard Error 1.79
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.PSA homozygous (1245C)2.221 nMStandard Error 1.027
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.FKBP5 homozygous (1245C)2.221 nMStandard Error 1.027
Apalutamide + Leuprolide AcetatePSA, FKBP5, TMPRSS2, EZH2, H3K27, and UBE2C Expression (Via qPCR) in Malignant Prostate Tissue After Neoadjuvant Leuprolide and Apalutamide Based on Genotype Status.TMPRSS2 homozygous (1245C)2.345 nMStandard Error 1.145
Secondary

To Compare the Level of DHT, T, DHEA, Androstenediol, 5alpha-dione, AD, Androsterone and 5alpha-androstanediol Between Normal and Malignant Prostate Tissue After Neoadjuvant Leuprolide and ARN-509.

To compare the level of DHT, T, DHEA, androstenediol, 5alpha-dione, AD, androsterone and 5alpha-androstanediol between normal and malignant prostate tissue after neoadjuvant leuprolide and ARN-509.

Time frame: Up to 28 Days

Population: Insufficent Tissue

Source: ClinicalTrials.gov · Data processed: Feb 24, 2026