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Study of Pembrolizumab (MK-3475) in Participants With Metastatic Castration-Resistant Prostate Cancer (mCRPC)(MK-3475-199/KEYNOTE-199)

Phase II Trial of Pembrolizumab (MK-3475) in Subjects With Metastatic Castration-Resistant Prostate Cancer (mCRPC) (KEYNOTE-199)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02787005
Enrollment
388
Registered
2016-06-01
Start date
2016-07-01
Completion date
2022-02-28
Last updated
2024-11-21

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

Conditions

Metastatic Castration-resistant Prostate Cancer

Keywords

Programmed Cell Death-1 (PD1, PD-1), Programmed Cell Death 1 Ligand 1(PDL1, PD-L1), Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)

Brief summary

This is a study of pembrolizumab (MK-3475) in participants with metastatic castration-resistant prostate cancer (mCRPC). Participants will be enrolled into one of five cohorts: Cohort 1 (participants with programmed cell death ligand 1 \[PD-L1\]-positive, measurable disease), Cohort 2 (participants with PD-L1 negative, measurable disease), Cohort 3 (participants with bone-metastases and non-measurable disease) post-chemotherapy, Cohort 4 (participants with Response Evaluation Criteria in Solid Tumors version 1.1- \[RECIST 1.1\]-measureable disease) and Cohort 5 (participants with bone metastases only or bone-predominant disease) pre-chemotherapy.

Detailed description

Participants with mCRPC previously treated with docetaxel-based chemotherapy in Cohorts 1 to 3 will receive monotherapy with pembrolizumab. Chemotherapy-naïve subjects with mCRPC either having failed or showing signs of failure with enzalutamide in Cohorts 4 and 5 will receive pembrolizumab monotherapy in addition to their current regimen of enzalutamide. In all cohorts, pembrolizumab administration will occur on Day 1 of each 3-week dosing cycle and will continue for a maximum of 35 cycles (approximately 2 years) unless specific withdrawal/discontinuation criteria are met. Participants who discontinue after 35 infusions of pembrolizumab for reasons other than disease progression or intolerability, or who discontinue after attaining a complete response may be eligible for up to 17 additional infusions (approximately 1 year) after they have experienced disease progression.

Interventions

BIOLOGICALPembrolizumab

Intravenous infusion

Sponsors

Merck Sharp & Dohme LLC
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Has histologically- or cytologically-confirmed adenocarcinoma of the prostate without small cell histology. Disease must be either metastatic or locally confined inoperable disease that cannot be treated with definitive intent (no chance for a curative intervention). * Has supplied tumor tissue from a newly obtained biopsy or a biopsy obtained ≤12 months prior to study start and an archival specimen, if available, from a site not previously irradiated. Participants in Cohorts 1, 2, and 4 with visceral/measurable lesions must provide a newly obtained biopsy performed after the last line of systemic therapy or a biopsy obtained ≤12 months prior to study start and an archival specimen, if available. Participants in Cohorts 3 and 5 must at least provide an archival specimen. For Cohorts 1, 2, and 3 only: * Has been treated with: * At least 1 targeted endocrine therapy (defined as second generation antiandrogen therapies that include but are not limited to abiraterone acetate with prednisone, enzalutamide, and next generation targeted agents such as ARN-509). * At least 1 regimen/line of chemotherapy that contained docetaxel. * No more than 2 chemotherapy regimens. * No more than 3 regimens/lines of the aforementioned treatments (having failed/progressed on chemotherapy and targeted endocrine therapy). For Cohorts 4 and 5 only: * Failing or showing early signs of failure on current pre-chemotherapy enzalutamide treatment as defined by Prostate Cancer Working Group 3 (PCWG3) guidelines. Participants can have failed prior abiraterone treatment before current enzalutamide treatment. Participants must have had a clinically meaningful response to enzalutamide treatment. Enzalutamide must have been initiated no less than 4 weeks prior to the first dose of trial treatment and be continued throughout the study. For All Cohorts: * Has documented prostate cancer progression within 6 months prior to screening, as determined by the Investigator, by means of one of the following: 1) PSA progression as defined by a minimum of 3 rising PSA levels with an interval of ≥1 week between each assessment where the PSA value at screening should be ≥2 ng/mL, OR, 2) Radiographic disease progression in soft tissue or bone with or without PSA progression * Has ongoing androgen deprivation with total serum testosterone \<50 ng/dL (\<2.0 nM). * Participants receiving bone resorptive therapy (including but not limited to bisphosphonate or Receptor activator of nuclear factor kappa-B ligand \[RANK-L inhibitor\]) must have been on stable doses for ≥4 weeks prior to first dose of study drug. * Has a performance status of 0, 1 or 2 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale * Participants of reproductive potential must agree to use an adequate method of contraception, starting with the first dose of study drug through at least the time needed to eliminate each study intervention after the last dose of study intervention. The length of time required to continue contraception after the last dose of enzalutamide is 30 days. * Demonstrates adequate organ function.

Exclusion criteria

For All Cohorts: * Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigation device within 4 weeks of the first dose of study drug. * Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug. * Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to the first dose of study drug or who has not recovered (i.e., ≤ Grade 1 or at Baseline) from AEs due to mAbs administered more than 4 weeks earlier. * Has had prior chemotherapy, targeted small molecule therapy, or external beam radiation therapy within 4 weeks prior to the first dose of study drug or who has not recovered (i.e., ≤ Grade 1 or at Baseline) from AEs due to a previously administered agent. * Has a known additional malignancy that has had progression or has required active treatment in the last 3 years. Exceptions include basal cell carcinoma of the skin and squamous cell carcinoma of the skin that has undergone potentially curative therapy. * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. * Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). * Has evidence of interstitial lung disease and/or a history of (non-infectious) pneumonitis that required steroids, or current pneumonitis. * Has an active infection requiring systemic therapy. * Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. * Has previously participated in any other pembrolizumab (MK-3475) trial, or received prior therapy with an anti-programmed cell death 1 (anti-PD-1, anti-PD ligand 1 \[anti-PD-L1\], and anti-PD-L2 \[including ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways\]). * Has a known history of Human Immunodeficiency Virus (HIV). * Has known active Hepatitis B or Hepatitis C. * Has received a live vaccine within 30 days of planned start of study drug. Any licensed coronavirus disease 2019 (COVID-19) vaccine (including for Emergency use) in a particular country is allowed in the study as long as they are messenger ribonucleic acid (mRNA) vaccines, adenoviral vaccines, or inactivated vaccines. Investigational vaccines (ie, those not licensed or approved for Emergency Use) are not allowed. For Cohorts 4 and 5 only: * Has received prior chemotherapy (e.g., docetaxel) for mCPRC. * Has any condition (cardiac, neurologic, absorption) other than clinically failing or showing early signs of failure on enzalutamide treatment that would require imminent discontinuation of enzalutamide treatment.

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)Up to ~52 monthsORR was defined as the percentage of participants who experienced a complete response (CR; disappearance of all target lesions) or a partial response (PR; at least a 30% decrease in the sum of diameters of target lesions) and was assessed using RECIST 1.1 by central imaging vendor. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, as well as in Cohorts 1, 2, and 4 separately for the first course of treatment.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Discontinued Study Treatment Due to an AEUp to ~52 monthsAn AE was defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants who discontinued study treatment during the first course of treatment due to an AE was reported.
Disease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)Up to ~52 monthsPercentage of participants who had CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions)or stable disease (SD; Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease) for at least 6 months, by central imaging vendor where progressive disease (PD) in bone-only tumors were determined by radionuclide bone scan using Prostate Cancer Working Group (PCWG3) criteria and PD for all other tumors was determined using RECIST 1.1. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.
Duration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)Up to ~52 monthsDOR was defined as the time from first documented evidence of complete response (CR; disappearance of all target lesions) or partial response (PR; ≥30% decrease in the sum of diameters of target lesions) until progressive disease (PD) assessed by central imaging where PD was determined by radionuclide bone scan using Prostate Cancer Working Group (PCWG3)-modified RECIST 1.1 criteria and PD for all other tumors was determined using RECIST 1.1 or death due to any cause, whichever occurred first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1, 2 and 4 separately, well as in Cohorts 1 and 2 combined for the first course of treatment.
DOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)Up to ~52 monthsDOR was defined as the time from first documented evidence of complete response (CR; disappearance of all target lesions) or partial response (PR; ≥30% decrease in the sum of diameters of target lesions) ) until progressive disease (PD) assessed by central imaging where PD was determined by radionuclide bone scan using RECIST 1.1 and PD for all other tumors was determined using RECIST 1.1 or death due to any cause, whichever occurred first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1, 2 and 4 separately, well as in Cohorts 1 and 2 combined for the first course of treatment.
Prostate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)Up to ~52 monthsPercentage of participants who had PSA response defined as at least 50% decline from baseline measured twice at least 3 weeks apart. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1, 2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 for the first course of treatment.
Time to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)Up to ~52 monthsTime to PSA progression was defined as the time from first day of study treatment to the date of PSA progression. Participants without PSA progression were censored at the last PSA assessment date. PSA progression was defined as the date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from the nadir were documented. For participants who had a decline in PSA during treatment, PSA progression must have been confirmed by a second value 3 or more weeks later increased with respect to the nadir PSA. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.
Percentage of Participants Who Experienced an Adverse Event (AE)Up to ~52 monthsAn AE was defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants that experienced at least one AE for the first course of treatment was reported.
Overall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)Up to ~52 monthsOS was defined as the time from first day of study treatment to the time of death. Participants without documented death were censored at the date of the last follow up. The OS was calculated using the product-limit (Kaplan-Meier) method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.
Duration of PSA Response (Cohorts 4 and 5 by Cohort and Combined)Up to ~52 monthsDuration of PSA response was defined as the time from PSA response, when the PSA value first declined by at least 50% of the baseline (must have been confirmed by a second value), to the date of PSA progression at which there was an increase of 25% or more from the nadir PSA, provided the absolute increase from the nadir PSA was at least 2 ng/mL. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.
Time to Initiation of Cytotoxic Chemotherapy (Cohorts 4 and 5 by Cohort and Combined)Up to ~52 monthsTime to initiation of cytotoxic chemotherapy was defined as the time from first day of study treatment to the time of initiation of cytotoxic chemotherapy for prostate cancer. The median time was calculated using the Kaplan-Meier method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.
Time to New-Anticancer Therapy (Cohorts 4 and 5 By Cohort and Combined)Up to ~52 monthsTime to new-anticancer therapy was defined as the time from first day of study treatment to the time of new-anticancer therapy for prostate cancer. The median time was calculated using the Kaplan-Meier method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.
Time to First Skeletal-related Event (Cohorts 4 and 5 By Cohort and Combined)Up to ~52 monthsTime to initiation of first skeletal-related event was defined as the time from first day of study treatment to the first skeletal-related event, which was defined as radiation therapy or surgery to bone, pathologic bone fracture, spinal cord compression, or change or antineoplastic therapy to treat bone pain. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.
Radiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)Up to ~52 monthsrPFS was defined as the time from first day of study treatment to the documented disease progression by central imaging vendor where PD in bone-only tumors was determined by radionuclide bone scan using PCWG3 criteria and PD for all other tumors were determined using RECIST 1.1 or death due to any cause, whichever occurs first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.

Participant flow

Pre-assignment details

Male participants at least 18 years of age with Metastatic Castration-resistant Prostate Cancer (mCRPC) were screened for enrollment in the study. Per protocol, response/progression or adverse events (AEs) that occurred during the second course were not counted towards efficacy outcome measures or safety outcome measures, respectively.

Participants by arm

ArmCount
Cohort 1: PD-L1 Positive With Measurable Disease
Participants with PD-L1-positive, measurable disease received pembrolizumab 200 mg via IV infusion on Day 1 of every 3-week cycle for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab with SD or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
133
Cohort 2: PD-L1 Negative With Measurable Disease
Participants with PD-L1 negative, measurable disease received pembrolizumab 200 mg via IV infusion on Day 1 of every 3-week cycle for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
69
Cohort 3: Bone Metastases With Non-measurable Disease
Participants with bone metastases and non-measurable disease received pembrolizumab 200 mg via IV infusion on Day 1 of every 3-week cycle for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
58
Cohort 4: RECIST 1.1-measureable Disease
Participants with RECIST 1.1-measureable disease received pembrolizumab 200 mg via IV infusion on Day 1 of every 3-week cycle for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab with SD or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
81
Cohort 5: Bone Metastases Only or Bone-predominant Disease
Participants with bone metastases only or bone-predominant disease received pembrolizumab 200 mg via IV infusion on Day 1 of every 3-week cycle for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab with SD or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
47
Total388

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Overall StudyAdverse Event249972
Overall StudyDeath10053486938
Overall StudyLost to Follow-up00010
Overall StudyScreen Failure02001
Overall StudySponsor Decision74045
Overall StudyWithdrawal by Subject21101

Baseline characteristics

CharacteristicCohort 1: PD-L1 Positive With Measurable DiseaseCohort 2: PD-L1 Negative With Measurable DiseaseCohort 3: Bone Metastases With Non-measurable DiseaseCohort 4: RECIST 1.1-measureable DiseaseCohort 5: Bone Metastases Only or Bone-predominant DiseaseTotal
Age, Continuous67.9 years
STANDARD_DEVIATION 7.6
68.6 years
STANDARD_DEVIATION 7.2
69.4 years
STANDARD_DEVIATION 7.1
73.1 years
STANDARD_DEVIATION 8.4
69.7 years
STANDARD_DEVIATION 9.5
69.5 years
STANDARD_DEVIATION 8.1
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants4 Participants1 Participants3 Participants3 Participants14 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
121 Participants55 Participants55 Participants76 Participants44 Participants351 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
9 Participants10 Participants2 Participants2 Participants0 Participants23 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
13 Participants6 Participants7 Participants5 Participants2 Participants33 Participants
Race (NIH/OMB)
Black or African American
3 Participants1 Participants1 Participants3 Participants3 Participants11 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants1 Participants0 Participants1 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
8 Participants10 Participants2 Participants2 Participants0 Participants22 Participants
Race (NIH/OMB)
White
109 Participants52 Participants48 Participants70 Participants42 Participants321 Participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Sex: Female, Male
Male
133 Participants69 Participants58 Participants81 Participants47 Participants388 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
126 / 13363 / 6957 / 5876 / 8140 / 470 / 1
other
Total, other adverse events
128 / 13362 / 6757 / 5879 / 8142 / 451 / 1
serious
Total, serious adverse events
70 / 13328 / 6725 / 5826 / 8119 / 450 / 1

Outcome results

Primary

Objective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)

ORR was defined as the percentage of participants who experienced a complete response (CR; disappearance of all target lesions) or a partial response (PR; at least a 30% decrease in the sum of diameters of target lesions) and was assessed using RECIST 1.1 by central imaging vendor. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, as well as in Cohorts 1, 2, and 4 separately for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the All Subjects as Treated (ASaT) which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (NUMBER)
Cohort 1: PD-L1 Positive With Measurable DiseaseObjective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)6.0 Percentage of Participants
Cohort 2: PD-L1 Negative With Measurable DiseaseObjective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)3.0 Percentage of Participants
Cohort 4: RECIST 1.1-measureable DiseaseObjective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)12.3 Percentage of Participants
Cohorts 1 and 2 CombinedObjective Response Rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)5.0 Percentage of Participants
Secondary

Disease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)

Percentage of participants who had CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions)or stable disease (SD; Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease) for at least 6 months, by central imaging vendor where progressive disease (PD) in bone-only tumors were determined by radionuclide bone scan using Prostate Cancer Working Group (PCWG3) criteria and PD for all other tumors was determined using RECIST 1.1. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (NUMBER)
Cohort 1: PD-L1 Positive With Measurable DiseaseDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)10.5 Percentage of Participants
Cohort 2: PD-L1 Negative With Measurable DiseaseDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)4.5 Percentage of Participants
Cohort 4: RECIST 1.1-measureable DiseaseDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)24.1 Percentage of Participants
Cohorts 1 and 2 CombinedDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)29.6 Percentage of Participants
Cohort 5: Bone Metastases Only or Bone-predominant DiseaseDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)31.1 Percentage of Participants
Cohorts 1 and 2 CombinedDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)8.5 Percentage of Participants
Cohorts 1, 2, and 3 CombinedDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)12.0 Percentage of Participants
Cohorts 4 and 5 CombinedDisease Control Rate (DCR) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)30.2 Percentage of Participants
Secondary

DOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)

DOR was defined as the time from first documented evidence of complete response (CR; disappearance of all target lesions) or partial response (PR; ≥30% decrease in the sum of diameters of target lesions) ) until progressive disease (PD) assessed by central imaging where PD was determined by radionuclide bone scan using RECIST 1.1 and PD for all other tumors was determined using RECIST 1.1 or death due to any cause, whichever occurred first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1, 2 and 4 separately, well as in Cohorts 1 and 2 combined for the first course of treatment.

Time frame: Up to ~52 months

Population: The analysis was based on all responders with measurable disease at baseline in the ASaT population which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseDOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohort 2: PD-L1 Negative With Measurable DiseaseDOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohort 4: RECIST 1.1-measureable DiseaseDOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohorts 1 and 2 CombinedDOR- Per RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Secondary

Duration of PSA Response (Cohorts 4 and 5 by Cohort and Combined)

Duration of PSA response was defined as the time from PSA response, when the PSA value first declined by at least 50% of the baseline (must have been confirmed by a second value), to the date of PSA progression at which there was an increase of 25% or more from the nadir PSA, provided the absolute increase from the nadir PSA was at least 2 ng/mL. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment and had a confirmed PSA response.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseDuration of PSA Response (Cohorts 4 and 5 by Cohort and Combined)8.3 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseDuration of PSA Response (Cohorts 4 and 5 by Cohort and Combined)18.0 Months
Cohort 4: RECIST 1.1-measureable DiseaseDuration of PSA Response (Cohorts 4 and 5 by Cohort and Combined)18.0 Months
Secondary

Duration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)

DOR was defined as the time from first documented evidence of complete response (CR; disappearance of all target lesions) or partial response (PR; ≥30% decrease in the sum of diameters of target lesions) until progressive disease (PD) assessed by central imaging where PD was determined by radionuclide bone scan using Prostate Cancer Working Group (PCWG3)-modified RECIST 1.1 criteria and PD for all other tumors was determined using RECIST 1.1 or death due to any cause, whichever occurred first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1, 2 and 4 separately, well as in Cohorts 1 and 2 combined for the first course of treatment.

Time frame: Up to ~52 months

Population: The analysis was based on all responders with measurable disease at baseline in the ASaT population which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseDuration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohort 2: PD-L1 Negative With Measurable DiseaseDuration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohort 4: RECIST 1.1-measureable DiseaseDuration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Cohorts 1 and 2 CombinedDuration of Response (DOR) Per PCWG3-modified RECIST 1.1 (Cohort 1, Cohort 2, Cohort 4 and Cohorts 1 and 2 Combined)NA Months
Secondary

Overall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)

OS was defined as the time from first day of study treatment to the time of death. Participants without documented death were censored at the date of the last follow up. The OS was calculated using the product-limit (Kaplan-Meier) method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)9.5 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)7.9 Months
Cohort 4: RECIST 1.1-measureable DiseaseOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)14.1 Months
Cohorts 1 and 2 CombinedOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)17.6 Months
Cohort 5: Bone Metastases Only or Bone-predominant DiseaseOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)20.8 Months
Cohorts 1 and 2 CombinedOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)8.1 Months
Cohorts 1, 2, and 3 CombinedOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)9.6 Months
Cohorts 4 and 5 CombinedOverall Survival (OS) (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, Cohorts 4 and 5 Combined)18.9 Months
Secondary

Percentage of Participants Who Discontinued Study Treatment Due to an AE

An AE was defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants who discontinued study treatment during the first course of treatment due to an AE was reported.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (NUMBER)
Cohort 1: PD-L1 Positive With Measurable DiseasePercentage of Participants Who Discontinued Study Treatment Due to an AE10.5 Percentage of Participants
Cohort 2: PD-L1 Negative With Measurable DiseasePercentage of Participants Who Discontinued Study Treatment Due to an AE3.0 Percentage of Participants
Cohort 4: RECIST 1.1-measureable DiseasePercentage of Participants Who Discontinued Study Treatment Due to an AE12.1 Percentage of Participants
Cohorts 1 and 2 CombinedPercentage of Participants Who Discontinued Study Treatment Due to an AE18.5 Percentage of Participants
Cohort 5: Bone Metastases Only or Bone-predominant DiseasePercentage of Participants Who Discontinued Study Treatment Due to an AE20.0 Percentage of Participants
Secondary

Percentage of Participants Who Experienced an Adverse Event (AE)

An AE was defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants that experienced at least one AE for the first course of treatment was reported.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (NUMBER)
Cohort 1: PD-L1 Positive With Measurable DiseasePercentage of Participants Who Experienced an Adverse Event (AE)99.2 Percentage of Participants
Cohort 2: PD-L1 Negative With Measurable DiseasePercentage of Participants Who Experienced an Adverse Event (AE)97.0 Percentage of Participants
Cohort 4: RECIST 1.1-measureable DiseasePercentage of Participants Who Experienced an Adverse Event (AE)100.0 Percentage of Participants
Cohorts 1 and 2 CombinedPercentage of Participants Who Experienced an Adverse Event (AE)98.8 Percentage of Participants
Cohort 5: Bone Metastases Only or Bone-predominant DiseasePercentage of Participants Who Experienced an Adverse Event (AE)97.8 Percentage of Participants
Secondary

Prostate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)

Percentage of participants who had PSA response defined as at least 50% decline from baseline measured twice at least 3 weeks apart. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1, 2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least one dose of study treatment and had a PSA measurement at baseline.

ArmMeasureValue (NUMBER)
Cohort 1: PD-L1 Positive With Measurable DiseaseProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)6.5 Percentage of Participants
Cohort 2: PD-L1 Negative With Measurable DiseaseProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)8.2 Percentage of Participants
Cohort 4: RECIST 1.1-measureable DiseaseProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)1.7 Percentage of Participants
Cohorts 1 and 2 CombinedProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)16.3 Percentage of Participants
Cohort 5: Bone Metastases Only or Bone-predominant DiseaseProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)8.9 Percentage of Participants
Cohorts 1 and 2 CombinedProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)7.0 Percentage of Participants
Cohorts 1, 2, and 3 CombinedProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)5.8 Percentage of Participants
Cohorts 4 and 5 CombinedProstate-specific Antigen (PSA) Response Rate (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)13.6 Percentage of Participants
Secondary

Radiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)

rPFS was defined as the time from first day of study treatment to the documented disease progression by central imaging vendor where PD in bone-only tumors was determined by radionuclide bone scan using PCWG3 criteria and PD for all other tumors were determined using RECIST 1.1 or death due to any cause, whichever occurs first. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)2.1 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)2.1 Months
Cohort 4: RECIST 1.1-measureable DiseaseRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)3.7 Months
Cohorts 1 and 2 CombinedRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)4.2 Months
Cohort 5: Bone Metastases Only or Bone-predominant DiseaseRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)4.4 Months
Cohorts 1 and 2 CombinedRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)2.1 Months
Cohorts 1, 2, and 3 CombinedRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)2.1 Months
Cohorts 4 and 5 CombinedRadiographic Progression-free Survival (rPFS) - Per PCWG3-modified RECIST 1.1 (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined, and Cohorts 4 and 5 Combined)4.2 Months
Secondary

Time to First Skeletal-related Event (Cohorts 4 and 5 By Cohort and Combined)

Time to initiation of first skeletal-related event was defined as the time from first day of study treatment to the first skeletal-related event, which was defined as radiation therapy or surgery to bone, pathologic bone fracture, spinal cord compression, or change or antineoplastic therapy to treat bone pain. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseTime to First Skeletal-related Event (Cohorts 4 and 5 By Cohort and Combined)NA Months
Cohort 2: PD-L1 Negative With Measurable DiseaseTime to First Skeletal-related Event (Cohorts 4 and 5 By Cohort and Combined)NA Months
Cohort 4: RECIST 1.1-measureable DiseaseTime to First Skeletal-related Event (Cohorts 4 and 5 By Cohort and Combined)NA Months
Secondary

Time to Initiation of Cytotoxic Chemotherapy (Cohorts 4 and 5 by Cohort and Combined)

Time to initiation of cytotoxic chemotherapy was defined as the time from first day of study treatment to the time of initiation of cytotoxic chemotherapy for prostate cancer. The median time was calculated using the Kaplan-Meier method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseTime to Initiation of Cytotoxic Chemotherapy (Cohorts 4 and 5 by Cohort and Combined)11.1 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseTime to Initiation of Cytotoxic Chemotherapy (Cohorts 4 and 5 by Cohort and Combined)11.3 Months
Cohort 4: RECIST 1.1-measureable DiseaseTime to Initiation of Cytotoxic Chemotherapy (Cohorts 4 and 5 by Cohort and Combined)11.1 Months
Secondary

Time to New-Anticancer Therapy (Cohorts 4 and 5 By Cohort and Combined)

Time to new-anticancer therapy was defined as the time from first day of study treatment to the time of new-anticancer therapy for prostate cancer. The median time was calculated using the Kaplan-Meier method for censored data. Per protocol, analysis for this outcome measure was conducted in Cohorts 4 and 5 separately and combined for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseTime to New-Anticancer Therapy (Cohorts 4 and 5 By Cohort and Combined)9.5 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseTime to New-Anticancer Therapy (Cohorts 4 and 5 By Cohort and Combined)9.5 Months
Cohort 4: RECIST 1.1-measureable DiseaseTime to New-Anticancer Therapy (Cohorts 4 and 5 By Cohort and Combined)9.5 Months
Secondary

Time to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)

Time to PSA progression was defined as the time from first day of study treatment to the date of PSA progression. Participants without PSA progression were censored at the last PSA assessment date. PSA progression was defined as the date that an increase of 25% or more and an absolute increase of 2 ng/mL or more from the nadir were documented. For participants who had a decline in PSA during treatment, PSA progression must have been confirmed by a second value 3 or more weeks later increased with respect to the nadir PSA. Per protocol, analysis for this outcome measure was conducted in Cohorts 1 and 2 combined, Cohorts 1,2, and 3 combined, Cohorts 4 and 5 combined well as in Cohorts 1 to 5 separately for the first course of treatment.

Time frame: Up to ~52 months

Population: Analysis population was the ASaT which consisted of all allocated participants who received at least 1 dose of study treatment.

ArmMeasureValue (MEDIAN)
Cohort 1: PD-L1 Positive With Measurable DiseaseTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)5.1 Months
Cohort 2: PD-L1 Negative With Measurable DiseaseTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)6.2 Months
Cohort 4: RECIST 1.1-measureable DiseaseTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)4.2 Months
Cohorts 1 and 2 CombinedTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)5.6 Months
Cohort 5: Bone Metastases Only or Bone-predominant DiseaseTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)4.2 Months
Cohorts 1 and 2 CombinedTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)6.2 Months
Cohorts 1, 2, and 3 CombinedTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)4.4 Months
Cohorts 4 and 5 CombinedTime to PSA Progression (By Each Cohort, Cohorts 1 and 2 Combined, Cohorts 1, 2, and 3 Combined and Cohorts 4 and 5 Combined)4.4 Months

Source: ClinicalTrials.gov · Data processed: Mar 4, 2026