Metastatic Castration Resistant Prostate Cancer (mCRPC)
Conditions
Keywords
Phase 1/2, Oncology, EZH2 Inhibitor
Brief summary
This was an open-label Phase 1b/2 study involving oral administration of CPI-1205 in combination with either enzalutamide or abiraterone/prednisone in male patients with metastatic Castration-Resistant Prostate Cancer. The study was designed to determine the maximum tolerated dose (MTD) and the recommended Phase II dose (RP2D) based on the safety, tolerability, pharmacokinetic, and efficacy profiles of CPI-1205 in combination with either enzalutamide or abiraterone/prednisone. Following the determination of the MTD and RP2D, the study proceeded to Phase 2. Patients in Phase 2 received CPI-1205 at the RP2D in combination with either enzalutamide or abiraterone/prednisone versus either enzalutamide or abiraterone/prednisone as a control arm.
Detailed description
Study CPI-1205-201 was a Phase 1b/2, multi-center, open-label study of CPI-1205 alone and with cobicistat in subjects with mCRPC in combination with either enzalutamide or abiraterone/prednisone. The study initially had two phases: a Phase 1 dose-finding, dose-escalation study intended to establish the Recommended Phase 2 Dose (RP2D) of CPI-1205 for the Phase 2 portion. The study underwent three amendments. PHASE 1b In the Phase 1b dose-escalation phase and prior to Amendment 2, subjects were enrolled into Phase 1b dose level CPI-1205 PO three times daily (TID) + enzalutamide or abiraterone/prednisone. In Amendment 2, new subjects were enrolled into cohorts including: Dose-escalating CPI-1205 PO twice daily (BID) + fixed-dose cobicistat PO BID + enzalutamide Dose-escalating CPI-1205 PO BID + fixed-dose cobicistat PO BID + abiraterone/prednisone In Amendment 3, Phase 1b expansion cohort(s) were added in the heavily pretreated population (HPEC). An HPEC began enrollment if 0 out of 3 or 1 out of 6 subjects treated with a specific regimen (i.e., CPI-1205 with or without cobicistat, in combination with enzalutamide or abiraterone) at a given dose level during Phase 1b dose escalation experienced a dose-limiting toxicity (DLT). Following determination of the maximum tolerated dose (MTD) in each of the CPI-1205 BID + cobicistat combinations (and possibly in the CPI-1205 TID combination) and after evaluation of the BID cohorts without cobicistat (if applicable), only one of the CPI-1205 dosing schedules was selected as the RP2D for each combination. One or both combinations proceeded to Phase 2 after consideration of pharmacokinetic (PK) and pharmacodynamic (PD) results, data from the HPEC(s), and safety data. PHASE 2 If only one partner product was chosen for Phase 2, the study proceeded as an open-label randomized Phase 2 trial, with subjects randomized to either the combination arm (CPI-1205 at the RP2D \[with or without cobicistat\] in combination with enzalutamide or abiraterone/prednisone) or the control arm (enzalutamide or abiraterone/prednisone as monotherapy). If both partner products were chosen, the second Phase 2 was either a second open-label randomized trial or a single-arm Phase 2 trial (following a Simon's 2-stage design). The design of the second trial was determined by the Sponsor based on preliminary efficacy and PK. CPI-1205 was administered orally TID or BID (as of Amendment 2). Cobicistat dosing began with one dose the evening prior to Day 1 of CPI-1205 and continued PO BID starting on Day 1. Enzalutamide and abiraterone were given PO once daily, and prednisone was given PO BID (or at the investigator's discretion). Successive 28-day treatment cycles were repeated without planned breaks, as long as the combination was well tolerated, until radiographic disease progression, unequivocal clinical progression, or planned initiation of another systemic treatment. Investigators could continue treatment in subjects with progression in one site if other lesions might benefit. Subjects in the control arm who progressed had the option to cross over to the combination arm, provided they met eligibility criteria.
Interventions
DRUGCPI-1205
CPI-1205: Either 400 mg BID or 800 mg TID during Phase 1 dose-escalation and RP2D, 800 mg TID, for Phase 2
DRUGCobicistat
Cobicistat 150 mg PO BID
DRUGEnzalutamide
Enzalutamide 160mg PO QD
DRUGAbiraterone
Abiraterone 1000mg PO QD
DRUGPrednisone
Prednisone 5mg PO BID
Sponsors
Constellation Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
PHASE 1b DOSE ESCALATION Inclusion Criteria for Phase 1b Dose Escalation Patients must meet all the following criteria to be enrolled in this study: 1. Age ≥ 18 years 2. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1 3. Life expectancy of at least 12 weeks 4. Histologically or cytologically confirmed adenocarcinoma of the prostate (pure small cell carcinoma excluded) 5. Documented metastatic disease 6. Must have undergone bilateral orchiectomy (surgical castration) or willing to continue gonadotropin-releasing hormone (GnRH) analog or antagonist (medical castration) 7. Serum testosterone \< 50 ng/dL 8. Progressive disease in the setting of medical or surgical castration (i.e., Castration-resistant Prostate Cancer \[CRPC\]) as assessed by the investigator and includes at least one of the following: 1. Evidence of progression as measured by PSA increase of ≥ 25% and an absolute increase of ≥ 2 ng/mL in \< 6 months from end of last therapy prior to enrollment and/or 2. Soft tissue disease progression as per Response Evaluation Criteria in Solid Tumors (RECIST) and/or 3. Bone disease progression defined by two or more new lesions on bone scan 9. Bisphosphonate or denosumab therapy allowed provided dose has been stable for at least 4 weeks prior to Day 1 of treatment 10. Prior treatment: 1. Prior treatment for metastatic CRPC (mCRPC) must have included at least one line with a second-generation androgen inhibitor (e.g., abiraterone, enzalutamide, apalutamide, daralutamide) 2. Prior chemotherapy permitted when administered in the metastatic hormone-sensitive prostate cancer setting. In addition, up to one line of chemotherapy is allowed in the mCRPC setting. 3. Prior treatment with sipuleucel-T, radium-223, or other non-chemotherapy based treatments for mCRPC (e.g., olaparib, pembrolizumab) is allowed. 11. Recovery from recent surgery, radiotherapy, chemotherapy or other anti-cancer treatment to baseline or ≤ Grade 1 (other than alopecia) 12. Demonstrate adequate organ function as defined in the table below; all Screening labs obtained within 28 days prior to Day 1 of treatment. 13. Patients who have not undergone a bilateral orchiectomy and have a female partner of childbearing potential must use an adequate barrier method of contraception during study treatment and for 90 days after receiving the last dose of CPI-1205 14. Willing to provide access to archival tumor tissue for research purposes 15. Ability to swallow and retain oral medications 16. Ability to understand and willingness to sign an IRB approved written informed consent form (ICF) and authorization permitting release of personal health information including genetic testing relevant to cancer. 17. Able to comply with study visit schedule and assessments
Exclusion criteria
for Phase 1b Dose Escalation Patients who meet any of the following criteria will not be enrolled in the study: 1. Known symptomatic brain metastases 2. Treatment with any of the following for prostate cancer within the indicated timeframe prior to Day 1 of treatment 1. First generation: AR antagonists (e.g., bicalutamide, nilutamide, flutamide) within 4 weeks 2. 5 alpha reductase inhibitors, ketoconazole, estrogens (including diethylstilbesterol \[DES\]), or progesterones within 2 weeks 3. Chemotherapy within 3 weeks 4. Biologic therapy within 4 weeks 5. Investigational therapy within 3 weeks (or within a time interval less than at least 5 half-lives of the investigational agent \[if known\], whichever is longer). 6. Immunotherapy within 4 weeks 7. Radionuclide therapy within 4 weeks 3. Radiation therapy for the treatment of metastasis within 1 week prior to Day 1 of treatment 4. Herbal products that may decrease PSA levels within 4 weeks prior to day 1 of treatment 5. Systemic steroids greater than 10 mg of prednisone/prednisolone per day within 4 weeks prior to day 1 of treatment 6. Major surgery within 4 weeks prior to Day 1 of treatment 7. Planned palliative procedures for alleviation of bone pain such as radiation therapy or surgery 8. Structurally unstable bone lesions concerning for impending fracture 9. Clinically significant cardiovascular disease including: 1. Myocardial infarction (MI)/Stroke within 6 months prior to Day 1 of treatment 2. Uncontrolled angina within 3 months 3. Congestive heart failure (CHF) with New York Heart Association (NYHA) Class 3 or 4 4. History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes) 5. Uncontrolled hypertension (systolic blood pressure (BP) \> 170 mmHg or diastolic BP \> 105 mmHg at screening) despite 2 concomitant antihypertensive therapies 6. QT interval corrected by the Fridericia correction formula (QTcF) \> 500 msec on the screening ECG 10. Active or symptomatic viral hepatitis or chronic liver disease 11. History of unresolved adrenal dysfunction 12. GI disorder that negatively affects absorption 13. Required treatment with one of the prohibited concomitant medications; 14. Achlorhydria, either documented or suspected on the basis of an associated disease (e.g., pernicious anemia, atrophic gastritis, or certain gastric surgical procedures) 15. History of seizure, underlying brain injury with loss of consciousness, transient ischemic attack within 12 months prior to Day 1 of treatment, cerebral vascular accident or brain arteriovenous malformation 16. Known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ bladder cancer, or other cancer for which the patient has been disease-free for at least two years 17. Any other concurrent severe and/or uncontrolled concomitant medical condition that could compromise participation in the study (e.g., clinically significant pulmonary disease, clinically significant psychiatric or neurological disorder, active or uncontrolled infection) 18. Patient unwilling or unable to comply with this study protocol PHASE 1b: HEAVILY PRETREATED EXPANSION COHORT (HPEC) Inclusion Criteria for Phase 1b HPEC Patients must meet all the following criteria to be enrolled in this study: 1. Age ≥ 18 years 2. ECOG Performance Status 0-1 3. Life expectancy of at least 12 weeks 4. Histologically or cytologically confirmed adenocarcinoma of the prostate (pure small cell carcinoma excluded) 5. Documented metastatic disease 6. At least 1 measurable lymph node per Prostate Cancer Clinical Trials Working Group 3 (PCWG3) 7. Must have undergone bilateral orchiectomy (surgical castration) or willing to continue GnRH analog or antagonist (medical castration) 8. Serum testosterone \< 50 ng/dL 9. Progressive disease in the setting of medical or surgical castration (i.e., CRPC) as assessed by the investigator and that includes at least 1 of the following: 1. Evidence of progression as measured by PSA defined as: PSA at least 2 ng/mL (or PSA at least 1 ng/mL if PSA progression is the only manifestation of progressive disease) and rising PSA by at least 2 consecutive measurements a minimum of 1-week apart and/or 2. Soft tissue disease progression as per RECIST 1.1 and/or 3. Bone disease progression defined by two or more new lesions on bone scan 10. Prior treatment: 1. Only 1 prior line of a second-generation androgen inhibitor from a different class than the one chosen for the applicable phase 2 study (the 2 classes are CYP17 inhibitors \[e.g., abiraterone, orteronel\] and AR inhibitors \[e.g., enzalutamide, apalutamide\]). Patient must have progressed after ≥ 24 weeks of treatment with this second generation angrogen inhibitor. 2. The last second-generation androgen inhibitor treatment received must not be from the same class as that incorporated in the applicable HPEC; i.e., if the HPEC incorporates enzalutamide, the last second generation androgen inhibitor therapy cannot be enzalutamide, apalutamide, etc. 3. Prior chemotherapy for mCRPC must have included at least 1 and no more than 2 prior lines of taxane-based chemotherapy administered in the metastatic hormone-sensitive prostate cancer setting is allowed 4. Prior treatment with sipuleucel-T, radium-223, or other non-chemotherapy-based treatments for mCRPC (e.g., olaparib, pembrolizumab, nivolumab) is allowed. 11. Recovery from recent surgery, radiotherapy, chemotherapy or other anti-cancer treatment to baseline or ≤ Grade 1 (other than alopecia) 12. Demonstrate adequate organ function as defined in the table below; all Screening labs to be obtained within 28 days prior to Day 1 of treatment 13. Patients who had not undergone a bilateral orchiectomy and have a female partner of childbearing potential must use an adequate barrier method of contraception during study treatment and for 90 days after receiving the last dose of CPI-1205 14. Willing to provide access to archival tumor tissue for research purposes 15. Ability to swallow and retain oral medications 16. Ability to understand and willingness to sign an IRB approved written ICF and authorization permitting release of personal health information including genetic testing relevant to cancer. 17. Able to comply with study visit schedule and assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy: Best Objective Response Rate Percent by Treatment Group | Up to 2 years [or until disease progression or unacceptable toxicity] | Best overall response rate (%) defined as complete response (CR) + partial response (PR) divided by the total number of subjects as assessed by Investigator. The response assessment was performed per Prostate Cancer Working Group 3 (PCWG3) based on modifications of the RECIST 1.1 criteria. Per RECIST 1.1, a CR was assessed when all target lesions disappeared (any pathological lymph node must have reduction in short axis to \<10 mm) in the post-baseline scan. A PR was assessed when there was at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. |
| Efficacy: Percentage (%) of Subjects With PSA30 | 2 years [or until progressive disease or unacceptable toxicity] | The number of subjects who had a confirmed reduction of 30% of prostate-specific antigen (PSA30) from baseline |
| Efficacy: Percentage (%) of Subjects With PSA50 | 2 years [or until progressive disease or unacceptable toxicity] | The number of subjects who had a confirmed reduction of 50% of prostate-specific antigen (PSA50) from baseline |
| Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups | Up to 2 years [or until progressive disease or unacceptable toxicity] | Subjects who had a circulating tumor cell of 30% (CTC 30%) or an objective response rate divided by the number of evaluable subjects |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy: Best Responses by Treatment Group | Up to 2 years [or until disease progression or unacceptable toxicity] | Best overall response defined as complete response (CR), partial response (PR); stable disease (SD); progressive disease (PD); and unknown/missing for the Phase 1b dose-escalation group, the Phase 1b HPEC group, the Phase 2 randomized groups, crossover group and the Phase 2 single-arm group. Assessed by Investigator |
| Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | Up to 2 years [or until clinical progression, radiographic disease progression, or until unacceptable toxicity] | Treatment-emergent Adverse events (AEs) leading to subjects withdrawing from treatment |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID +Cobi + Enza CPI-1205 400 mg BID in combination with Cobicistat 150mg PO BID and Enzalutamide 160 mg PO QD (28-day cycles) | 7 |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred CPI-1205 400 mg BID in combination iwth Cobicistat 150 mg PO BID and Abiraterone 1000 mg PO QD and Prednisone 5 mg PO BID (28-day cycles) | 8 |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza CPI-1205 800 mg TID in combination with Enzalutamide 160 mg PO QD (28-day cycles) | 9 |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/Pred CPI-1205 800 mg TID in combination with Abiraterone 1000 mg PO QD and Prednisone 5 mg PO BID (28-day cycles) | 12 |
| Phase 1b HPEC: CPI-1205 800 mg TID Heavily Pretreated Expansion Cohort + Enza CPI-1205 800 mg TID in heavily pretreated expansion cohort in combination with Enzalutamide 160 mg PO QD (28-day cycles) | 31 |
| Phase 2 Randomized Controlled: Enza Control group of Phase 2 randomized: Enzalutamide 160 mg PO QD | 35 |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D + Enza CPI-1205 800 mg TID (RP2D) in combination with Enzalutamide 160 mg PO QD | 39 |
| Phase 2 Single Arm: CPI-1205 at RP2D + Abi/Pred CPI-1205 800 mg TID (RP2D) in combination with Abiraterone 1000 mg PO QD and Prednisone 5 mg PO BID (28-day cycles) | 32 |
| Total | 173 |
Baseline characteristics
| Characteristic | Phase 1b Dose Escalation: CPI-1205 400 mg BID +Cobi + Enza | Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Phase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/Pred | Phase 1b HPEC: CPI-1205 800 mg TID Heavily Pretreated Expansion Cohort + Enza | Phase 2 Randomized Controlled: Enza | Phase 2 Randomized Experimental: CPI-1205 at RP2D + Enza | Phase 2 Single Arm: CPI-1205 at RP2D + Abi/Pred | Total |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 5 Participants | 8 Participants | 6 Participants | 10 Participants | 22 Participants | 26 Participants | 23 Participants | 23 Participants | 123 Participants |
| Age, Categorical Between 18 and 65 years | 2 Participants | 0 Participants | 3 Participants | 2 Participants | 9 Participants | 9 Participants | 16 Participants | 9 Participants | 50 Participants |
| Prior cancer chemotherapy No | 4 Participants | 5 Participants | 6 Participants | 8 Participants | 0 Participants | 28 Participants | 30 Participants | 24 Participants | 105 Participants |
| Prior cancer chemotherapy Yes | 3 Participants | 3 Participants | 3 Participants | 4 Participants | 31 Participants | 7 Participants | 9 Participants | 8 Participants | 68 Participants |
| Prior cancer hormonal Therapy No | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| Prior cancer hormonal Therapy Yes | 7 Participants | 8 Participants | 9 Participants | 12 Participants | 31 Participants | 35 Participants | 39 Participants | 31 Participants | 172 Participants |
| Prior cancer Immunotherapy No | 5 Participants | 4 Participants | 5 Participants | 8 Participants | 17 Participants | 27 Participants | 29 Participants | 20 Participants | 115 Participants |
| Prior cancer Immunotherapy Yes | 2 Participants | 4 Participants | 4 Participants | 4 Participants | 14 Participants | 8 Participants | 10 Participants | 12 Participants | 58 Participants |
| Prior radiation therapy No | 1 Participants | 3 Participants | 3 Participants | 3 Participants | 3 Participants | 16 Participants | 11 Participants | 8 Participants | 48 Participants |
| Prior radiation therapy Yes | 6 Participants | 5 Participants | 6 Participants | 9 Participants | 28 Participants | 19 Participants | 28 Participants | 24 Participants | 125 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants | 2 Participants | 3 Participants | 2 Participants | 6 Participants | 8 Participants | 6 Participants | 7 Participants | 35 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 2 Participants | 5 Participants | 3 Participants | 3 Participants | 13 Participants |
| Race (NIH/OMB) White | 6 Participants | 6 Participants | 6 Participants | 10 Participants | 23 Participants | 22 Participants | 29 Participants | 21 Participants | 123 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 7 Participants | 8 Participants | 9 Participants | 12 Participants | 31 Participants | 35 Participants | 39 Participants | 32 Participants | 173 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 1 / 7 | 2 / 8 | 1 / 9 | 1 / 12 | 17 / 31 | 10 / 35 | 7 / 39 | 4 / 12 | 9 / 32 |
| other Total, other adverse events | 7 / 7 | 8 / 8 | 9 / 9 | 12 / 12 | 31 / 31 | 33 / 35 | 38 / 39 | 11 / 12 | 30 / 32 |
| serious Total, serious adverse events | 2 / 7 | 3 / 8 | 2 / 9 | 1 / 12 | 11 / 31 | 8 / 35 | 5 / 39 | 0 / 12 | 1 / 32 |
Outcome results
Primary
Efficacy: Best Objective Response Rate Percent by Treatment Group
Best overall response rate (%) defined as complete response (CR) + partial response (PR) divided by the total number of subjects as assessed by Investigator. The response assessment was performed per Prostate Cancer Working Group 3 (PCWG3) based on modifications of the RECIST 1.1 criteria. Per RECIST 1.1, a CR was assessed when all target lesions disappeared (any pathological lymph node must have reduction in short axis to \<10 mm) in the post-baseline scan. A PR was assessed when there was at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
Time frame: Up to 2 years [or until disease progression or unacceptable toxicity]
Population: Efficacy Analysis Set: subjects with a baseline measurement of response and at least 1 timepoint after baseline
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Objective Response Rate Percent by Treatment Group | 8.00 Percent (%) of subjects |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Objective Response Rate Percent by Treatment Group | 5.71 Percent (%) of subjects |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Objective Response Rate Percent by Treatment Group | 7.89 Percent (%) of subjects |
| Phase 2 Randomized Crossover Period | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Objective Response Rate Percent by Treatment Group | 0 Percent (%) of subjects |
Primary
Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups
Subjects who had a circulating tumor cell of 30% (CTC 30%) or an objective response rate divided by the number of evaluable subjects
Time frame: Up to 2 years [or until progressive disease or unacceptable toxicity]
Population: Efficacy Analysis Set (EAS): Subset of Subjects with an unfavorable assessment at baseline and at least one CTC assessment post baseline.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups | 17.1 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups | 31.4 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups | 0 Percent (%) of subjects |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups | 21.4 Percent (%) of subjects |
Primary
Efficacy: Percentage (%) of Subjects With PSA30
The number of subjects who had a confirmed reduction of 30% of prostate-specific antigen (PSA30) from baseline
Time frame: 2 years [or until progressive disease or unacceptable toxicity]
Population: Efficacy Analysis Set (EAS): Subset of Subjects with a baseline measurement PSA30 and at least 1 measurement post-baseline
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Percentage (%) of Subjects With PSA30 | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA30 | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Percentage (%) of Subjects With PSA30 | 2 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA30 | 1 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Percentage (%) of Subjects With PSA30 | 7 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Percentage (%) of Subjects With PSA30 | 7 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Percentage (%) of Subjects With PSA30 | 12 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Percentage (%) of Subjects With PSA30 | 1 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA30 | 4 Participants |
Primary
Efficacy: Percentage (%) of Subjects With PSA50
The number of subjects who had a confirmed reduction of 50% of prostate-specific antigen (PSA50) from baseline
Time frame: 2 years [or until progressive disease or unacceptable toxicity]
Population: Efficacy Analysis Set (EAS): Subset of Subjects with a baseline measurement PSA50 and at least 1 measurement post-baseline
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Percentage (%) of Subjects With PSA50 | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA50 | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Percentage (%) of Subjects With PSA50 | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA50 | 1 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Percentage (%) of Subjects With PSA50 | 4 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Percentage (%) of Subjects With PSA50 | 5 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Percentage (%) of Subjects With PSA50 | 10 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Percentage (%) of Subjects With PSA50 | 0 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Percentage (%) of Subjects With PSA50 | 2 Participants |
Secondary
Efficacy: Best Responses by Treatment Group
Best overall response defined as complete response (CR), partial response (PR); stable disease (SD); progressive disease (PD); and unknown/missing for the Phase 1b dose-escalation group, the Phase 1b HPEC group, the Phase 2 randomized groups, crossover group and the Phase 2 single-arm group. Assessed by Investigator
Time frame: Up to 2 years [or until disease progression or unacceptable toxicity]
Population: Efficacy Analysis Set: subjects with a baseline measurement of response and at least 1 timepoint after baseline
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Responses by Treatment Group | PD | 3 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Efficacy: Best Responses by Treatment Group | SD | 2 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Responses by Treatment Group | SD | 3 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Efficacy: Best Responses by Treatment Group | PD | 3 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | PD | 4 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | SD | 5 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Responses by Treatment Group | SD | 7 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Responses by Treatment Group | PD | 1 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 3 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | PR | 2 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | PD | 10 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 3 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Efficacy: Best Responses by Treatment Group | SD | 10 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 1 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Responses by Treatment Group | PR | 2 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Responses by Treatment Group | SD | 23 Participants |
| Phase 2 Randomized Controlled: Enza | Efficacy: Best Responses by Treatment Group | PD | 9 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 4 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Responses by Treatment Group | SD | 24 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Responses by Treatment Group | PD | 7 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Efficacy: Best Responses by Treatment Group | PR | 3 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Best Responses by Treatment Group | SD | 5 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Best Responses by Treatment Group | PD | 0 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 7 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 2 Randomized Crossover Period | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Responses by Treatment Group | PD | 5 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Responses by Treatment Group | CR | 0 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Responses by Treatment Group | PR | 0 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Responses by Treatment Group | SD | 21 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Efficacy: Best Responses by Treatment Group | Not evaluable, unknown, or missing | 2 Participants |
Secondary
Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation
Treatment-emergent Adverse events (AEs) leading to subjects withdrawing from treatment
Time frame: Up to 2 years [or until clinical progression, radiographic disease progression, or until unacceptable toxicity]
Population: Safety Population: all subjects who receive any amount of treatment (includes phase Ib dose-escalation, phase 1b expansion, phase 2 randomized, phase 2 single-arm)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 4 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 0 Participants |
| Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 2 Participants |
| Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 4 Participants |
| Phase 2 Randomized Controlled: Enza | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 2 Participants |
| Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 4 Participants |
| Phase 2 Randomized Crossover Period | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 0 Participants |
| Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred | Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation | 2 Participants |