Prostate Cancer
Conditions
Keywords
Metastatic Castration Resistant Prostate Cancer, mCRPC
Brief summary
This study is being done to see how safe and effective abemaciclib is when given together with abiraterone acetate plus prednisone in participants with metastatic castration resistant prostate cancer. Prednisolone may be used instead of prednisone per local regulation.
Interventions
Administered orally.
Administered orally.
Administered orally.
Administered orally.
Sponsors
Study design
Eligibility
Inclusion criteria
* Histologically confirmed adenocarcinoma of the prostate. * Metastatic prostate cancer documented by positive bone scan and/or measurable soft tissue metastatic lesions by CT or magnetic resonance imaging (MRI). * Progressive disease at study entry demonstrated during continuous androgen-deprivation therapy (ADT)/post orchiectomy defined as one or more of the following: * PSA progression * Radiographic progression per Response Evaluation Criteria in Solid Tumors (RECIST)1.1 for soft tissue and/or per Prostate Cancer Working Group 3 (PCWG3) for bone, with or without PSA progression * Have adequate organ function. * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1.
Exclusion criteria
* Prior therapy with cytochrome P450 (CYP)17 inhibitors. * Prior treatment with abemaciclib or any cyclin-dependent kinase (CDK) 4 \& 6 inhibitors. * Prior cytotoxic chemotherapy for metastatic castration resistant prostate cancer (participants treated with docetaxel in the metastatic hormone-sensitive prostate cancer \[mHSPC\] are eligible). Prior radiopharmaceuticals for prostate cancer, or prior enzalutamide, apalutamide, darolutamide or sipuleucel-T. Participants who had prior radiation or surgery to all target lesions. * Currently enrolled in a clinical study involving an investigational product. * Gastrointestinal disorder affecting the absorption or ability to swallow large pills. * Clinically significant heart disease, active or chronic liver disease, moderate/severe hepatic impairment (Child-Pugh Class B and C).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Progression Free Survival (rPFS) | From Date of Randomization to Radiographic Disease Progression or Death from Any Cause (Up to 60 Months) | The rPFS time is measured from the date of randomization to the earliest date of investigator determined radiographic disease progression (by objective radiographic disease assessment per response evaluation criteria in solid tumors (RECIST) version 1.1 for soft tissue AND/OR radionuclide bone scan using prostate cancer working group 3 -PCWG3 criteria for bone) or death from any cause, whichever occurs first. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Prostate-Specific Antigen (PSA) Progression | From Date of Randomization to the Date of the First Observation of PSA Progression (Up to 60 Months) | The PSA progression is defined as a greater than or equal to (\>=) 25 percentage (%) increase and an absolute increase of \>=2 nanogram/milliliter (ng/mL) above the nadir (or baseline value if baseline is the smallest on study), which is confirmed by a second value obtained 3 or more weeks later. |
| Radiographic Progression Free Survival (rPFS) Determined by Blinded Independent Central Review | From Date of Randomization Until Radiographic Disease Progression or Death from Any Cause (Up to 60 Months) | rPFS is defined as the time from the date of randomization to the earliest date of radiographic disease progression determined by blinded independent central review (BICR) or death from any cause, whichever occurs first. |
| Objective Response Rate (ORR): Percentage of Participants With a Complete Response (CR) or Partial Response (PR) | Baseline to Radiographic Disease Progression (Up to 60 Months) | ORR is a summary measure of best overall response (BOR) as defined by RECIST 1.1 for soft tissue per investigator assessment. BOR is derived from time point responses. All time point responses observed while on study treatment and during the short-term follow-up period (but before the initiation of post-discontinuation systemic anticancer therapy) will be included in the derivation. Each patient's BOR will be categorized as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), or not evaluable (NE). A BOR of CR or PR will require confirmation, but sensitivity analyses of response-based endpoints may be performed where confirmation of a BOR of CR or PR is not required. |
| Duration of Response (DOR) | Date of First Documented CR or PR to Date of Radiographic Disease Progression or Death from Any Cause (Up to 60 Months) | The DoR time is defined only for responders (participants with a soft tissue BOR of CR or PR) in the measurable disease population. It is measured from the date of first evidence of soft tissue CR or PR to the earliest date of investigator determined radiographic disease progression or death from any cause, whichever is earlier. |
| Overall Survival (OS) | From Date of Randomization to Date of Death Due to Any Cause (Up to 60 Months) | The OS time is measured from the date of randomization to the date of death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data were censored on the last date the participant was known to be alive. |
| Time to Symptomatic Progression | From Randomization to the Date of the First Documented Symptomatic Progression (Up to 60 Months) | Time to symptomatic progression is defined as the time from randomization to any of the following (whichever occurs earlier): 1. Symptomatic Skeletal Event (SSE), defined as symptomatic fracture, surgery or radiation to bone, or spinal cord compression. 2. Pain progression or worsening of disease-related symptoms requiring initiation of a new systemic anti-cancer therapy. 3. Development of clinically significant symptoms due to loco-regional tumor progression requiring surgical intervention or radiation therapy. |
| Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | Cycle (C) 1 Day (D) 1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle) | PK: Mean steady state exposure of abemaciclib. |
| PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C1 D1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle) | PK: Mean steady state exposure of abemaciclib metabolite LSN2839567. |
| PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C1 D1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle) | PK: Mean steady state exposure of abemaciclib metabolite LSN3106726. |
| PK: Mean Steady State Exposure of Abiraterone Acetate | C1 D15, Post dose | PK: Mean Steady State Exposure of Abiraterone Acetate. |
| Time to Worst Pain Progression | From Randomization Through Follow-up (Up to 60 months) | Time to Worst Pain Progression defined as the time from randomization to any of the following (whichever occurs earlier): For participants without opioid use at baseline (World Health Organization-Analgesic Ladder-WHO-AL ≤ 2):- Worst pain progression (an increase of 2 points from baseline on the Worst Pain Numeric Rating Scale (NRS) item on 2 consecutive evaluations), Initiation of weak or strong opioids (WHO-AL ≥ 3); For participants with weak or strong opioid use at baseline (WHO-AL ≥ 3): Worst pain progression (an increase of 2 points from baseline on the Worst Pain NRS item on 2 consecutive evaluations) without concurrent decreased opioid use (a decrease in WHO-AL of 1 or more) -Increased opioid use (an increase in WHO-AL of 1 or more). |
Countries
Australia, China, Denmark, France, Germany, Japan, Netherlands, Romania, South Korea, Spain, United States
Contacts
Eli Lilly and Company
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Abemaciclib Participants received 200 mg abemaciclib BID in combination with standard doses of 1000 mg abiraterone acetate once daily and 5mg prednisone BID administered orally on a continuous dosing schedule on days 1 through 28 of a 28-day cycle until radiographic and/or symptomatic progression or until another discontinuation criterion is met. | 206 |
| Placebo Participants received placebo BID in combination with standard doses of 1000 mg abiraterone once daily and 5 mg prednisone BID administered orally on a continuous dosing schedule on days 1 through 28 of a 28-day cycle until radiographic and/or symptomatic progression or until another discontinuation criterion is met. | 187 |
| Total | 393 |
Baseline characteristics
| Characteristic | Abemaciclib | Total | Placebo |
|---|---|---|---|
| Age, Continuous | 68.70 years STANDARD_DEVIATION 8.57 | 69.10 years STANDARD_DEVIATION 8.69 | 69.60 years STANDARD_DEVIATION 8.81 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 13 Participants | 20 Participants | 7 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 186 Participants | 360 Participants | 174 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 7 Participants | 13 Participants | 6 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 35 Participants | 80 Participants | 45 Participants |
| Race (NIH/OMB) Black or African American | 7 Participants | 17 Participants | 10 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants | 6 Participants | 4 Participants |
| Race (NIH/OMB) White | 161 Participants | 289 Participants | 128 Participants |
| Region of Enrollment Australia | 17 participants | 35 participants | 18 participants |
| Region of Enrollment China | 4 participants | 13 participants | 9 participants |
| Region of Enrollment Denmark | 7 participants | 17 participants | 10 participants |
| Region of Enrollment France | 4 participants | 9 participants | 5 participants |
| Region of Enrollment Germany | 23 participants | 39 participants | 16 participants |
| Region of Enrollment Japan | 15 participants | 33 participants | 18 participants |
| Region of Enrollment Netherlands | 7 participants | 15 participants | 8 participants |
| Region of Enrollment Romania | 10 participants | 17 participants | 7 participants |
| Region of Enrollment South Korea | 14 participants | 31 participants | 17 participants |
| Region of Enrollment Spain | 45 participants | 75 participants | 30 participants |
| Region of Enrollment United Kingdom | 11 participants | 20 participants | 9 participants |
| Region of Enrollment United States | 49 participants | 89 participants | 40 participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 206 Participants | 393 Participants | 187 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 81 / 206 | 72 / 187 |
| other Total, other adverse events | 204 / 206 | 176 / 185 |
| serious Total, serious adverse events | 89 / 206 | 66 / 185 |
Outcome results
Radiographic Progression Free Survival (rPFS)
The rPFS time is measured from the date of randomization to the earliest date of investigator determined radiographic disease progression (by objective radiographic disease assessment per response evaluation criteria in solid tumors (RECIST) version 1.1 for soft tissue AND/OR radionuclide bone scan using prostate cancer working group 3 -PCWG3 criteria for bone) or death from any cause, whichever occurs first.
Time frame: From Date of Randomization to Radiographic Disease Progression or Death from Any Cause (Up to 60 Months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Radiographic Progression Free Survival (rPFS) | 21.96 Months |
| Placebo | Radiographic Progression Free Survival (rPFS) | 20.28 Months |
Duration of Response (DOR)
The DoR time is defined only for responders (participants with a soft tissue BOR of CR or PR) in the measurable disease population. It is measured from the date of first evidence of soft tissue CR or PR to the earliest date of investigator determined radiographic disease progression or death from any cause, whichever is earlier.
Time frame: Date of First Documented CR or PR to Date of Radiographic Disease Progression or Death from Any Cause (Up to 60 Months)
Population: All randomized participants who received at least one dose of the study drug and had CR or PR responses with objective response.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Duration of Response (DOR) | 21.27 Months |
| Placebo | Duration of Response (DOR) | 15.68 Months |
Objective Response Rate (ORR): Percentage of Participants With a Complete Response (CR) or Partial Response (PR)
ORR is a summary measure of best overall response (BOR) as defined by RECIST 1.1 for soft tissue per investigator assessment. BOR is derived from time point responses. All time point responses observed while on study treatment and during the short-term follow-up period (but before the initiation of post-discontinuation systemic anticancer therapy) will be included in the derivation. Each patient's BOR will be categorized as complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), or not evaluable (NE). A BOR of CR or PR will require confirmation, but sensitivity analyses of response-based endpoints may be performed where confirmation of a BOR of CR or PR is not required.
Time frame: Baseline to Radiographic Disease Progression (Up to 60 Months)
Population: All randomized participants who received at least one dose of the study drug and had CR or PR responses.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Abemaciclib | Objective Response Rate (ORR): Percentage of Participants With a Complete Response (CR) or Partial Response (PR) | 45.2 percentage of participants |
| Placebo | Objective Response Rate (ORR): Percentage of Participants With a Complete Response (CR) or Partial Response (PR) | 54.8 percentage of participants |
Overall Survival (OS)
The OS time is measured from the date of randomization to the date of death from any cause. If the participant was alive or lost to follow-up at the time of data analysis, OS data were censored on the last date the participant was known to be alive.
Time frame: From Date of Randomization to Date of Death Due to Any Cause (Up to 60 Months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Overall Survival (OS) | 38.01 Months |
| Placebo | Overall Survival (OS) | 33.21 Months |
Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib
PK: Mean steady state exposure of abemaciclib.
Time frame: Cycle (C) 1 Day (D) 1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle)
Population: All participants who received at least one dose of study drug had evaluable PK data.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Abemaciclib | Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | C1 D1 | 4.79 nanogram per milliliter (ng/mL) | Geometric Coefficient of Variation 157 |
| Abemaciclib | Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | C1 D15 | 289 nanogram per milliliter (ng/mL) | Geometric Coefficient of Variation 58.7 |
| Abemaciclib | Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | C2 D1 | 253 nanogram per milliliter (ng/mL) | Geometric Coefficient of Variation 65.7 |
| Abemaciclib | Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | C2 D15 | 252 nanogram per milliliter (ng/mL) | Geometric Coefficient of Variation 68.4 |
| Abemaciclib | Pharmacokinetics (PK): Mean Steady State Exposure of Abemaciclib | C3 D1 | 270 nanogram per milliliter (ng/mL) | Geometric Coefficient of Variation 54.5 |
PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567
PK: Mean steady state exposure of abemaciclib metabolite LSN2839567.
Time frame: C1 D1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle)
Population: All participants who received at least one dose of study drug had evaluable PK data.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C1 D1 | 2.90 ng/mL | Geometric Coefficient of Variation 87.4 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C1 D15 | 125 ng/mL | Geometric Coefficient of Variation 50.4 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C2 D1 | 112 ng/mL | Geometric Coefficient of Variation 50.1 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C2 D15 | 116 ng/mL | Geometric Coefficient of Variation 51 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN2839567 | C3 D1 | 110 ng/mL | Geometric Coefficient of Variation 62.2 |
PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726
PK: Mean steady state exposure of abemaciclib metabolite LSN3106726.
Time frame: C1 D1: Predose, 30 min post-dose; C1 D15, C2 D1, C2 D15, C3 D1: Post dose (28 Days Cycle)
Population: All participants who received at least one dose of study drug had evaluable PK data.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C3 D1 | 176 ng/mL | Geometric Coefficient of Variation 36.4 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C1 D1 | 2.80 ng/mL | Geometric Coefficient of Variation 77.7 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C1 D15 | 195 ng/mL | Geometric Coefficient of Variation 43 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C2 D1 | 174 ng/mL | Geometric Coefficient of Variation 42.8 |
| Abemaciclib | PK: Mean Steady State Exposure of Abemaciclib Metabolite LSN3106726 | C2 D15 | 174 ng/mL | Geometric Coefficient of Variation 44.1 |
PK: Mean Steady State Exposure of Abiraterone Acetate
PK: Mean Steady State Exposure of Abiraterone Acetate.
Time frame: C1 D15, Post dose
Population: All participants who received at least one dose of study drug had evaluable PK data.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Abemaciclib | PK: Mean Steady State Exposure of Abiraterone Acetate | 45.2 ng/mL | Geometric Coefficient of Variation 175 |
| Placebo | PK: Mean Steady State Exposure of Abiraterone Acetate | 40.0 ng/mL | Geometric Coefficient of Variation 203 |
Radiographic Progression Free Survival (rPFS) Determined by Blinded Independent Central Review
rPFS is defined as the time from the date of randomization to the earliest date of radiographic disease progression determined by blinded independent central review (BICR) or death from any cause, whichever occurs first.
Time frame: From Date of Randomization Until Radiographic Disease Progression or Death from Any Cause (Up to 60 Months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Radiographic Progression Free Survival (rPFS) Determined by Blinded Independent Central Review | 24.89 Months |
| Placebo | Radiographic Progression Free Survival (rPFS) Determined by Blinded Independent Central Review | 22.88 Months |
Time to Prostate-Specific Antigen (PSA) Progression
The PSA progression is defined as a greater than or equal to (\>=) 25 percentage (%) increase and an absolute increase of \>=2 nanogram/milliliter (ng/mL) above the nadir (or baseline value if baseline is the smallest on study), which is confirmed by a second value obtained 3 or more weeks later.
Time frame: From Date of Randomization to the Date of the First Observation of PSA Progression (Up to 60 Months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Time to Prostate-Specific Antigen (PSA) Progression | 22.19 Months |
| Placebo | Time to Prostate-Specific Antigen (PSA) Progression | 16.60 Months |
Time to Symptomatic Progression
Time to symptomatic progression is defined as the time from randomization to any of the following (whichever occurs earlier): 1. Symptomatic Skeletal Event (SSE), defined as symptomatic fracture, surgery or radiation to bone, or spinal cord compression. 2. Pain progression or worsening of disease-related symptoms requiring initiation of a new systemic anti-cancer therapy. 3. Development of clinically significant symptoms due to loco-regional tumor progression requiring surgical intervention or radiation therapy.
Time frame: From Randomization to the Date of the First Documented Symptomatic Progression (Up to 60 Months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Time to Symptomatic Progression | 51.39 Months |
| Placebo | Time to Symptomatic Progression | 35.74 Months |
Time to Worst Pain Progression
Time to Worst Pain Progression defined as the time from randomization to any of the following (whichever occurs earlier): For participants without opioid use at baseline (World Health Organization-Analgesic Ladder-WHO-AL ≤ 2):- Worst pain progression (an increase of 2 points from baseline on the Worst Pain Numeric Rating Scale (NRS) item on 2 consecutive evaluations), Initiation of weak or strong opioids (WHO-AL ≥ 3); For participants with weak or strong opioid use at baseline (WHO-AL ≥ 3): Worst pain progression (an increase of 2 points from baseline on the Worst Pain NRS item on 2 consecutive evaluations) without concurrent decreased opioid use (a decrease in WHO-AL of 1 or more) -Increased opioid use (an increase in WHO-AL of 1 or more).
Time frame: From Randomization Through Follow-up (Up to 60 months)
Population: All randomized participants. Participants were analyzed according to the treatment arm they were assigned to regardless of what actual treatment they received.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Abemaciclib | Time to Worst Pain Progression | 41.49 Months |
| Placebo | Time to Worst Pain Progression | 24.79 Months |