A Study of Opevesostat (MK-5684) Versus Alternative Next-generation Hormonal Agent (NHA) in Metastatic Castration-resistant Prostate Cancer (mCRPC) Post One NHA (MK-5684-004)

Purpose

The purpose of this study is to assess the efficacy and safety of opevesostat plus hormone replacement therapy (HRT) compared to alternative abiraterone acetate or enzalutamide in participants with Metastatic Castration-resistant Prostate Cancer (mCRPC) previously treated with one next-generation hormonal agent (NHA). The primary study hypothesis is that opevesostat is superior to alternative abiraterone acetate or enzalutamide with respect to radiographic progression free survival (rPFS) per Prostate Cancer Working Group (PCWG) Modified Response Evaluation Criteria in Solid Tumors (RECIST 1.1), as assessed by Blinded Independent Central Review (BICR), in androgen receptor ligand binding domain (AR LBD) mutation positive and negative participants.

Conditions

  • Metastatic Castration-resistant Prostate Cancer (mCRPC)
  • Prostatic Neoplasms

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

The main inclusion criteria include but are not limited to the following: - Have histologically or cytologically confirmed adenocarcinoma of the prostate without small cell histology - Has prostate cancer progression while receiving androgen deprivation therapy (ADT) (or post bilateral orchiectomy) within 6 months before screening - Has current evidence of distant metastatic disease (M1 disease) documented by either bone lesions on bone scan and/or soft tissue disease shown by computed tomography (CT)/magnetic resonance imaging (MRI) - Has disease that progressed during or after treatment with one next-generation hormonal agent (NHA) for hormone sensitive prostate cancer (HSPC) (metastatic hormone-sensitive prostate cancer [mHSPC] or non-metastatic hormone-sensitive prostate cancer [nmHSPC]), or castration-resistant prostate cancer (CRPC) (metastatic castration-resistant prostate cancer [mCRPC] or non-metastatic castration-resistant prostate cancer [nmCRPC]), for at least 8 weeks of NHA treatment (at least 14 weeks of NHA treatment for participants with bone progression). Note: Participants may have received abiraterone acetate and docetaxel or darolutamide and docetaxel for HSPC. However, participants must have received no more than 6 cycles of docetaxel and had no radiographic disease progression while receiving docetaxel - Has had prior treatment with poly (ADP-ribose) polymerase inhibitor (PARPi) or were deemed ineligible to receive treatment by the investigator or have refused PARPi treatment - Has ongoing androgen deprivation therapy (ADT) with serum testosterone <50 ng/dL (<1.7 nM) - Has an eastern clinical oncology group (ECOG) performance status of 0 or 1 assessed within 10 days before randomization - Has adequate organ function - Has provided tumor tissue from a fresh core or excisional biopsy from soft tissue not previously irradiated. Samples from tumors progressing at a prior site of radiation are allowed - Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load before randomization - Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening - Participants who have adverse event (AEs) due to previous anticancer therapies must have recovered to ≤Grade 1 or baseline. Participants with endocrine-related AEs who are adequately treated with hormone replacement therapy (HRT) or participants who have ≤Grade 2 neuropathy or ≤Grade 2 osteopenia/osteoporosis are eligible - Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy (ART)

Exclusion Criteria

The main exclusion criteria include but are not limited to the following: - Has presence of gastrointestinal condition - Is unable to swallow capsules/tablets - Has history of pituitary dysfunction - Has poorly controlled diabetes mellitus - Has clinically significant abnormal serum potassium or sodium level - Has any of the following at screening visit: Hypotension: systolic blood pressure (BP) <110 mmHg, or uncontrolled hypertension: systolic BP ≥160mmHg or diastolic blood BP ≥90 mmHg, in 2 out of the 3 recordings with optimized antihypertensive therapy - Has a history of active or unstable cardio/cerebrovascular disease, including thromboembolic events - History or family history of long QTc syndrome - Has a history of seizure(s) within 6 months before providing documented informed consent (IC) or has any condition that may predispose to seizure within 12 months prior to the date of enrollment - Has a history of clinically significant ventricular arrhythmias or Mobitz II second degree or third-degree heart block without a permanent pacemaker in place - Has received a taxane-based chemotherapy for metastatic castration-resistant prostate cancer (mCRPC) - Has not adequately recovered from major surgery or have ongoing surgical complications - Is currently being treated with Cytochrome P450 (CYP450)-inducing antiepileptic drugs for seizures - Participants on an unstable dose of thyroid hormone therapy, as judged by the investigator, within 6 months before the start of the study intervention - Receives prior radiotherapy within 2 weeks before the first dose of study intervention, or radiation-related toxicities, requiring corticosteroids - Receives prior systemic anticancer therapy including investigational agents within 4 weeks before the first dose of study intervention - Has systemic use of strong Cytochrome P450 3A4 (CYP3A4) inducers and P-glycoprotein (P-gp) inhibitors within 2 weeks before the first dose of study intervention - Has received prior targeted small molecule therapy or NHA treatment within 4 weeks before the first dose of study intervention - Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention - Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration - Has known hypersensitivity to the components or excipients in abiraterone acetate, prednisone or prednisolone, enzalutamide, fludrocortisone, dexamethasone, or opevesostat - Has a "superscan" bone scan defined as an intense symmetric activity in the bones and diminished renal parenchymal activity on baseline bone scan such that the presence of additional metastases in the future could not be evaluated - Has known additional malignancy that is progressing or has required active treatment within the past 3 years - Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study medication - Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, (ie, without evidence of progression) for at least 4 weeks as confirmed by repeat imaging performed during study screening, are clinically stable and have not required steroid treatment for at least 14 days prior to the first dose of study intervention - Has active autoimmune disease that has required systemic treatment in the past 2 years. Replacement therapy is allowed - Active infection requiring systemic therapy - Has concurrent active Hepatitis B virus and Hepatitis C virus infection

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Hormone Replacement Therapy (HRT) + Opevesostat
Participants receive opevesostat 5 mg by oral tablets twice daily (BID) plus dexamethasone 1.5 mg by oral tablets and fludrocortisone acetate 0.1 mg oral tablet once daily (QD) continuously until disease progression. Hydrocortisone 100 mg (oral or intramuscular [IM]) will also be provided to participants for use as rescue medication.
  • Drug: Opevesostat
    Administered orally
    Other names:
    • MK-5684
  • Drug: Dexamethasone
    Administered orally
  • Drug: Fludrocortisone acetate
    Administered orally
  • Drug: Hydrocortisone
    Administered orally or IM as a rescue drug
Active Comparator
Alternative Next-Generation Hormonal Agent (NHA)
Participants receive abiraterone 1000mg QD by oral tablets plus prednisone 5 mg BID by oral tablets or enzalutamide 160 mg QD by oral tablets until disease progression.
  • Drug: Abiraterone acetate
    Administered orally
    Other names:
    • Zytiga
    • Yonsa
  • Drug: Prednisone acetate
    Administered orally
  • Drug: Enzalutamide
    Administered orally
    Other names:
    • Xtandi

Recruiting Locations

The University of Arizona Cancer Center - North Campus ( Site 0073)
Tucson 5318313, Arizona 5551752 85719
Contact:
Study Coordinator
520-626-1068

UCLA Hematology/Oncology - Santa Monica ( Site 0044)
Los Angeles 5368361, California 5332921 90404
Contact:
Study Coordinator
888-577-8839

University of California, Irvine (UCI) Health - UC Irvine Medical Center ( Site 0040)
Orange 5379513, California 5332921 92868
Contact:
Study Coordinator
888-577-8839

University of California, Irvine (UCI) Health - UC Irvine Medical Center (0120)
Orange 5379513, California 5332921 92868
Contact:
Arash Rezazadeh Kalebasty
502-472-3237
arez@hs.uci.edu

University of California Davis (UC Davis) Comprehensive Cancer Center ( Site 0114)
Sacramento 5389489, California 5332921 95817
Contact:
Study Coordinator
916-734-3772

Kaiser Permanente-Kaiser Permanente, Vallejo Medical Center, Adult Oncology ( Site 0101)
Vallejo 5405380, California 5332921 94589
Contact:
Study Coordinator
888-577-8839

University of Colorado Anschutz Medical Campus ( Site 0046)
Aurora 5412347, Colorado 5417618 80045
Contact:
Study Coordinator
888-577-8839

UCHealth Highlands Ranch Hospital ( Site 0111)
Highlands Ranch 5425043, Colorado 5417618 80129
Contact:
Study Coordinator
720-516-1000

Colorado Clinical Research ( Site 0067)
Lakewood 5427946, Colorado 5417618 80228
Contact:
Study Coordinator
888-577-8839

University of Colorado Health - Lone Tree Medical Center ( Site 0112)
Lone Tree 5429208, Colorado 5417618 80124
Contact:
Study Coordinator
720-470-9107

Yale-New Haven Hospital-Yale Cancer Center ( Site 0064)
New Haven 4839366, Connecticut 4831725 06510
Contact:
Study Coordinator
888-577-8839

MedStar Washington Hospital Center ( Site 0103)
Washington D.C. 4140963, District of Columbia 4138106 20010
Contact:
Study Coordinator
888-577-8839

Memorial Hospital West-Memorial Cancer Institute ( Site 0109)
Pembroke Pines 4168139, Florida 4155751 33028
Contact:
Study Coordinator
954-265-4325

Northside Hospital-Northside Hospital Oncology Network ( Site 0100)
Atlanta 4180439, Georgia 4197000 30342
Contact:
Study Coordinator
770-590-8311

Edward-Elmhurst Healthcare, Elmhurst Hospital-Nancy W. Knowles Cancer Center ( Site 0074)
Elmhurst 4891010, Illinois 4896861 60126
Contact:
Study Coordinator
888-577-8839

Edward-Elmhurst Healthcare, Edward Hospital-Edward Cancer Center ( Site 0075)
Naperville 4903279, Illinois 4896861 60540
Contact:
Study Coordinator
888-577-8839

Illinois Cancer Care ( Site 0104)
Peoria 4905687, Illinois 4896861 61615
Contact:
Study Coordinator
888-577-8839

Urology of Indiana - Carmel ( Site 0055)
Carmel 4255466, Indiana 4921868 46032
Contact:
Study Coordinator
888-577-8839

Baltimore Veterans Affairs Medical Center ( Site 0069)
Baltimore 4347778, Maryland 4361885 21201
Contact:
Study Coordinator
888-577-8839

Greenebaum Comprehensive Cancer Center ( Site 0049)
Baltimore 4347778, Maryland 4361885 21201
Contact:
Study Coordinator
888-577-8839

Chesapeake Urology ( Site 0009)
Towson 4371582, Maryland 4361885 21204
Contact:
Study Coordinator
888-577-8839

Henry Ford Hospital ( Site 0015)
Detroit 4990729, Michigan 5001836 48202
Contact:
Study Coordinator
313-916-1784

Cancer and Hematology Centers of Western Michigan ( Site 0005)
Grand Rapids 4994358, Michigan 5001836 49503
Contact:
Study Coordinator
888-577-8839

HealthPartners Cancer Research Center-HealthPartners Frauenshuh Cancer Center ( Site 0072)
Saint Louis Park 5045021, Minnesota 5037779 55426
Contact:
Study Coordinator
888-577-8839

St. Vincent Frontier Cancer Center-Research ( Site 0037)
Billings 5640350, Montana 5667009 59102
Contact:
Study Coordinator
888-577-8839

Oncology Hematology West P.C. dba Nebraska Cancer Specialists ( Site 0026)
Omaha 5074472, Nebraska 5073708 68130
Contact:
Study Coordinator
888-577-8839

OptumCare Cancer Care-Research Department ( Site 0078)
Las Vegas 5506956, Nevada 5509151 89102
Contact:
Study Coordinator
888-577-8839

Comprehensive Cancer Centers of Nevada ( Site 0010)
Las Vegas 5506956, Nevada 5509151 89148
Contact:
Study Coordinator
888-577-8839

Rutgers Cancer Institute of New Jersey ( Site 0033)
New Brunswick 5101717, New Jersey 5101760 08901
Contact:
Study Coordinator
888-577-8839

Associated Medical Professionals - Urology ( Site 0081)
Syracuse 5140405, New York 5128638 13210
Contact:
Study Coordinator
315-478-4185

University Hospitals Cleveland Medical Center ( Site 0043)
Cleveland 5150529, Ohio 5165418 44106
Contact:
Study Coordinator
888-577-8839

Genesis Healthcare System ( Site 0102)
Zanesville 4528923, Ohio 5165418 43701
Contact:
Study Coordinator
740-454-5271

MidLantic urology ( Site 0022)
Bala-Cynwyd 5178892, Pennsylvania 6254927 19004
Contact:
Study Coordinator
888-577-8839

Ralph H. Johnson VA Health Care System (RHJVAHCS)-Urology ( Site 0083)
Charleston 4574324, South Carolina 4597040 29401
Contact:
Study Coordinator
888-577-8839

Avera Cancer Institute- Research ( Site 0094)
Sioux Falls 5231851, South Dakota 5769223 57105
Contact:
Study Coordinator
605-322-6900

Avera Cancer Institute - Yankton ( Site 0117)
Yankton 5233053, South Dakota 5769223 57078
Contact:
Study Coordinator
605-655-1800

The West Clinic, PLLC dba West Cancer Center ( Site 0063)
Germantown 4624601, Tennessee 4662168 38138
Contact:
Study Coordinator
888-577-8839

Texas Oncology - Central/South Texas ( Site 8003)
Austin 4671654, Texas 4736286 78731
Contact:
Study Coordinator
512-427-9400

Texas Oncology - DFW ( Site 8001)
Dallas 4684888, Texas 4736286 75246
Contact:
Study Coordinator
214-370-1000

Texas Oncology - Gulf Coast ( Site 8002)
Houston 4699066, Texas 4736286 77024
Contact:
Study Coordinator
888-577-8839

University of Virginia Health System ( Site 0054)
Charlottesville 4752031, Virginia 6254928 22908
Contact:
Study Coordinator
888-577-8839

Inova Schar Cancer Institute ( Site 0017)
Fairfax 4758023, Virginia 6254928 22031
Contact:
Study Coordinator
888-577-8839

Virginia Cancer Specialists (VCS) ( Site 8004)
Fairfax 4758023, Virginia 6254928 22031
Contact:
Study Coordinator
888-577-8839

VCU Health Adult Outpatient Pavillion ( Site 0061)
Richmond 4781708, Virginia 6254928 23219
Contact:
Study Coordinator
804-628-6430

Blue Ridge Cancer Care ( Site 0004)
Roanoke 4782167, Virginia 6254928 24014
Contact:
Study Coordinator
888-577-8839

Spokane Urology ( Site 0035)
Spokane 5811696, Washington 5815135 99202
Contact:
Study Coordinator
888-577-8839

Northwest Cancer Specialists (Compass Oncology) ( Site 8008)
Vancouver 5814616, Washington 5815135 98684
Contact:
Study Coordinator
971-708-7600

MEDICAL COLLEGE OF WISCONSIN ( Site 0020)
Milwaukee 5263045, Wisconsin 5279468 53226
Contact:
Study Coordinator
414-805-6700

Ad-Vance Medical Research-Research ( Site 1177)
Ponce 4566880, Puerto Rico 00717
Contact:
Study Coordinator
+1787-651-6697

Pan American Center for Oncology Trials - Ciudadela ( Site 1176)
San Juan 4568127, Puerto Rico 00909
Contact:
Study Coordinator
+1 787-407-3333

More Details

Status
Recruiting
Sponsor
Merck Sharp & Dohme LLC

Study Contact

Toll Free Number
1-888-577-8839
Trialsites@msd.com

Detailed Description

Per Protocol Amendment 08, overall survival (OS) was moved to be a secondary outcome measure.