Prostate Cancer Clinical Trial
Randomized Study to Evaluate MACE in Patients With Prostate Cancer Treated With Relugolix or Leuprolide Acetate
Summary
This is a randomized study to evaluate the risk of major adverse cardiovascular events (MACE) for relugolix compared with leuprolide acetate. This study will collect clinical and cardiovascular risk factor data on patients ages 18 and older who are receiving relugolix or leuprolide acetate for their prostate cancer or as adjunct to radiation therapy with a treatment plan to be on androgen deprivation therapy (ADT) for at least one year.
Full Description
Eligible patients will be randomized (1:1) to receive either relugolix or leuprolide acetate for prostate cancer or as an adjunct to primary or salvage radiation therapy. Patients who experience major adverse cardiovascular events (MACE) during the trial will be encouraged to stay on the study and continue to fill out questionnaires every 3 months. Each patient will also be asked to provide information regarding alternative contacts (eg, close relatives or friends, or primary care physician or cardiologist). In addition, patients will provide consent to obtain medical records (eg, hospitalizations, emergency room visits and clinic notes) for additional information, when appropriate.
The primary endpoint in this study will be the time to first adjudicated MACE (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death). A surveillance approach will be used to collect clinical and cardiovascular risk data on patients receiving relugolix or leuprolide acetate for their prostate cancer. A rigorous, blinded adjudication of MACE by an independent clinical event adjudication committee (CEC) is included.
Eligibility Criteria
Inclusion Criteria:
Has voluntarily signed and dated the informed consent form prior to baseline visit;
Is a male and 18 years of age or older on the day of signing and dating the informed consent form;
Patient has sufficient cognitive function in the investigator's opinion to complete the questionnaires and other activities related to the study;
Has a histologically or cytologically confirmed diagnosis of adenocarcinoma of the prostate;
Is, in the opinion of the investigator, a candidate for at least 1 year of continuous ADT for the management of prostate cancer with one of the following clinical disease state presentations:
Evidence of biochemical (prostate-specific antigen [PSA], confirmed with two measurements at least one week apart) or clinical relapse following local primary intervention with curative intent (such as surgery, radiation therapy, cryotherapy, or high-frequency ultrasound and not a candidate for salvage treatment by surgery);
Newly diagnosed hormone-sensitive metastatic disease (metastases in regional lymph node[s] are considered N1 and will, therefore, be stratified as non-metastatic);
Advanced localized disease unlikely to be cured by local primary intervention with curative intent;
Patients receiving primary or salvage radiation therapy with adjuvant ADT;
Patients with high-risk cardiovascular disease defined as prior history of MACE (myocardial infarction, stroke, coronary revascularization [including percutaneous procedures] or revascularization affecting cerebral blood flow [including carotid procedures]) > 1 month before enrollment in the study; OR
Patients with ≥ 3 of the following cardiovascular risk factors:
Age (≥ 55 years of age);
Hypertension defined as self-reported high blood pressure, or use of a blood pressure-lowering medication;
Diabetes defined as self-reported diabetes or use of hypoglycemic medication;
Dyslipidemia defined as self-reported high cholesterol or use of a lipid-lowering medication;
Current cigarette use, defined as smoking within the year prior to the screening visit;
Family history of cardiovascular disease, defined as a myocardial infarction or stroke or coronary revascularization or revascularization affecting cerebral blood flow (ie, carotid procedures) or sudden death in a first-degree relative < 60 years old;
Serum testosterone before starting relugolix or leuprolide acetate of ≥ 150 ng/dL (1.50 ng/mL or 5.2 nmol/L) within 6 months prior to screening;
Serum PSA concentration of > 2.0 ng/mL (2.0 μg/L) or, when applicable, post radical prostatectomy of > 0.2 ng/mL (0.2 μg/L) within 6 months prior to screening (by medical history);
Patients, in the opinion of the investigator, must be equally eligible for either treatment in the study. If either the patient or the physician has a strong preference that one of the treatments be prescribed over the other, the patient must not be enrolled;
Patients must not be participating or intending to participate in an interventional therapeutic study.
Exclusion Criteria:
Any significant cardiovascular conditions per the investigator within 1 month before study entry including but not limited to: myocardial infarction, stroke, New York Heart Association class III or IV heart failure, thromboembolic events, major cardiovascular or cerebrovascular procedures or any other condition that in the investigator's opinion puts the patient at unacceptable risk to enter the study;
Any major cardiovascular or cerebrovascular procedures planned within the 1 month after enrollment;
Patients with QT interval corrected for heart rate (QTc) determined using Fridericia's formula (QTcF; QTcF = QT/[R-R interval {RR}^0.33]) > 470 msec within 6 months of screening;
Uncontrolled hypertension (systolic blood pressure > 180 mm Hg or diastolic blood pressure > 110 mm Hg) at the time of screening;
Previously received gonadotropin-releasing hormone (GnRH) receptor agonist (eg, leuprolide, goserelin, histrelin, triptorelin), GnRH receptor antagonist, or other forms of ADT (estrogen or antiandrogen) for > 18 months total duration. If ADT was received for ≤ 18 months total duration, then that therapy must have been completed at least 12 months prior to baseline. Once enrolled in the study, patients may be treated with ADT and anti-androgen (abiraterone, enzalutamide, apalutamide, darolutamide);
Metastases to brain per prior clinical evaluation;
Prescriber plans to switch from relugolix to leuprolide acetate or another GnRH agonist or antagonist or from leuprolide acetate to relugolix or another GnRH agonist or antagonist during the study;
Treatment with any investigational product within 28 days or 5 half-lives (whichever is longer). Exception: treatment for prostate cancer with any investigational products where the mechanism of action is testosterone lowering. In this circumstance, there must be a minimum 12-month treatment free interval;
Active malignancy beyond prostate cancer with the exception of the following:
Adequately treated basal cell carcinoma or squamous cell carcinoma of the skin;
Adequately treated Stage I cancer from which the patient is currently disease-free for ≥ 2 years;
Any other cancer from which the patient has been disease-free for ≥ 5 years;
Other malignancy upon agreement with the medical monitor.
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There are 97 Locations for this study
Mobile Alabama, 36608, United States
Tucson Arizona, 85704, United States
Little Rock Arkansas, 72211, United States
Downey California, 90241, United States More Info
Principal Investigator
Fountain Valley California, 92708, United States
Los Alamitos California, 90270, United States More Info
Principal Investigator
Los Angeles California, 90048, United States
Monterey California, 93940, United States
Murrieta California, 92562, United States
Murrieta California, 92563, United States
San Bernardino California, 92404, United States
San Diego California, 92123, United States More Info
Principal Investigator
Sherman Oaks California, 91411, United States More Info
Principal Investigator
Temecula California, 92592, United States
Torrance California, 90503, United States More Info
Principal Investigator
Torrance California, 90505, United States More Info
Principal Investigator
Torrance California, 90505, United States More Info
Principal Investigator
Washington District of Columbia, 20010, United States
Washington District of Columbia, 20036, United States
Daytona Beach Florida, 32114, United States
Jacksonville Florida, 32204, United States
Jacksonville Florida, 32216, United States
Jacksonville Florida, 32256, United States
Lake City Florida, 32024, United States
Miami Florida, 33145, United States
Tampa Florida, 33578, United States
Tampa Florida, 33609, United States
Tampa Florida, 33615, United States
Augusta Georgia, 30912, United States
Augusta Georgia, 30912, United States
Boise Idaho, 83712, United States
Boise Idaho, 83712, United States
Fruitland Idaho, 83619, United States
Meridian Idaho, 83642, United States
Meridian Idaho, 83642, United States
Nampa Idaho, 83687, United States
Nampa Idaho, 83687, United States
Twin Falls Idaho, 83301, United States
Twin Falls Idaho, 83301, United States
Bloomington Illinois, 61704, United States
Chicago Ridge Illinois, 60415, United States
Chicago Illinois, 60611, United States
Chicago Illinois, 60625, United States
Evanston Illinois, 60201, United States
Galesburg Illinois, 61401, United States
Glenview Illinois, 60026, United States
Highland Park Illinois, 60035, United States
Lake Barrington Illinois, 60010, United States
New Lenox Illinois, 60451, United States
Ottawa Illinois, 61350, United States
Pekin Illinois, 61554, United States
Peoria Illinois, 61615, United States
Peru Illinois, 61354, United States
Washington Illinois, 61571, United States
Carmel Indiana, 46032, United States
Greenwood Indiana, 46143, United States
Lafayette Indiana, 47904, United States
Muncie Indiana, 47303, United States
Council Bluffs Iowa, 51501, United States
Creston Iowa, 50801, United States
Wichita Kansas, 67205, United States
Wichita Kansas, 67206, United States
Wichita Kansas, 67226, United States
Royal Oak Michigan, 48073, United States
Troy Michigan, 48084, United States
Osage Beach Missouri, 65065, United States
Saint Louis Missouri, 63141, United States
Saint Louis Missouri, 63141, United States
Billings Montana, 59101, United States
Billings Montana, 59102, United States
Omaha Nebraska, 68114, United States
Pennington New Jersey, 08534, United States
Albuquerque New Mexico, 87131, United States
Albany New York, 12208, United States
Syracuse New York, 13210, United States
Charlotte North Carolina, 28207, United States
Raleigh North Carolina, 27612, United States
Grand Forks North Dakota, 58201, United States
Grand Forks North Dakota, 58201, United States
Grand Forks North Dakota, 58201, United States
Avon Ohio, 44011, United States
Cincinnati Ohio, 45212, United States
Cleveland Ohio, 44106, United States
Gahanna Ohio, 43230, United States
Gahanna Ohio, 43230, United States
Mentor Ohio, 44060, United States
Middleburg Heights Ohio, 44130, United States
Orange Village Ohio, 44122, United States
Bala-Cynwyd Pennsylvania, 19004, United States
Lancaster Pennsylvania, 17604, United States
Sayre Pennsylvania, 18840, United States
Sayre Pennsylvania, 18840, United States
Myrtle Beach South Carolina, 29572, United States
Nashville Tennessee, 37209, United States
Harlingen Texas, 78550, United States
Houston Texas, 77027, United States
San Antonio Texas, 78229, United States
San Antonio Texas, 78240, United States
Logan Utah, 84341, United States
Murray Utah, 84107, United States
Ogden Utah, 84403, United States
Provo Utah, 84604, United States
Saint George Utah, 84790, United States
Alexandria Virginia, 22311, United States
Richmond Virginia, 23235, United States
Virginia Beach Virginia, 23462, United States
Woodbridge Virginia, 22191, United States
Spokane Washington, 99202, United States
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