Study of Cabozantinib in Combination With Atezolizumab Versus Second NHT in Subjects With mCRPC

Inclusion Criteria:

Men with histologically or cytologically confirmed adenocarcinoma of the prostate
Prior treatment with one, and only one, NHT (eg, abiraterone, apalutamide, darolutamide, or enzalutamide) for castration-sensitive locally advanced (T3 or T4) or mCSPC, M0 CRPC, or mCRPC
Surgical or medical castration, with serum testosterone ≤ 50 ng/dL (≤ 1.73 nmol/L) at screening
Measurable (extrapelvic soft tissue) metastatic disease per Investigator assessment defined by at least one of the following: measurable visceral disease (eg, adrenal, kidney, liver, lung, pancreas, spleen) per RECIST 1.1; OR measurable extrapelvic adenopathy (ie, adenopathy above the aortic bifurcation)
Progressive disease at study entry as defined by specific criteria for prostate specific antigen (PSA) progression OR soft tissue disease progression in the opinion of the Investigator (Note: subjects with bone disease progression alone are not eligible)
Age ≥ 18 years old or meeting country definition of adult, whichever is older, on the day of consent
ECOG performance status of 0 or 1
Recovery to baseline or ≤ Grade 1 per Common Terminology Criteria for Adverse Events (CTCAE) v5 from toxicities related to any prior treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive therapy in the opinion of the Investigator
Adequate organ and marrow function based upon specific laboratory assessments obtained within 21 days prior to randomization
Understanding and ability to comply with protocol requirements

Exclusion Criteria:

Any prior nonhormonal therapy initiated for the treatment of mCRPC
Receipt of abiraterone within 1 week; cyproterone within 10 days; or flutamide, nilutamide, bicalutamide, enzalutamide, or other androgen-receptor inhibitors within 2 weeks before randomization
Radiation therapy within 4 weeks (2 weeks for bone metastases) prior to randomization (subjects with clinically relevant ongoing complications from prior radiation therapy are not eligible)
Known brain metastases or cranial epidural disease unless adequately treated and clinically stable at least 4 weeks prior to randomization
Symptomatic or impending spinal cord compression or cauda equina syndrome
Concomitant anticoagulation with oral anticoagulants (some specific exceptions apply)
Administration of a live, attenuated vaccine within 30 days prior to randomization
Systematic treatment with, or any condition requiring, either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days prior to randomization
Uncontrolled, significant intercurrent or recent illness
Major surgery within 4 weeks prior to randomization
Corrected QT interval calculated by the Fridericia formula (QTcF) > 480 ms per ECG within 21 days before randomization
Inability or unwillingness to swallow pills or receive IV administration
Previously identified allergy or hypersensitivity to components of the study treatment formulations or history of severe infusion-related reactions to monoclonal antibodies
Any other active malignancy at time of randomization or diagnosis of another malignancy within 2 years prior to randomization that requires active treatment (some exceptions apply such as locally curable cancers that have apparently been cured).