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Published in: Targeted Oncology 3/2023

Open Access 15-04-2023 | Prostate Cancer | Original Research Article

A Phase I Clinical Trial Evaluating the Safety and Dosing of Relugolix with Novel Hormonal Therapy for the Treatment of Advanced Prostate Cancer

Authors: Jose De La Cerda, Curtis Dunshee, Lawrence Gervasi, Paul Sieber, Laurence Belkoff, Ronald Tutrone, Sophia Lu, Sergio C. Gatoulis, Bruce Brown, Elizabeth Migoya, Neal Shore

Published in: Targeted Oncology | Issue 3/2023

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Abstract

Background

Androgen deprivation therapy (ADT), a cornerstone of prostate cancer treatment, is commonly co-prescribed as combination therapy.

Objective

To better understand the safety and tolerability profile of relugolix, an oral non-peptide gonadotropin-releasing hormone (GnRH) receptor antagonist, in combination with abiraterone acetate (abiraterone) and apalutamide, a phase I study was undertaken.

Patients and Methods

This is an ongoing, 52-week, open-label, parallel cohort study of relugolix in combination with abiraterone in men with metastatic castration-sensitive prostate cancer (mCSPC) or metastatic castration-resistant prostate cancer (mCRPC) [Part 1] and apalutamide in men with mCSPC or non-metastatic castration-resistant prostate cancer (nmCRPC) [Part 2]. Eligible patients treated with leuprolide acetate or degarelix with abiraterone or apalutamide prior to baseline, at which time they were transitioned to relugolix. Assessments included reporting of adverse events, clinical laboratory tests, vital sign measurements, electrocardiogram (ECG) parameters, and testosterone serum concentrations. In this interim report, patients completing ≥12 weeks were included.

Results

Overall, 15 men were enrolled in Part 1 and 10 in Part 2. Adverse events were mostly mild-to-moderate in intensity and were consistent with the known safety profiles of the individual medications. No transition (from prior ADT treatment)- or time-related trends in clinical laboratory tests, vital sign measurements, or ECG parameters were observed. Mean testosterone concentrations remained below castration levels.

Conclusions

Combination therapy of relugolix and abiraterone or apalutamide was associated with a favorable safety and tolerability profile consistent with the known profiles of the individual medications. Castration levels of testosterone were maintained after transitioning to relugolix from other ADTs.

Clinical Trial Registration

ClinicalTrials.gov identifier: NCT04666129
Appendix
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Literature
1.
go back to reference ORGOVYX (relugolix) tablets [package insert]. Brisbane: Myovant Sciences, Inc.; 2022. ORGOVYX (relugolix) tablets [package insert]. Brisbane: Myovant Sciences, Inc.; 2022.
3.
go back to reference Suzuki H, Uemura H, Mizokami A, et al. Phase I trial of TAK-385 in hormone treatment-naïve Japanese patients with nonmetastatic prostate cancer. Cancer Med. 2019;8(13):5891–902.CrossRefPubMedPubMedCentral Suzuki H, Uemura H, Mizokami A, et al. Phase I trial of TAK-385 in hormone treatment-naïve Japanese patients with nonmetastatic prostate cancer. Cancer Med. 2019;8(13):5891–902.CrossRefPubMedPubMedCentral
4.
go back to reference MacLean DB, Shi H, Faessel HM, et al. Medical castration using the investigational oral GnRH antagonist TAK-385 (relugolix): phase 1 study in healthy males. J Clin Endocrinol Metab. 2015;100:4579–87.CrossRefPubMedPubMedCentral MacLean DB, Shi H, Faessel HM, et al. Medical castration using the investigational oral GnRH antagonist TAK-385 (relugolix): phase 1 study in healthy males. J Clin Endocrinol Metab. 2015;100:4579–87.CrossRefPubMedPubMedCentral
5.
go back to reference Dearnaley DP, Saltzstein DR, Sylvester JE, et al. The oral gonadotropin-releasing hormone receptor antagonist relugolix as neoadjuvant/adjuvant androgen deprivation therapy to external beam radiotherapy in patients with localised intermediate-risk prostate cancer: a randomised, open-label, parallel-group phase 2 trial. Eur Urol. 2020;78(2):184–92.CrossRefPubMed Dearnaley DP, Saltzstein DR, Sylvester JE, et al. The oral gonadotropin-releasing hormone receptor antagonist relugolix as neoadjuvant/adjuvant androgen deprivation therapy to external beam radiotherapy in patients with localised intermediate-risk prostate cancer: a randomised, open-label, parallel-group phase 2 trial. Eur Urol. 2020;78(2):184–92.CrossRefPubMed
6.
go back to reference Saad F, Bailen JL, Pieczonka CM, et al. Second interim analysis (IA2) results from a phase II trial of TAK-385, an oral GnRH antagonist, in prostate cancer patients (pts). J Clin Oncol. 2016;34(2 Suppl):200.CrossRef Saad F, Bailen JL, Pieczonka CM, et al. Second interim analysis (IA2) results from a phase II trial of TAK-385, an oral GnRH antagonist, in prostate cancer patients (pts). J Clin Oncol. 2016;34(2 Suppl):200.CrossRef
7.
go back to reference Shore ND, Saad F, Cookson MS, et al. Oral relugolix for androgen-deprivation therapy in advanced prostate cancer. N Engl J Med. 2020;382(23):2187–96.CrossRefPubMed Shore ND, Saad F, Cookson MS, et al. Oral relugolix for androgen-deprivation therapy in advanced prostate cancer. N Engl J Med. 2020;382(23):2187–96.CrossRefPubMed
8.
go back to reference National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. Prostate Cancer. 2022. Version 1.2023. 16 Sep 2022. Available at: www.NCCN.org. Accessed 18 Dec 2022. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. Prostate Cancer. 2022. Version 1.2023. 16 Sep 2022. Available at: www.​NCCN.​org. Accessed 18 Dec 2022.
9.
go back to reference Lowrance WT, Breau RH, Chou R, et al. Advanced prostate cancer: AUA/ASTRO/SUO guideline PART I. J Urol. 2021;205(1):14–21.CrossRefPubMed Lowrance WT, Breau RH, Chou R, et al. Advanced prostate cancer: AUA/ASTRO/SUO guideline PART I. J Urol. 2021;205(1):14–21.CrossRefPubMed
10.
go back to reference Parker C, Castro E, Fizazi K, et al. Electronic address: clinicalguidelines@esmo.org. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(9):1119–34.CrossRefPubMed Parker C, Castro E, Fizazi K, et al. Electronic address: clinicalguidelines@esmo.org. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(9):1119–34.CrossRefPubMed
11.
go back to reference Efstathiou E, Titus M, Tsavachidou D, et al. Effects of abiraterone acetate on androgen signaling in castrate-resistant prostate cancer in bone. J Clin Oncol. 2012;30(6):637–43.CrossRefPubMed Efstathiou E, Titus M, Tsavachidou D, et al. Effects of abiraterone acetate on androgen signaling in castrate-resistant prostate cancer in bone. J Clin Oncol. 2012;30(6):637–43.CrossRefPubMed
12.
go back to reference Zytiga (abiraterone) Prescribing information. Horsham: Janssen Biotech, Inc.; 2021. Zytiga (abiraterone) Prescribing information. Horsham: Janssen Biotech, Inc.; 2021.
13.
go back to reference Erleada (apalutamide) Prescribing Information. Horsham: Janssen Pharmaceutical Companies; 2019. Erleada (apalutamide) Prescribing Information. Horsham: Janssen Pharmaceutical Companies; 2019.
14.
go back to reference George DJ, Shore ND, Saad F, et al. Impact of concomitant prostate cancer therapy on efficacy and safety of relugolix versus leuprolide in men with advanced prostate cancer: Subgroup analysis from the phase III HERO study. J Clin Oncol. 2021;39(Suppl 6):106.CrossRef George DJ, Shore ND, Saad F, et al. Impact of concomitant prostate cancer therapy on efficacy and safety of relugolix versus leuprolide in men with advanced prostate cancer: Subgroup analysis from the phase III HERO study. J Clin Oncol. 2021;39(Suppl 6):106.CrossRef
15.
go back to reference Brown G, Belkoff L, Hafron JM, et al. Coadministration of apalutamide and relugolix in patients with localized prostate cancer at high risk for metastases. Target Oncol. 2023;18:95–103.CrossRefPubMed Brown G, Belkoff L, Hafron JM, et al. Coadministration of apalutamide and relugolix in patients with localized prostate cancer at high risk for metastases. Target Oncol. 2023;18:95–103.CrossRefPubMed
16.
go back to reference Scher HI, Morris MJ, Stadler WM, et al. Trial design and objectives for castration resistant prostate cancer: updated recommendations from the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016;34:1402–18.CrossRefPubMedPubMedCentral Scher HI, Morris MJ, Stadler WM, et al. Trial design and objectives for castration resistant prostate cancer: updated recommendations from the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016;34:1402–18.CrossRefPubMedPubMedCentral
17.
go back to reference Becker DJ, Iyengar AD, Punekar SR, et al. Treatment of metastatic castration-resistant prostate cancer with abiraterone and enzalutamide despite PSA progression. Anticancer Res. 2019;39(5):2467–73.CrossRefPubMed Becker DJ, Iyengar AD, Punekar SR, et al. Treatment of metastatic castration-resistant prostate cancer with abiraterone and enzalutamide despite PSA progression. Anticancer Res. 2019;39(5):2467–73.CrossRefPubMed
18.
go back to reference DeTora, et al. Good publication practice (GPP) guidelines for company-sponsored biomedical research: 2022 update. Ann Intern Med. 2022;175(9):1298–304.CrossRefPubMed DeTora, et al. Good publication practice (GPP) guidelines for company-sponsored biomedical research: 2022 update. Ann Intern Med. 2022;175(9):1298–304.CrossRefPubMed
Metadata
Title
A Phase I Clinical Trial Evaluating the Safety and Dosing of Relugolix with Novel Hormonal Therapy for the Treatment of Advanced Prostate Cancer
Authors
Jose De La Cerda
Curtis Dunshee
Lawrence Gervasi
Paul Sieber
Laurence Belkoff
Ronald Tutrone
Sophia Lu
Sergio C. Gatoulis
Bruce Brown
Elizabeth Migoya
Neal Shore
Publication date
15-04-2023
Publisher
Springer International Publishing
Published in
Targeted Oncology / Issue 3/2023
Print ISSN: 1776-2596
Electronic ISSN: 1776-260X
DOI
https://doi.org/10.1007/s11523-023-00967-5

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