Study of Apalutamide With Carotuximab in Metastatic, Castration-Resistant Prostate Cancer
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ClinicalTrials.gov Identifier: NCT05534646 |
Recruitment Status :
Not yet recruiting
First Posted : September 9, 2022
Last Update Posted : September 9, 2022
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Condition or disease | Intervention/treatment | Phase |
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Castration-resistant Prostate Cancer | Drug: Apalutamide Drug: Carotuximab | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Phase II Study of Apalutamide With Carotuximab in Metastatic, Castration-Resistant Prostate Cancer |
Estimated Study Start Date : | November 2022 |
Estimated Primary Completion Date : | November 2025 |
Estimated Study Completion Date : | November 2025 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Apalutamide monotherapy
After progression, subjects will crossover to combination therapy
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Drug: Apalutamide
Standard of care Apalutamide 240 mg administered orally and daily on Days 1-28 of every 28 day cycle |
Experimental: Combination therapy (Apalutamide + Carotuximab) |
Drug: Apalutamide
Standard of care Apalutamide 240 mg administered orally and daily on Days 1-28 of every 28 day cycle Drug: Carotuximab Carotuximab administered intravenously at the following doses: Cycle 1 Day 1: 3 mg/kg Cycle 1 Day 4: 7 mg/kg Cycle 1 Day 8: 10 mg/kg Cycle 1 Day 15: 10 mg/kg Cycle 1 Day 22: 10 mg/kg Cycle 2 Day 1: 15 mg/kg Cycle 2 Day 15: 15 mg/kg Cycle 3+ Day 1: 15 mg/kg After completion of cycle 2, dosing of carotuximab will continue at a q4 week schedule using the 15 mg/kg dose. |
- Radiographic progression free survival (rPFS) between patients receiving apalutamide and apalutamide + carotuximab [ Time Frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]From the start of study treatment until documented progression, per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3, or death due to any cause.
- Incidence of Adverse events (grade 3 or higher) related to carotuximab and apalutamide [ Time Frame: From start of study treatment through 4 weeks on treatment ]Grade 3 or above treatment related adverse events as assessed per NCI Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
- Overall radiographic response rate (ORR) of the combination of apalutamide + carotuximab [ Time Frame: From the start of combination study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]Participants of the combination of apalutamide + carotuximab, with confirmed complete response (CR) or partial response (PR) per RECIST v.1.1 and Prostate Cancer Working Group 3
- Proportion of patients resistant to apalutamide benefit from the addition of carotuximab [ Time Frame: From the start of combination therapy study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]Participants of the monotherapy group that crossover to combination therapy at progression, with confirmed complete response (CR) or partial response (PR) per RECIST v.1.1 and Prostate Cancer Working Group 3
- Overall radiographic response rate (ORR) in the overall population [ Time Frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]Determined by confirmed complete response (CR) or partial response (PR) per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3
- To determine the radiographic progression free survival (rPFS) in the overall population [ Time Frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]From the start of study treatment until documented progression, per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3, or death due to any cause.
- To determine the biochemical PFS (by PCWG3) in the overall population [ Time Frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment. ]From the start of study treatment until documented progression, per Prostate Cancer Working Group 3, or death due to any cause.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Male |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- History of castration-resistant prostate cancer with rising PSA (prostate-specific antigen) on a contemporary ARSI (Androgen receptor (AR) signaling inhibitor: abiraterone, enzalutamide, darolutamide). Bicalutamide, nilutamide, and flutamide will not be considered as contemporary ARSIs
- Patient must have had 1 and can have up to 2 prior AR targeted therapy with the exception of apalutamide.
- Patients must decline or be ineligible for taxane therapy in the opinion of the treating physician.
- All patients must agree to use an adequate method of contraception, in the opinion of the treating investigator, while on protocol treatment and for 3 months after the last dose of protocol treatment (apalutamide and/or carotuximab)
Exclusion Criteria:
- Non-PSA producing prostate cancers such as small cell prostate cancers or those prostate cancers which exhibit radiographic progression without PSA rise
- Prior use of apalutamide
- Other prior malignancy requiring active anticancer therapy
- Prior exposure to carotuximab or any CD105 targeted antibody
- Active bleeding or pathologic medical conditions that carries a high bleeding risk
- A known diagnosis of Osler-Weber-Rendu syndrome

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05534646
Contact: Clinical Trial Recruitment Navigator | 3104232133 | cancer.trial.info@cshs.org |
United States, California | |
Cedars-Sinai Medical Center | |
Los Angeles, California, United States, 90048 | |
Contact: Clinical Trial Recruitment Navigator 310-423-2133 cancer.trial.info@cshs.org | |
Sub-Investigator: Robert Figlin, MD FACP | |
Sub-Investigator: Jun Gong, MD | |
Sub-Investigator: Kevin Scher, MD MBA | |
Sub-Investigator: David Hoffman, MD | |
Sub-Investigator: Leland Green, MD | |
Sub-Investigator: Kristopher Wentzel, MD |
Principal Investigator: | Edwin Posadas, MD FACP | Cedars-Sinai Medical Center |
Responsible Party: | Edwin Posadas, MD, Co-Director, Experimental Therapeutics Program, Cedars-Sinai Medical Center |
ClinicalTrials.gov Identifier: | NCT05534646 |
Other Study ID Numbers: |
IIT2021-06-Posadas-APA105 |
First Posted: | September 9, 2022 Key Record Dates |
Last Update Posted: | September 9, 2022 |
Last Verified: | September 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Prostate cancer Castration-resistant CRPC |
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms |
Neoplasms by Site Neoplasms Prostatic Diseases |