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ProSTAR: A Study Evaluating CPI-1205 in Patients With Metastatic Castration Resistant Prostate Cancer

NCT03480646 — Phase 1 / Phase 2, Completed, 175 participants, Constellation Pharmaceuticals

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A Phase 1b/2 Study of CPI-1205, a Small Molecule Inhibitor of EZH2, Combined With Enzalutamide or Abiraterone/Prednisone in Patients With Metastatic Castration Resistant Prostate Cancer

RegistryNCT03480646
StatusCompleted
PhasePhase 1 / Phase 2
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment175 (Actual)
SponsorConstellation Pharmaceuticals (Industry)
ConditionsMetastatic Castration Resistant Prostate Cancer (mCRPC)
InterventionsCPI-1205, Cobicistat, Enzalutamide, Abiraterone, Prednisone (Drug)
Datesstart 2017-11-15, primary completion 2021-02-03, completion 2021-02-03, first posted 2018-03-29, last updated 2025-10-29
Locations41 sites in United States

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-Summary

This was an open-label Phase 1b/2 study involving oral administration of CPI-1205 in combination with either enzalutamide or abiraterone/prednisone in male patients with metastatic Castration-Resistant Prostate Cancer. The study was designed to determine the maximum tolerated dose (MTD) and the recommended Phase II dose (RP2D) based on the safety, tolerability, pharmacokinetic, and efficacy profiles of CPI-1205 in combination with either enzalutamide or abiraterone/prednisone.

Following the determination of the MTD and RP2D, the study proceeded to Phase 2. Patients in Phase 2 received CPI-1205 at the RP2D in combination with either enzalutamide or abiraterone/prednisone versus either enzalutamide or abiraterone/prednisone as a control arm.

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+Detailed description

Study CPI-1205-201 was a Phase 1b/2, multi-center, open-label study of CPI-1205 alone and with cobicistat in subjects with mCRPC in combination with either enzalutamide or abiraterone/prednisone. The study initially had two phases: a Phase 1 dose-finding, dose-escalation study intended to establish the Recommended Phase 2 Dose (RP2D) of CPI-1205 for the Phase 2 portion.

The study underwent three amendments.

PHASE 1b In the Phase 1b dose-escalation phase and prior to Amendment 2, subjects were enrolled into Phase 1b dose level CPI-1205 PO three times daily (TID) + enzalutamide or abiraterone/prednisone.

In Amendment 2, new subjects were enrolled into cohorts including:

Dose-escalating CPI-1205 PO twice daily (BID) + fixed-dose cobicistat PO BID + enzalutamide Dose-escalating CPI-1205 PO BID + fixed-dose cobicistat PO BID + abiraterone/prednisone In Amendment 3, Phase 1b expansion cohort(s) were added in the heavily pretreated population (HPEC). An HPEC began enrollment if 0 out of 3 or 1 out of 6 subjects treated with a specific regimen (i.e., CPI-1205 with or without cobicistat, in combination with enzalutamide or abiraterone) at a given dose level during Phase 1b dose escalation experienced a dose-limiting toxicity (DLT).

Following determination of the maximum tolerated dose (MTD) in each of the CPI-1205 BID + cobicistat combinations (and possibly in the CPI-1205 TID combination) and after evaluation of the BID cohorts without cobicistat (if applicable), only one of the CPI-1205 dosing schedules was selected as the RP2D for each combination. One or both combinations proceeded to Phase 2 after consideration of pharmacokinetic (PK) and pharmacodynamic (PD) results, data from the HPEC(s), and safety data.

PHASE 2 If only one partner product was chosen for Phase 2, the study proceeded as an open-label randomized Phase 2 trial, with subjects randomized to either the combination arm (CPI-1205 at the RP2D \[with or without cobicistat\] in combination with enzalutamide or abiraterone/prednisone) or the control arm (enzalutamide or abiraterone/prednisone as monotherapy). If both partner products were chosen, the second Phase 2 was either a second open-label randomized trial or a single-arm Phase 2 trial (following a Simon's 2-stage design). The design of the second trial was determined by the Sponsor based on preliminary efficacy and PK.

CPI-1205 was administered orally TID or BID (as of Amendment 2). Cobicistat dosing began with one dose the evening prior to Day 1 of CPI-1205 and continued PO BID starting on Day 1. Enzalutamide and abiraterone were given PO once daily, and prednisone was given PO BID (or at the investigator's discretion).

Successive 28-day treatment cycles were repeated without planned breaks, as long as the combination was well tolerated, until radiographic disease progression, unequivocal clinical progression, or planned initiation of another systemic treatment. Investigators could continue treatment in subjects with progression in one site if other lesions might benefit. Subjects in the control arm who progressed had the option to cross over to the combination arm, provided they met eligibility criteria.

+Arms and interventions

ArmTypeInterventionsDescription
Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + EnzaExperimentalDrug: CPI-1205; Drug: Cobicistat; Drug: EnzalutamideCPI-1205 400 mg BID in combination with Cobicistat 150 mg PO BID and Enzalutamide 160 mg PO QD (28-day cycles)
Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi+ Abi/PredExperimentalDrug: CPI-1205; Drug: Cobicistat; Drug: Abiraterone; Drug: PrednisoneCPI-1205 400 mg BID in combination with Cobicistat 150 mg PO BID and Abiraterone 100 mg PO QD and Prednisone 5 mg PO BID (28-day cycle)
Phase 1b Dose Escalation: CPI-1205 800 mg TID + EnzaExperimentalDrug: CPI-1205; Drug: EnzalutamideCPI-1205 800 mg TID in combination with Enzalutamide 160 mg PO QD (28-day cycle)
Phase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/PredExperimentalDrug: CPI-1205; Drug: Abiraterone; Drug: PrednisoneCPI-1205 800 mg TID in combination with Abiraterone 100 mg PO QD and Prednisone 5 mg PO BID (28-day cycle)
Phase 1b HPEC: CPI-1205 800 mg TID + EnzaExperimentalDrug: CPI-1205; Drug: EnzalutamideCPI-1205 800 mg TID highly pretreated expansion cohort (HEPC) in combination with Enzalutamide 160 mg PO QD (28-day cycles)
Phase 2 Randomized Controlled Group: EnzaActive comparatorDrug: EnzalutamideDrug: Enzalutamide 160mg PO QD (28-day cycles)
Phase 2 Randomized at RP2D: CPI-1205 800 mg TID + EnzaExperimentalDrug: CPI-1205; Drug: EnzalutamideCPI-1205 (at Recommended Phase 2 Dose \[RP2D\]) in combination with Drug: Enzalutamide 160 mg PO QD
Phase 2 Single Arm at RP2D: CPI-1205 800 mg TID + Abi/PredExperimentalDrug: CPI-1205; Drug: Abiraterone; Drug: PrednisoneCPI-1205 at 800 mg TID (Recommended Phase 2 Dose \[RP2D\]) 800 mg TID in combination with Abiraterone 1000 mg PO QD and Prednisone 5 mg PO BID (28-day cycles)
  • CPI-1205 (Drug): CPI-1205: Either 400 mg BID or 800 mg TID during Phase 1 dose-escalation and RP2D, 800 mg TID, for Phase 2
  • Cobicistat (Drug): Cobicistat 150 mg PO BID
  • Enzalutamide (Drug): Enzalutamide 160mg PO QD
  • Abiraterone (Drug): Abiraterone 1000mg PO QD
  • Prednisone (Drug): Prednisone 5mg PO BID

+Outcome measures

Primary outcomes

  • Efficacy: Best Objective Response Rate Percent by Treatment Group [Up to 2 years [or until disease progression or unacceptable toxicity]]: Best overall response rate (%) defined as complete response (CR) + partial response (PR) divided by the total number of subjects as assessed by Investigator. The response assessment was performed per Prostate Cancer Working Group 3 (PCWG3) based on modifications of the RECIST 1.1 criteria. Per RECIST 1.1, a CR was assessed when all target lesions disappeared (any pathological lymph node must have reduction in short axis to <10 mm) in the post-baseline scan. A PR was assessed when there was at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters.
  • Efficacy: Percentage (%) of Subjects With PSA30 [2 years [or until progressive disease or unacceptable toxicity]]: The number of subjects who had a confirmed reduction of 30% of prostate-specific antigen (PSA30) from baseline
  • Efficacy: Percentage (%) of Subjects With PSA50 [2 years [or until progressive disease or unacceptable toxicity]]: The number of subjects who had a confirmed reduction of 50% of prostate-specific antigen (PSA50) from baseline
  • Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups [Up to 2 years [or until progressive disease or unacceptable toxicity]]: Subjects who had a circulating tumor cell of 30% (CTC 30%) or an objective response rate divided by the number of evaluable subjects

Secondary outcomes

  • Efficacy: Best Responses by Treatment Group [Up to 2 years [or until disease progression or unacceptable toxicity]]: Best overall response defined as complete response (CR), partial response (PR); stable disease (SD); progressive disease (PD); and unknown/missing for the Phase 1b dose-escalation group, the Phase 1b HPEC group, the Phase 2 randomized groups, crossover group and the Phase 2 single-arm group. Assessed by Investigator
  • Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation [Up to 2 years [or until clinical progression, radiographic disease progression, or until unacceptable toxicity]]: Treatment-emergent Adverse events (AEs) leading to subjects withdrawing from treatment

+Eligibility

Sex: Male, ages: 18 Years to any

PHASE 1b DOSE ESCALATION

Inclusion Criteria for Phase 1b Dose Escalation

Patients must meet all the following criteria to be enrolled in this study:

1. Age ≥ 18 years
2. Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
3. Life expectancy of at least 12 weeks
4. Histologically or cytologically confirmed adenocarcinoma of the prostate (pure small cell carcinoma excluded)
5. Documented metastatic disease
6. Must have undergone bilateral orchiectomy (surgical castration) or willing to continue gonadotropin-releasing hormone (GnRH) analog or antagonist (medical castration)
7. Serum testosterone < 50 ng/dL
8. Progressive disease in the setting of medical or surgical castration (i.e., Castration-resistant Prostate Cancer \[CRPC\]) as assessed by the investigator and includes at least one of the following:

   1. Evidence of progression as measured by PSA increase of ≥ 25% and an absolute increase of ≥ 2 ng/mL in < 6 months from end of last therapy prior to enrollment and/or
   2. Soft tissue disease progression as per Response Evaluation Criteria in Solid Tumors (RECIST) and/or
   3. Bone disease progression defined by two or more new lesions on bone scan
9. Bisphosphonate or denosumab therapy allowed provided dose has been stable for at least 4 weeks prior to Day 1 of treatment
10. Prior treatment:

    1. Prior treatment for metastatic CRPC (mCRPC) must have included at least one line with a second-generation androgen inhibitor (e.g., abiraterone, enzalutamide, apalutamide, daralutamide)
    2. Prior chemotherapy permitted when administered in the metastatic hormone-sensitive prostate cancer setting. In addition, up to one line of chemotherapy is allowed in the mCRPC setting.
    3. Prior treatment with sipuleucel-T, radium-223, or other non-chemotherapy based treatments for mCRPC (e.g., olaparib, pembrolizumab) is allowed.
11. Recovery from recent surgery, radiotherapy, chemotherapy or other anti-cancer treatment to baseline or ≤ Grade 1 (other than alopecia)
12. Demonstrate adequate organ function as defined in the table below; all Screening labs obtained within 28 days prior to Day 1 of treatment.
13. Patients who have not undergone a bilateral orchiectomy and have a female partner of childbearing potential must use an adequate barrier method of contraception during study treatment and for 90 days after receiving the last dose of CPI-1205
14. Willing to provide access to archival tumor tissue for research purposes
15. Ability to swallow and retain oral medications
16. Ability to understand and willingness to sign an IRB approved written informed consent form (ICF) and authorization permitting release of personal health information including genetic testing relevant to cancer.
17. Able to comply with study visit schedule and assessments

Exclusion Criteria for Phase 1b Dose Escalation

Patients who meet any of the following criteria will not be enrolled in the study:

1. Known symptomatic brain metastases
2. Treatment with any of the following for prostate cancer within the indicated timeframe prior to Day 1 of treatment

   1. First generation: AR antagonists (e.g., bicalutamide, nilutamide, flutamide) within 4 weeks
   2. 5 alpha reductase inhibitors, ketoconazole, estrogens (including diethylstilbesterol \[DES\]), or progesterones within 2 weeks
   3. Chemotherapy within 3 weeks
   4. Biologic therapy within 4 weeks
   5. Investigational therapy within 3 weeks (or within a time interval less than at least 5 half-lives of the investigational agent \[if known\], whichever is longer).
   6. Immunotherapy within 4 weeks
   7. Radionuclide therapy within 4 weeks
3. Radiation therapy for the treatment of metastasis within 1 week prior to Day 1 of treatment
4. Herbal products that may decrease PSA levels within 4 weeks prior to day 1 of treatment
5. Systemic steroids greater than 10 mg of prednisone/prednisolone per day within 4 weeks prior to day 1 of treatment
6. Major surgery within 4 weeks prior to Day 1 of treatment
7. Planned palliative procedures for alleviation of bone pain such as radiation therapy or surgery
8. Structurally unstable bone lesions concerning for impending fracture
9. Clinically significant cardiovascular disease including:

   1. Myocardial infarction (MI)/Stroke within 6 months prior to Day 1 of treatment
   2. Uncontrolled angina within 3 months
   3. Congestive heart failure (CHF) with New York Heart Association (NYHA) Class 3 or 4
   4. History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes)
   5. Uncontrolled hypertension (systolic blood pressure (BP) > 170 mmHg or diastolic BP > 105 mmHg at screening) despite 2 concomitant antihypertensive therapies
   6. QT interval corrected by the Fridericia correction formula (QTcF) > 500 msec on the screening ECG
10. Active or symptomatic viral hepatitis or chronic liver disease
11. History of unresolved adrenal dysfunction
12. GI disorder that negatively affects absorption
13. Required treatment with one of the prohibited concomitant medications;
14. Achlorhydria, either documented or suspected on the basis of an associated disease (e.g., pernicious anemia, atrophic gastritis, or certain gastric surgical procedures)
15. History of seizure, underlying brain injury with loss of consciousness, transient ischemic attack within 12 months prior to Day 1 of treatment, cerebral vascular accident or brain arteriovenous malformation
16. Known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ bladder cancer, or other cancer for which the patient has been disease-free for at least two years
17. Any other concurrent severe and/or uncontrolled concomitant medical condition that could compromise participation in the study (e.g., clinically significant pulmonary disease, clinically significant psychiatric or neurological disorder, active or uncontrolled infection)
18. Patient unwilling or unable to comply with this study protocol

PHASE 1b: HEAVILY PRETREATED EXPANSION COHORT (HPEC)

Inclusion Criteria for Phase 1b HPEC

Patients must meet all the following criteria to be enrolled in this study:

1. Age ≥ 18 years
2. ECOG Performance Status 0-1
3. Life expectancy of at least 12 weeks
4. Histologically or cytologically confirmed adenocarcinoma of the prostate (pure small cell carcinoma excluded)
5. Documented metastatic disease
6. At least 1 measurable lymph node per Prostate Cancer Clinical Trials Working Group 3 (PCWG3)
7. Must have undergone bilateral orchiectomy (surgical castration) or willing to continue GnRH analog or antagonist (medical castration)
8. Serum testosterone < 50 ng/dL
9. Progressive disease in the setting of medical or surgical castration (i.e., CRPC) as assessed by the investigator and that includes at least 1 of the following:

   1. Evidence of progression as measured by PSA defined as: PSA at least 2 ng/mL (or PSA at least 1 ng/mL if PSA progression is the only manifestation of progressive disease) and rising PSA by at least 2 consecutive measurements a minimum of 1-week apart and/or
   2. Soft tissue disease progression as per RECIST 1.1 and/or
   3. Bone disease progression defined by two or more new lesions on bone scan
10. Prior treatment:

    1. Only 1 prior line of a second-generation androgen inhibitor from a different class than the one chosen for the applicable phase 2 study (the 2 classes are CYP17 inhibitors \[e.g., abiraterone, orteronel\] and AR inhibitors \[e.g., enzalutamide, apalutamide\]). Patient must have progressed after ≥ 24 weeks of treatment with this second generation angrogen inhibitor.
    2. The last second-generation androgen inhibitor treatment received must not be from the same class as that incorporated in the applicable HPEC; i.e., if the HPEC incorporates enzalutamide, the last second generation androgen inhibitor therapy cannot be enzalutamide, apalutamide, etc.
    3. Prior chemotherapy for mCRPC must have included at least 1 and no more than 2 prior lines of taxane-based chemotherapy administered in the metastatic hormone-sensitive prostate cancer setting is allowed
    4. Prior treatment with sipuleucel-T, radium-223, or other non-chemotherapy-based treatments for mCRPC (e.g., olaparib, pembrolizumab, nivolumab) is allowed.
11. Recovery from recent surgery, radiotherapy, chemotherapy or other anti-cancer treatment to baseline or ≤ Grade 1 (other than alopecia)
12. Demonstrate adequate organ function as defined in the table below; all Screening labs to be obtained within 28 days prior to Day 1 of treatment
13. Patients who had not undergone a bilateral orchiectomy and have a female partner of childbearing potential must use an adequate barrier method of contraception during study treatment and for 90 days after receiving the last dose of CPI-1205
14. Willing to provide access to archival tumor tissue for research purposes
15. Ability to swallow and retain oral medications
16. Ability to understand and willingness to sign an IRB approved written ICF and authorization permitting release of personal health information including genetic testing relevant to cancer.
17. Able to comply with study visit schedule and assessments

Exclusion Criteria for Phase 1b HPEC

Patients meeting any of the following criteria will not be enrolled in the study:

1. Known symptomatic brain metastases
2. Treatment with any of the following for prostate cancer within the indicated timeframe prior to Day 1 of treatment

   1. First-generation: AR antagonists (e.g., bicalutamide, nilutamide, flutamide) within 4 weeks
   2. 5-alpha reductase inhibitors, ketoconazole, estrogens (including DES), or progesterones within 2 weeks
   3. Chemotherapy within 3 weeks
   4. Biologic therapy within 4 weeks
   5. Investigational therapy within 3 weeks (or within a time interval less than at least 5 half-lives of the investigational agent \[if known\], whichever is longer).
   6. Immunotherapy within 4 weeks
   7. Radionuclide therapy within 4 weeks
3. Radiation therapy for the treatment of metastasis within 1 week prior to Day 1 of treatment
4. Herbal products that may decrease PSA levels within 4 weeks prior to Day 1 of treatment
5. Systemic steroids greater than 10 mg of prednisone/prednisolone per day within 4 weeks prior to Day 1 of treatment
6. Major surgery within 4 weeks prior to Day 1 of treatment
7. Structurally unstable bone lesions concerning for impending fracture
8. Clinically significant cardiovascular disease including:

   1. MI/Stroke within 6 months prior to Day 1 of treatment
   2. Uncontrolled angina within 3 months
   3. CHF with NYHA Class 3 or 4
   4. History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes)
   5. Uncontrolled hypertension (systolic BP > 170 mmHg or diastolic BP > 105 mmHg at screening) despite two concomitant antihypertensive therapies
   6. QTcF >500 msec on the screening ECG
9. Active or symptomatic viral hepatitis or chronic liver disease
10. History of unresolved adrenal dysfunction
11. GI disorder that negatively affects absorption
12. Required treatment with one of the prohibited concomitant medications
13. Achlorhydria, either documented or suspected on the basis of an associated disease (e.g., pernicious anemia, atrophic gastritis, or certain gastric surgical procedures)
14. History of seizure, underlying brain injury with loss of consciousness, transient ischemic attack within 12 months prior to day 1 of treatment, cerebral vascular accident or brain arteriovenous malformation
15. Known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ bladder cancer, or other cancer for which the patient has been disease-free for at least 2 years
16. Any other concurrent severe and/or uncontrolled concomitant medical condition that could compromise participation in the study (e.g., clinically significant pulmonary disease, clinically significant psychiatric or neurological disorder, active or uncontrolled infection)
17. Patient unwilling or unable to comply with this study protocol

PHASE 2

Phase 2 Inclusion Criteria

Patients must meet all of the following criteria to be enrolled in this study:

1. Age ≥ 18 years
2. ECOG Performance Status 0-1
3. Life expectancy of at least 12 weeks
4. Histologically or cytologically confirmed adenocarcinoma of the prostate (pure small cell carcinoma excluded)
5. Documented metastatic disease
6. Must have undergone bilateral orchiectomy (surgical castration) or willing to continue GnRH analog or antagonist (medical castration).
7. Serum testosterone <5 0 ng/dL
8. Progressive disease in the setting of medical or surgical castration (i.e., CRPC) as assessed by the investigator and that includes at least 1 of the following:

   1. Evidence of progression as measured by PSA defined as: PSA greater than or equal to 2 ng/mL (or PSA greater than or equal to 1 ng/mL if PSA progression is the only manifestation of progressive disease) and rising PSA by at least 2 consecutive measurements a minimum of 1-week apart and/or
   2. Soft tissue disease progression as per RECIST 1.1 and/or
   3. Bone disease progression defined by two or more new lesions on bone scan
9. Bisphosphonate or denosumab therapy allowed provided dose has been stable for ≥ 4 weeks prior to Day 1 of treatment.
10. Prior treatment:

    1. Only one prior line of a second-generation androgen inhibitor from a different class than the one chosen for the applicable phase 2 study (the 2 classes are CYP17 inhibitors \[e.g., abiraterone, orteronel\] and AR inhibitors \[e.g., enzalutamide, apalutamide\]). Patient must have progressed after ≥ 24 weeks of treatment with this second generation angrogen inhibitor
    2. No prior chemotherapy for mCRPC allowed; chemotherapy (including taxane-based) administered in the metastatic hormone-sensitive prostate cancer setting is allowed.
    3. Prior treatment with sipuleucel-T, radium-223, or other non-chemotherapy based treatments approved by the US FDA for the treatment of mCRPC is allowed; prior treatment with non-chemotherapy based treatments that are not approved for the treatment of mCRPC (e.g., pembrolizumab, ipilimumab, olaparib) are not allowed.
11. Recovery from recent surgery, radiotherapy, chemotherapy or other anti-cancer treatment to baseline or ≤ Grade 1 (other than alopecia)
12. Demonstrate adequate organ function
13. Patients who have not undergone a bilateral orchiectomy and have a female partner of childbearing potential must use an adequate barrier method of contraception during study treatment and for 90 days after receiving the last dose of CPI-1205 (or partner drug in the control arm of any randomized phase 2 trial if the patient does not participate in the crossover).
14. Willing to provide access to archival tumor tissue for research purposes, if available
15. Ability to swallow and retain oral medications.
16. Ability to understand and willingness to sign an IRB approved written ICF and authorization permitting release of personal health information including genetic testing relevant to cancer.
17. Able to comply with study visit schedule and assessments

Phase 2 Exclusion Criteria

Patients who meet any of the following criteria will not be enrolled in the study:

1. Known symptomatic brain metastases
2. Treatment with any of the following for prostate cancer within the indicated timeframe prior to Day 1 of treatment

   1. First-generation AR antagonists (e.g., bicalutamide, nilutamide, flutamide) within 4 weeks
   2. 5-alpha reductase inhibitors, ketoconazole, estrogens (including DES), or progesterones within 2 weeks
   3. Chemotherapy within 3 weeks
   4. Biologic therapy within 4 weeks
   5. Radionuclide therapy within 4 weeks
3. Radiation therapy for the treatment of metastasis within 1 week prior to Day 1 of treatment
4. Herbal products that may decrease PSA levels within 4 weeks prior to Day 1 of treatment
5. Systemic steroids > 10 mg of prednisone/prednisolone per day within 4 weeks prior to Day 1 of treatment
6. Major surgery within 4 weeks prior to Day 1 of treatment
7. Planned palliative procedures for alleviation of bone pain such as radiation therapy or surgery
8. Structurally unstable bone lesions concerning for impending fracture
9. Clinically significant cardiovascular disease including:

   1. MI/stroke within 6 months prior to day 1 of treatment
   2. Unstable angina within 3 months
   3. CHF with NYHA Class 3 or 4
   4. History of clinically significant ventricular arrhythmias (e.g., ventricular tachycardia, ventricular fibrillation, torsades de pointes)
   5. Uncontrolled hypertension (systolic BP > 170 mmHg or diastolic BP > 105 mmHg at screening) despite two concomitant antihypertensive therapies
   6. QTcF > 500 msec on the screening ECG
10. Active or symptomatic viral hepatitis or chronic liver disease
11. History of unresolved adrenal dysfunction
12. GI disorder that negatively affects absorption
13. Required treatment with one of the prohibited concomitant medications
14. Achlorhydria, either documented or suspected on the basis of an associated disease (e.g., pernicious anemia, atrophic gastritis, or certain gastric surgical procedures)
15. History of seizure, underlying brain injury with loss of consciousness, transient ischemic attack within 12 months prior to Day 1 of treatment, cerebral vascular accident or brain arteriovenous malformation
16. Known additional malignancy that is active and/or progressive requiring treatment; exceptions include basal cell or squamous cell skin cancer, in situ bladder cancer, or other cancer for which the patient has been disease-free for at least two years
17. Any other concurrent severe and/or uncontrolled concomitant medical condition that could compromise participation in the study (e.g., clinically significant pulmonary disease, clinically significant psychiatric or neurological disorder, active or uncontrolled infection)
18. Patient unwilling or unable to comply with this study protocol

+Posted results

Participant flow

MilestonePhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + EnzaPhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/PredPhase 1b Dose Escalation: CPI-1205 800 mg TID + EnzaPhase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/PredPhase 1b HPEC: CPI-1205 800 mg TID Heavily Pre-treated Expansion Cohort + EnzaPhase 2 Randomized Controlled: EnzaPhase 2 Randomized Experimental: CPI-1205 at RP2D + EnzaPhase 2 Single Arm: CPI-1205 (at RP2D) +Abi/Pred
Started7891332353932
Phase 2: crossover from enza to cpi-1205 800mg tid + enza000001200
Safety analysis set (saf)7891231353932
Full analysis set (fas)7891231353932
Efficacy analysis set (eas)5791125353828
Completed00000000
Not completed7891332353932

Outcome results

  • Efficacy: Best Objective Response Rate Percent by Treatment Group (Primary), Number, Percent (%) of subjects: Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza 0 (0 to 52.18); Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred 0 (0 to 40.96); Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza 0 (0 to 33.63); Phase 1b Dose Escalation: CPI-1205 800 mg TID +Abi/Pred 0 (0 to 28.49); Phase 1b HPEC: Heavily Pretreated Expansion Cohort CPI-1205 800 mg TID + Enza 8.00 (0.98 to 26.03); Phase 2 Randomized Controlled: Enza 5.71 (0.70 to 19.16); Phase 2 Randomized Experimental: CPI-1205 at RP2D (800 mg TID) + Enza 7.89 (1.66 to 21.38); Phase 2 Randomized Crossover Period 0 (0 to 26.46); Phase 2 Single Arm CPI-1205 at RP2D (800 mg TID) + Abi/Pred 0 (0 to 12.34)
  • Efficacy: Percentage (%) of Subjects With PSA30 (Primary), Count of participants, Participants: Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Enza 1; Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Abi/Pred 1; Phase 1b Dose Escalation: CPI-1205 800mg TID +Enza 2; Phase 1b Dose Escalation: CPI-1205 800mg TID +Abi/Pred 1; Phase 1b HPEC [Heavily Pre-treated Expansion Cohort] CPI-1205 800mg TID +Enza 7; Phase 2 Randomized Enza Contro 7; Phase 2 Randomized Combination With Enza 12; Phase 2 Randomized Crossover Period 1; Phase 2 Single Arm CPI-1205 +Abi/Pred 4
  • Efficacy: Percentage (%) of Subjects With PSA50 (Primary), Count of participants, Participants: Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Enza 1; Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Abi/Pred 1; Phase 1b Dose Escalation: CPI-1205 800mg TID +Enza 1; Phase 1b Dose Escalation: CPI-1205 800mg TID +Abi/Pred 1; Phase 1b HPEC [Heavily Pre-treated Expansion Cohort] CPI-1205 800mg TID +Enza 4; Phase 2 Randomized Enza Contro 5; Phase 2 Randomized Combination With Enza 10; Phase 2 Randomized Crossover Period 0; Phase 2 Single Arm CPI-1205 +Abi/Pred 2
  • Efficacy: Composite Response Rate (%) for Phase 2 Randomized and Phase 2 Single-arm Treatment Groups (Primary), Number, Percent (%) of subjects: Phase 2 Randomized Enza Contro 17.1 (6.6 to 33.6); Phase 2 Randomized Combination With Enza 31.4 (16.9 to 49.3); Phase 2 Randomized Crossover Period 0 (0.0 to 30.8); Phase 2 Single Arm CPI-1205 +Abi/Pred 21.4 (8.3 to 41.0)
  • Efficacy: Best Responses by Treatment Group (Secondary), Count of participants, Participants: Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Enza 0; Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Abi/Pred 0; Phase 1b Dose Escalation: CPI-1205 800mg TID +Enza 0; Phase 1b Dose Escalation: CPI-1205 800mg TID +Abi/Pred 0; Phase 1b HPEC [Heavily Pre-treated Expansion Cohort] CPI-1205 800mg TID +Enza 0; Phase 2 Randomized Enza Contro 0; Phase 2 Randomized Combination With Enza 0; Phase 2 Randomized Crossover Period 0; Phase 2 Single Arm CPI-1205 +Abi/Pred 0
  • Safety: Number of Participants With Treatment-emergent AEs Leading to Treatment Discontinuation (Secondary), Count of participants, Participants: Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Enza 0; Phase 1b Dose Escalation: CPI-1205 400mg BID +Cobi+Abi/Pred 4; Phase 1b Dose Escalation: CPI-1205 800mg TID +Enza 0; Phase 1b Dose Escalation: CPI-1205 800mg TID +Abi/Pred 2; Phase 1b HPEC [Heavily Pre-treated Expansion Cohort] CPI-1205 800mg TID +Enza 4; Phase 2 Randomized Enza Contro 2; Phase 2 Randomized Combination With Enza 4; Phase 2 Randomized Crossover Period 0; Phase 2 Single Arm CPI-1205 +Abi/Pred 2

Adverse events

Time frame: Up to 2 years [or until progressive disease or unacceptable toxicity]

ArmDeathsSerious adverse eventsOther adverse events
Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Enza1/7 (14.3%)2/7 (28.6%)7/7 (100.0%)
Phase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/Pred2/8 (25.0%)3/8 (37.5%)8/8 (100.0%)
Phase 1b Dose Escalation: CPI-1205 800 mg TID + Enza1/9 (11.1%)2/9 (22.2%)9/9 (100.0%)
Phase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/Pred1/12 (8.3%)1/12 (8.3%)12/12 (100.0%)
Phase 1b HPEC: CPI-1205 800 mg TID Heavily Pretreated Expansion Cohort + Enza17/31 (54.8%)11/31 (35.5%)31/31 (100.0%)
Phase 2 Randomized Control: Enza10/35 (28.6%)8/35 (22.9%)33/35 (94.3%)
Phase 2 Randomized Experimental: CPI-1205 at RP2D + Enza7/39 (17.9%)5/39 (12.8%)38/39 (97.4%)
Phase 2 Randomized Crossover Period4/12 (33.3%)0/12 (0.0%)11/12 (91.7%)
Phase 2 Single Arm: CPI-1205 (at RP2D) + Abi/Pred9/32 (28.1%)1/32 (3.1%)30/32 (93.8%)

Serious adverse events by term

TermOrgan systemPhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + EnzaPhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/PredPhase 1b Dose Escalation: CPI-1205 800 mg TID + EnzaPhase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/PredPhase 1b HPEC: CPI-1205 800 mg TID Heavily Pretreated Expansion Cohort + EnzaPhase 2 Randomized Control: EnzaPhase 2 Randomized Experimental: CPI-1205 at RP2D + EnzaPhase 2 Randomized Crossover PeriodPhase 2 Single Arm: CPI-1205 (at RP2D) + Abi/Pred
PainGeneral disorders1/70/80/90/120/310/350/390/120/32
Pelvic massGeneral disorders0/71/80/90/120/310/350/390/120/32
Systemic inflammatory response syndromeGeneral disorders0/70/80/91/120/310/350/390/120/32
Acute coronary syndromeCardiac disorders1/70/80/90/120/310/350/390/120/32
Cardiac failure congestiveCardiac disorders0/70/81/90/120/310/350/390/120/32
PneumoniaInfections and infestations0/71/80/90/120/311/350/390/120/32
Urinary tract infectionInfections and infestations0/71/80/90/121/310/350/390/120/32
Anal hemorrhageGastrointestinal disorders0/70/81/90/120/310/350/390/120/32
HypervolaemiaMetabolism and nutrition disorders0/70/81/90/120/310/350/390/120/32
Neoplasm malignantNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/70/80/90/120/310/350/390/120/32
Cerebrovascular accidentNervous system disorders1/70/80/90/121/310/350/390/120/32
Acute respiratory failureRespiratory, thoracic and mediastinal disorders0/71/80/90/120/310/350/390/120/32
HypotensionVascular disorders0/71/80/90/120/310/350/390/120/32
Depressed level of consciousnessNervous system disorders0/70/80/90/121/310/350/390/120/32
Spinal cord compressionNervous system disorders0/70/80/90/121/310/351/390/120/32
SyncopeNervous system disorders0/70/80/90/121/311/350/390/120/32
Acute kidney injuryRenal and urinary disorders0/70/80/90/122/310/350/390/120/32
Urinary tract obstructionRenal and urinary disorders0/70/80/90/122/310/350/390/120/32
HydronephrosisRenal and urinary disorders0/70/80/90/121/310/350/390/120/32
PyelonephritisInfections and infestations0/70/80/90/121/310/350/390/120/32
Prostate cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/70/80/90/121/310/350/390/120/32
Tumor painNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/70/80/90/121/310/350/390/120/32
Upper limb fractureInjury, poisoning and procedural complications0/70/80/90/121/310/350/390/120/32
AcidosisMetabolism and nutrition disorders0/70/80/90/121/310/350/390/120/32
Back painMusculoskeletal and connective tissue disorders0/70/80/90/121/310/350/390/120/32
CellullitisInfections and infestations0/70/80/90/120/310/351/390/120/32
Streptococcal sepsisInfections and infestations0/70/80/90/120/310/351/390/120/32
ArthralgiaMusculoskeletal and connective tissue disorders0/70/80/90/120/311/350/390/120/32
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders0/70/80/90/120/310/351/390/120/32
Pathological fractureMusculoskeletal and connective tissue disorders0/70/80/90/120/311/350/390/120/32
IleusGastrointestinal disorders0/70/80/90/120/310/351/390/120/32
Rectal hemorrhageGastrointestinal disorders0/70/80/90/120/311/350/390/120/32
Malignant melanomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/70/80/90/120/311/350/390/120/32
Transitional cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/70/80/90/120/311/350/390/120/32
Supraventricular tachycardiaCardiac disorders0/70/80/90/120/311/350/390/120/32
AstheniaGeneral disorders0/70/80/90/120/311/350/390/120/32
Musculoskeletal procedural complicationInjury, poisoning and procedural complications0/70/80/90/120/310/351/390/120/32
HaematuriaRenal and urinary disorders0/70/80/90/120/310/350/390/121/32

Other adverse events by term

TermOrgan systemPhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + EnzaPhase 1b Dose Escalation: CPI-1205 400 mg BID + Cobi + Abi/PredPhase 1b Dose Escalation: CPI-1205 800 mg TID + EnzaPhase 1b Dose Escalation: CPI-1205 800 mg TID + Abi/PredPhase 1b HPEC: CPI-1205 800 mg TID Heavily Pretreated Expansion Cohort + EnzaPhase 2 Randomized Control: EnzaPhase 2 Randomized Experimental: CPI-1205 at RP2D + EnzaPhase 2 Randomized Crossover PeriodPhase 2 Single Arm: CPI-1205 (at RP2D) + Abi/Pred
FatigueGeneral disorders3/73/87/94/1212/3118/3523/396/126/32
Axillary PainGeneral disorders0/70/80/92/120/310/350/390/120/32
Peripheral edemaGeneral disorders2/70/82/92/122/312/350/391/121/32
DiarrhoeaGastrointestinal disorders2/72/86/95/1214/316/3521/398/1218/32
NauseaGastrointestinal disorders0/73/85/94/1215/316/3512/394/129/32
ConstipationGastrointestinal disorders1/72/81/90/127/313/354/392/120/32
Abdominal painGastrointestinal disorders1/70/81/90/123/313/352/391/123/32
VomitingGastrointestinal disorders0/70/80/92/125/312/359/391/123/32
ArthralgiaMusculoskeletal and connective tissue disorders4/70/81/93/126/319/353/394/122/32
Back painMusculoskeletal and connective tissue disorders3/71/84/92/125/315/355/392/123/32
Muscular weaknessMusculoskeletal and connective tissue disorders1/70/81/90/121/315/353/391/121/32
Pain in extremityMusculoskeletal and connective tissue disorders1/71/82/94/120/311/357/391/126/32
Decreased appetiteMetabolism and nutrition disorders2/73/82/93/129/315/359/391/121/32
HypertriglyceridaemiaMetabolism and nutrition disorders1/70/80/90/122/312/353/392/121/32
HypocalcaemiaMetabolism and nutrition disorders0/70/80/92/121/311/350/391/121/32
HypokalaemiaMetabolism and nutrition disorders0/71/80/93/122/310/351/390/122/32
HypomagnesaemiaMetabolism and nutrition disorders0/70/81/91/121/311/351/391/120/32
HypophosphataemiaMetabolism and nutrition disorders0/70/81/92/122/311/351/390/122/32
HeadacheNervous system disorders0/71/82/93/122/311/356/390/122/32
DizzinessNervous system disorders1/72/82/91/125/310/352/390/120/32
Weight decreasedInvestigations0/71/81/90/125/313/354/392/123/32
Aspartate aminotransferase increasedInvestigations1/71/81/90/121/310/354/390/121/32
Alanine aminotransferase increasedInvestigations1/72/81/90/121/310/353/390/121/32
Hot flushVascular disorders0/70/81/90/122/314/354/391/122/32
AnemiaBlood and lymphatic system disorders0/71/81/93/125/315/354/394/126/32
FallInjury, poisoning and procedural complications0/71/81/92/124/313/350/391/122/32
HematuriaRenal and urinary disorders0/70/80/90/123/314/350/390/121/32

+Locations (41)

FacilityCityCountryStatus
Alaska Urological InstituteAnchorage, AlaskaUnited States
Beverly Hills Cancer Center (BHCC)Beverly Hills, CaliforniaUnited States
John Wayne Cancer Inst.Duarte, CaliforniaUnited States
UCLALos Angeles, CaliforniaUnited States
Rocky Mountain Cancer CentersAurora, ColoradoUnited States
University of Colorado Hospital - Anschutz Cancer PavilionAurora, ColoradoUnited States
University of FloridaJacksonville, FloridaUnited States
Mount Sinai Comprehensive Cancer CenterMiami, FloridaUnited States
H. Lee Moffitt Cancer Center & Research InstituteTampa, FloridaUnited States
Rush University Medical CenterChicago, IllinoisUnited States
University of Illinois Hospital and Health SystemsChicago, IllinoisUnited States
Indiana University- Simon Cancer CenterIndianapolis, IndianaUnited States
Tulane University Health Sciences CenterNew Orleans, LouisianaUnited States
University of MarylandBaltimore, MarylandUnited States
John Hopkins Kimmel Cancer CenterBaltimore, MarylandUnited States
Maryland Oncology HematologyRockville, MarylandUnited States
Dana Farber Cancer InstituteBoston, MassachusettsUnited States
Henry Ford Health SystemDetroit, MichiganUnited States
GU Research NetworkOmaha, NebraskaUnited States
Comprehensive Cancer Centers of NevadaLas Vegas, NevadaUnited States
New Mexico Cancer CenterAlbuquerque, New MexicoUnited States
Roswell Park Comprehensive Cancer CenterBuffalo, New YorkUnited States
North Shore Hematology Oncology AssociatesEast Setauket, New YorkUnited States
NYU Langone Medical Center Laura and Isaac Permlutter Cancer CenterNew York, New YorkUnited States
Icahn School of Medicine at Mt. SinaiNew York, New YorkUnited States
Eastchester Center for Cancer CareThe Bronx, New YorkUnited States
University of North Carolina-Chapel HillChapel Hill, North CarolinaUnited States
Levine Cancer InstituteCharlotte, North CarolinaUnited States
Duke University Medical CenterDurham, North CarolinaUnited States
Ohio State University - James Cancer Hospital and Solove Research InstituteColumbus, OhioUnited States
Toledo Clinic Cancer CenterToledo, OhioUnited States
Williamette Valley Cancer Institute and Research CenterEugene, OregonUnited States
Compass Oncology - EastTualatin, OregonUnited States
St. Luke's UniversityBethlehem, PennsylvaniaUnited States
Gettysburg Cancer CenterGettysburg, PennsylvaniaUnited States
Greenville Hospital System, Institute for Translational Oncology ResearchGreenville, South CarolinaUnited States
Carolina Urologic Research CenterMyrtle Beach, South CarolinaUnited States
Texas Oncology - Central Austin Cancer CenterAustin, TexasUnited States
Texas Oncology- Fort WorthFort Worth, TexasUnited States
Texas Oncology- TylerTyler, TexasUnited States
Virginia Oncology AssociatesHampton, VirginiaUnited States

+Study documents

My Notes