A Phase 4 interventional study of Enzalutamide in Metastatic Castration-resistant Prostate Cancer (mCRPC), sponsored by Astellas Pharma Global Development, Inc.. Completed at 76 sites in 20 countries. Open to male participants. Per ClinicalTrials.gov, last updated 2024-12-06.
Sponsored by Astellas Pharma Global Development, Inc. (part of Astellas Pharma Inc) · Phase 4, Interventional, and Treatment
The objective of this study was to evaluate the incidence of seizures and monitor the safety of enzalutamide treatment in participants with metastatic castration-resistant prostate cancer (mCRPC) known to have risk factor(s) for seizure.
This was a multicenter, single-arm, open-label, postmarketing safety study to evaluate the risk of seizure among patients with mCRPC treated with enzalutamide who were at potential increased risk of seizure.
Participants who met all inclusion and none of the exclusion criteria were enrolled into the study and participated in a 4-month treatment period, during which once daily dosing of enzalutamide (160 mg/day) occurred. At the end of the 4-month treatment period, participants who were assessed as deriving benefit from enzalutamide treatment were allowed to continue in the extension period where participants continued to receive enzalutamide until 1 of the following criteria was met:
Participants who continued to receive clinical benefit from treatment with enzalutamide and did not meet any discontinuation criteria may have transitioned to an open label roll-over extension study upon approval of the study protocol at the institution where they were receiving treatment.
Participants who did not continue in the extension period or who met a discontinuation criterion were discontinued from enzalutamide therapy and completed a follow-up visit 30 days from the last dose of enzalutamide or prior to the initiation of another anticancer therapy, whichever occurred first.
For participants who continued on treatment after the 12-month extension period, data collection was limited to dosing information, concomitant medications, and all adverse events (AEs) including serious adverse events (SAEs).
896 studies on the registry are indexed under Seizures; 145 are open to participants now.
This study's enrollment of 424 is above the median of 62 across 621 interventional studies indexed under Seizures.
Browse Seizures studies →Astellas Pharma Global Development, Inc. is the lead sponsor of 207 studies on the registry; 24 are open to participants now.
Of its 81 completed or terminated interventional studies of FDA-regulated products, 38 (47%) have results posted.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Subject has disease progression by at least one of the following:
Subject has been evaluated by a local neurologist prior to study entry who has determined the subject has at least one risk factor for seizure including:
Male subject and his female partner who is of childbearing potential must use two acceptable methods of birth control (one of which must include a condom as a barrier method of contraception) starting at Screening and continuing throughout the study period and for 3 months after final study drug administration.
1. Two acceptable forms of birth control include:
One of the following acceptable forms of contraception is required:
Exclusion Criteria:
Participants received 160 mg of enzalutamide orally once a day, for 4 months. At the end of the 4-month treatment period, participants who were assessed as deriving benefit from enzalutamide treatment continued in the extension period. The total study drug treatment duration for the extended period depended on individual clinical benefit. If a participant experienced a Grade 3 or higher toxicity that was attributed to enzalutamide and could not be ameliorated by the use of adequate medical intervention, treatment with enzalutamide was allowed to be interrupted for 1 week or until the toxicity grade improved to Grade 2 or lower severity. Subsequently, enzalutamide was restarted at the original dose 160 mg per day or a reduced dose 120 or 80 mg per day in consultation with the medical monitor.
Drug: Enzalutamide
Participants received 4 capsules (40 mg each) of enzalutamide orally once a day, for a total daily dose of 160 mg. Treatment was given with or without food and as close as possible to the same time each day.
Also known as: Xtandi, MDV3100
The Percentage of Evaluable Participants With at Least One Confirmed Seizure as Adjudicated by the Independent Adjudication Committee (IAC)
Percentage of evaluable participants with at least one confirmed seizure as adjudicated by the IAC during the first 4 months of treatment were reported.
Time frame: Day 1 up to week 17 (end of 4-month treatment period)
Study enrolled male participants with histologically-confirmed metastatic adenocarcinoma of prostate with ongoing androgen deprivation therapy with a gonadotropin-releasing hormone (GnRH) analogue (agonist or antagonist) or a prior orchiectomy. Participants were evaluated by a neurologist who determined they had at least 1 risk factor for seizure.
| Milestone | Enzalutamide 160 mg |
|---|---|
| Started | 423 |
| Completed | 322 |
| Not completed | 101 |
| Withdrew: Adverse event | 34 |
| Withdrew: Death | 3 |
| Withdrew: Progressive disease | 43 |
| Withdrew: Withdrawal by subject | 17 |
| Withdrew: Physician decision | 4 |
| Milestone | Enzalutamide 160 mg |
|---|---|
| Started | 287 |
| Completed | 157 |
| Not completed | 130 |
| Withdrew: Adverse event | 14 |
| Withdrew: Death | 10 |
| Withdrew: Lost to follow-up | 2 |
| Withdrew: Progressive disease | 86 |
| Withdrew: Withdrawal by subject | 11 |
| Withdrew: Physician decision | 6 |
| Withdrew: Miscellaneous | 1 |
| Milestone | Enzalutamide 160 mg |
|---|---|
| Started | 145 |
| Completed | 1 |
| Not completed | 144 |
| Withdrew: Adverse event | 5 |
| Withdrew: Death | 13 |
| Withdrew: Progressive disease | 60 |
| Withdrew: Withdrawal by subject | 13 |
| Withdrew: Physician decision | 4 |
| Withdrew: Miscellaneous | 49 |
Percentage of evaluable participants with at least one confirmed seizure as adjudicated by the IAC during the first 4 months of treatment were reported.
| percentage of participants | Enzalutamide 160 mg |
|---|---|
| The Percentage of Evaluable Participants With at Least One Confirmed Seizure as Adjudicated by the Independent Adjudication Committee (IAC) | 1.1 (0.3 to 2.8) |
Collected over From first dose of study drug up to 30 days after last dose of study drug (approximately 52 months). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Enzalutamide 160 mg | 62/423 (14.7%) | 193/423 (45.6%) | 318/423 (75.2%) |
| Event | Enzalutamide 160 mg |
|---|---|
| Malignant neoplasm progressionNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 34/423 |
| PneumoniaInfections and infestations | 13/423 |
| General physical health deteriorationGeneral disorders | 10/423 |
| FallInjury, poisoning and procedural complications | 10/423 |
| Confusional statePsychiatric disorders | 10/423 |
| AnaemiaBlood and lymphatic system disorders | 9/423 |
| PyrexiaGeneral disorders | 8/423 |
| Bone painMusculoskeletal and connective tissue disorders | 8/423 |
| ConvulsionNervous system disorders | 8/423 |
| HaematuriaRenal and urinary disorders | 8/423 |
| Event | Enzalutamide 160 mg |
|---|---|
| FatigueGeneral disorders | 92/423 |
| AstheniaGeneral disorders | 86/423 |
| Decreased appetiteMetabolism and nutrition disorders | 77/423 |
| Back painMusculoskeletal and connective tissue disorders | 68/423 |
| NauseaGastrointestinal disorders | 55/423 |
| AnaemiaBlood and lymphatic system disorders | 53/423 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 47/423 |
| ConstipationGastrointestinal disorders | 46/423 |
| DiarrhoeaGastrointestinal disorders | 43/423 |
| Oedema peripheralGeneral disorders | 33/423 |
The safety analysis set (SAF) consisted of all participants who took at least 1 dose of study drug and for whom any data was reported after first dose of study drug.
| Age, Continuous(Years) | Enzalutamide 160 mg |
|---|---|
| Mean | 73.2 ± 9 |
| Sex: Female, Male(Participants) | Enzalutamide 160 mg |
|---|---|
| Female | 0 |
| Male | 423 |
| Race/Ethnicity, Customized(Participants) | Enzalutamide 160 mg |
|---|---|
| WHITE | 381 |
| BLACK OR AFRICAN AMERICAN | 9 |
| ASIAN | 25 |
| NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER | 1 |
| NO DATA | 3 |
| OTHER | 4 |
| Ethnicity(Participants) | Enzalutamide 160 mg |
|---|---|
| NOT HISPANIC OR LATINO | 331 |
| HISPANIC OR LATINO | 89 |
| NO DATA | 3 |
| Eastern Cooperative Oncology Group (ECOG) At Study Entry(participants) | Enzalutamide 160 mg |
|---|---|
| Grade 0 | 188 |
| Grade 1 | 190 |
| Grade 2 | 45 |
Documents are hosted by the registry — open the source record to download them.
Plan to share: No — Access to anonymized individual participant level data will not be provided for this trial. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.
Ran from Sep 2013 to primary completion in Feb 2016, 28 months.
Results were first posted in Dec 2020, 4 years 10 months after primary completion.
Of 34 phase 4 interventional studies under Seizures, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 42. This study's 28 months is above that.
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Studies of the drug tested here: Enzalutamide
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