ClinicalTrials.gg
RecruitingNCT06592924TRIPLE-SWITCHUpdated Jul 14, 2026

Docetaxel to Androgen Receptor Pathway Inhibitors in Patients With Metastatic Castration Sensitive Prostate Cancer and Suboptimal PSA Response

A Phase 3 interventional study of Abiraterone and Enzalutamide in Prostate Cancer (Adenocarcinoma), sponsored by Canadian Cancer Trials Group. Recruiting at 395 sites in 4 countries. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-14.

Sponsored by Canadian Cancer Trials Group · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started May 2025; still recruiting 1 year 5 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
830
Allocation
Randomized
Ages
18 Years and older
Sex
Male
01

Study summary

This study is being done to answer the following question: can the chance of prostate cancer growing or spreading be lowered by adding a drug to the usual combination of drugs?

This study would like to find out if this approach is better or worse than the usual approach for prostate cancer.

The usual approach for patients who are not in a study is hormone treatment with Androgen Deprivation Therapy (ADT) and Androgen-Receptor Pathway Inhibitor (ARPI).

Read the detailed description

This is an international multi-centre, open-label, randomized phase III trial comparing Docetaxel chemotherapy added to standard of care Androgen Deprivation Therapy (ADT) + Androgen-Receptor Pathway Inhibitor (ARPI) versus standard of care Androgen Deprivation Therapy (ADT) + Androgen-Receptor Pathway Inhibitor (ARPI) in participants with metastatic castration sensitive prostate cancer (mCSPC) who have a suboptimal PSA response after 6-12 months of androgen-targeting therapy.

02

Conditions studied

  • Prostate Cancer (Adenocarcinoma)

Keywords

  • PR26
  • Castration sensitive
03

In context

Prostatic Neoplasms

7,046 studies on the registry are indexed under Prostatic Neoplasms; 1,580 are open to participants now.

This study's planned enrollment of 830 is above the median of 60 across 5,348 interventional studies indexed under Prostatic Neoplasms.

Browse Prostatic Neoplasms studies →

Lead sponsor

Canadian Cancer Trials Group is the lead sponsor of 93 studies on the registry; 29 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 7 (88%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

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.

Inclusion criteria

  • Histologically/ confirmed adenocarcinoma of the prostate or participants with a PSA >100 ng/ml (100 ug/L) and radiographic evidence of disease at diagnosis.
  • Metastatic disease by conventional imaging (bone scan or CT and/or MRI or PSMA-PET scan at the time of ADT initiation.
  • PSA of ≥ 2.0 ng/ml (2.0 ug/L) prior to commencement of ADT (this refers to patients who have histologically/cytologically confirmed adenocarcinoma of the prostate)
  • Patients will have recovered from any treatment-related toxicities prior to enrollment (unless ≤ grade 1, irreversible, or considered by investigator as not ).
  • Patients may enroll with persistent toxicities attributable to ADT, including hot flushes and fatigue, of any grade, provided these toxicities are clinically stable, not rapidly worsening, and not considered by the Investigator to pose a safety risk or impair the patient's ability to comply with study procedures. Such toxicities do not need to resolve to Grade ≤1 prior to study entry.
  • Receipt of ADT for mCSPC for at least 6 months and no greater than 12 months (+/- 3 weeks) at time of enrollment.
  • Receipt of ARPI (e.g. abiraterone acetate, enzalutamide, apalutamide, or darolutamide) for at least 4 months (+/- 2 weeks) at time of enrollment
  • Patients may have had radiotherapy to prostatic bed and/or metastatic sites prior to enrollment. Potential trial participants should have recovered from radiotherapy-related toxicities prior to enrollment.
  • Serum testosterone \<1.7 nmol/L or 50 ng/dL.
  • PSA ≥ 0.2 ng/ml (0.2 ug/L) within 28 days of enrollment.
  • Candidate for docetaxel chemotherapy
  • Performance Status (PS) 0 to 2.
  • Adequate organ and marrow function measured within 28 days prior to enrollment.
  • Participant consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each participant must sign a consent form prior to enrollment in the trial to document their willingness to participate.
  • Participants must be accessible for treatment and follow-up. Investigators must assure themselves the participants enrolled on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
  • In accordance with CCTG policy, protocol treatment is to begin within 10 working days of participant enrollment.
  • If the participant and the participant's partner are of , they must agree to use medically accepted methods of
  • -infected participants on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.
  • Participant access to all protocol therapies must be confirmed prior to enrollment

Exclusion criteria

Exclusion Criteria:

  • Confirmed PSA progression, defined by an increase in PSA of 25% above the nadir since achieving castration on ADT, an absolute increase in PSA value of 2.0 ng/ml (ug/L) above nadir, and a subsequent increase in PSA of 25% further separated by 3 or more weeks.
  • Evidence of confirmed radiographic progression or clinical progression since start of ADT. Participants may be enrolled on the study if, in the opinion of the investigator, any new bone lesions on bone scan and CT represent flare or treatment effect.
  • Docetaxel criteria:

    • Prior treatment with taxane chemotherapy
    • Grade 2 or worse peripheral neuropathy
    • Severe to drugs formulated with polysorbate 80
  • cardiac disease including:

    • History of unstable angina pectoris, symptomatic pericarditis, or myocardial infarction within 6 months prior to study entry.
    • History of documented congestive heart failure ( functions classification III-IV).
  • Patients with uncontrolled intercurrent illness or any other significant condition(s) that would make this protocol unreasonably hazardous.
  • Patients with a prior or concurrent whose natural history of treatment does not have the potential to interfere with the safety or efficacy assessment of the regimen are eligible for this trial.
  • Concurrent treatment with other anti-cancer systemic therapy other than ADT and ARPI.
  • administered within 30 days prior to enrollment/randomization.
  • For participants with a history of chronic virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.
  • Participants with a history of virus (HCV) infection must have been treated and cured. For participants with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load.
  • High-grade neuroendocrine prostate cancer or small cell features (except if a participant has no histological diagnosis but a PSA >100 ng/ml (>100 ug/L) at diagnosis and radiographic evidence of disease)
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
830 participants (estimated)

Study arms

  • Active comparator
    Standard ADT + ARPI

    Drug: Abiraterone · Drug: Enzalutamide · Drug: Apalutamide · Drug: Darolutamide (BAY 1841788) · Drug: ADT

  • Experimental
    Docetaxel + Standard ADT + ARPI

    Drug: Abiraterone · Drug: Enzalutamide · Drug: Apalutamide · Drug: Darolutamide (BAY 1841788) · Drug: Docetaxel · Drug: ADT

Interventions

06

What researchers measure

Primary outcomes

  1. Overall Survival

    Time frame: 39 months

Secondary outcomes

  1. PSA Progression compared in both arms

    Time frame: 39 months

  2. PSA Response comparison between arms

    PCWG3 criteria

    Time frame: 39 months

  3. PSA Kinetics compared between both arms

    * 90% PSA decline * PSA \<0.2ng/ml * PSA \<0.02ng/ml

    Time frame: 39 months

  4. Clinical progression-free survival between both arms

    Time frame: 39 months

07

Study locations

380 of 395 sites recruiting

Showing the first 100 of 395 sites across 4 countries. Choose a country and city above to see the rest.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 14, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06592924
Lead sponsor
Canadian Cancer Trials Group
Responsible party
Sponsor
First posted
Sep 19, 2024
Start date
May 28, 2025
Primary completion
Mar 14, 2031 (estimated)
Completion
Apr 15, 2031 (estimated)
Last update
Jul 14, 2026

Study contacts

Mariam Jafri
Contact
mjafri@ctg.queensu.ca
613-533-6430
Wendy Parulekar
Contact
wparulekar@ctg.queensu.ca
613-533-6430
Michael Ong
study chair · Ottawa Hospital Research Institute, Ottawa ON Canada
Alexandra Sokolova
study chair · Oregon Health and Science University, Portland, OR, USA

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Docetaxel

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