Debio 4228 for Prostate Cancer

Recruiting at22 trial locations

Age: 18+

Sex: Male

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 2

Recruiting

Sponsor: Debiopharm International SA

Must be taking: Androgen deprivation

Must not be taking: Exogenous testosterone

Disqualifiers: Abnormal cardiovascular, Diabetes, Major surgery, others

No Placebo Group

Prior Safety Data

Trial Summary

What is the purpose of this trial?

The primary purpose of this study is to determine the pharmacokinetics (PK) and pharmacodynamics (PD) of Debio 4228.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, if you are on androgen deprivation therapy or have used exogenous testosterone recently, you may not be eligible. It's best to discuss your specific medications with the study team.

What data supports the effectiveness of the drug Debio 4228 for prostate cancer?

While there is no direct data on Debio 4228, similar treatments like abiraterone and enzalutamide have shown to improve survival and disease outcomes in prostate cancer by targeting androgen receptor signaling, which is crucial in managing advanced stages of the disease. ^{1 2 3 4 5}

Research Team

Eligibility Criteria

This trial is for men with advanced or metastatic prostate cancer who are candidates for ongoing hormone therapy. They should have a life expectancy of at least 6 months, be relatively active (ECOG status 0-2), and have normal organ function. Specific medical criteria must also be met.

Inclusion Criteria

Life expectancy of at least 6 months

My prostate cancer is advanced and has spread beyond the prostate.

My doctor thinks I should be on continuous hormone therapy for my cancer.

Exclusion Criteria

I need hormone therapy for my cancer.

I have not had major surgery in the last 4 weeks.

I have had surgery to remove both testicles, adrenal glands, or pituitary gland.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a single intramuscular (IM) administration of Debio 4228 on Day 1

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 weeks

1 visit (in-person) at 12 weeks

Extension

Participants in Cohort 3 may receive a maintenance dose 12 weeks after the initial dose

12 weeks

1 visit (in-person) for maintenance dose

Treatment Details

Interventions

• Debio 4228 (Anti-tumor antibiotic)

Trial Overview The study is testing Debio 4228 to understand how it's processed in the body (pharmacokinetics) and its effects on the body's biological processes (pharmacodynamics) in patients with advanced prostate cancer.

Participant Groups

Group I: Cohort 3 Experimental Treatment 1 Intervention

If any alternative dose is deemed necessary based on preliminary data, participants may be enrolled in Cohort 3 to receive Debio 4228 loading dose IM, on Day 1 followed by a maintenance dose IM, 12 weeks after receiving the loading dose (Day 85).

Group II: Cohort 2: Debio 4228 Dose Level 2 Experimental Treatment 1 Intervention

Participants will receive a single IM administration of dose level 2 Debio 4228 on Day 1.

Group III: Cohort 1: Debio 4228 Dose Level 1 Experimental Treatment 1 Intervention

Participants will receive a single intramuscular (IM) administration of dose level 1 Debio 4228 on Day 1.

Who Is Running the Clinical Trial?

Debiopharm International SA

Lead Sponsor

Trials

53

Recruited

7,300+

Findings from Research

In a study of 75 patients with metastatic castration-resistant prostate cancer (mCRPC), enzalutamide showed a significantly higher PSA response rate (70.3%) compared to abiraterone (37.8%), indicating better efficacy in reducing prostate-specific antigen levels.

Patients treated with enzalutamide also experienced longer progression-free survival (7 months) and overall survival (30 months) compared to those on abiraterone (5 months and 13 months, respectively), suggesting that enzalutamide may be a more effective treatment option in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-World Data on Outcomes in Metastatic Castrate-Resistant Prostate Cancer Patients Treated With Abiraterone or Enzalutamide: A Regional Experience. Raju, R., Sahu, A., Klevansky, M., et al.[2023]

Abiraterone acetate has been shown to improve overall survival in patients with castration-resistant prostate cancer (CRPC) who have previously been treated with docetaxel, highlighting that CRPC remains hormone-driven even in advanced stages.

There is a need for better molecular characterization of prostate cancer to identify different disease subsets, which could lead to more effective and personalized treatment strategies, including the development of predictive biomarkers for clinical use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Targeting continued androgen receptor signaling in prostate cancer. Massard, C., Fizazi, K.[2015]

In a study of 36 patients with locally advanced prostate cancer and germline DNA damage repair gene defects, the combination of docetaxel and cisplatin chemotherapy showed a significant improvement in biochemical progression-free survival compared to docetaxel alone, with a median bPFS not reached in the cisplatin group versus 7.76 months in the docetaxel group.

The docetaxel plus cisplatin group also demonstrated a higher rate of tumor down-staging (78.57%) compared to the docetaxel group (40.9%), indicating enhanced efficacy, while maintaining a tolerable safety profile with only one case of severe liver insufficiency due to viral hepatitis A.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of neoadjuvant docetaxel + cisplatin chemo-hormonal therapy versus docetaxel chemo-hormonal therapy in patients with locally advanced prostate cancer with germline DNA damage repair gene alterations. Chi, C., Liu, J., Fan, L., et al.[2022]

The ARNEO trial is a phase II study involving at least 84 patients with intermediate to high-risk prostate cancer, aiming to evaluate the effectiveness of combining apalutamide with degarelix compared to degarelix alone in reducing minimal residual disease after surgery.

This study will also explore the molecular effects of the treatment on tumors and assess various clinical outcomes, including PSA levels, testosterone levels, and quality of life, providing comprehensive insights into the safety and efficacy of this combination therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neoadjuvant degarelix with or without apalutamide followed by radical prostatectomy for intermediate and high-risk prostate cancer: ARNEO, a randomized, double blind, placebo-controlled trial. Tosco, L., Laenen, A., Gevaert, T., et al.[2018]

In a study of 879 patients with metastatic prostate cancer, BRCA2, ATM, and CDK12 were identified as the most frequently disrupted DNA damage repair genes, found in 15% of cases, indicating potential therapeutic vulnerabilities.

The presence of BRCA2 and CDK12 mutations was linked to poorer clinical outcomes, while the stability of these mutations in both plasma cell-free DNA and archival tissues suggests that ctDNA could be a valuable diagnostic tool for monitoring disease progression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

BRCA2, ATM, and CDK12 Defects Differentially Shape Prostate Tumor Driver Genomics and Clinical Aggression. Warner, E., Herberts, C., Fu, S., et al.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Real-World Data on Outcomes in Metastatic Castrate-Resistant Prostate Cancer Patients Treated With Abiraterone or Enzalutamide: A Regional Experience. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Targeting continued androgen receptor signaling in prostate cancer. [2015]

3. England pubmed.ncbi.nlm.nih.gov

Efficacy of neoadjuvant docetaxel + cisplatin chemo-hormonal therapy versus docetaxel chemo-hormonal therapy in patients with locally advanced prostate cancer with germline DNA damage repair gene alterations. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Neoadjuvant degarelix with or without apalutamide followed by radical prostatectomy for intermediate and high-risk prostate cancer: ARNEO, a randomized, double blind, placebo-controlled trial. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

BRCA2, ATM, and CDK12 Defects Differentially Shape Prostate Tumor Driver Genomics and Clinical Aggression. [2022]