Overview
Sponsor-declared trial summary
Metastatic Castration-Resistant Prostate Cancer
1. To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to overall survival (OS) 2. To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to radiographic progression-free survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Eva…
Key facts
- Sponsor
- Merck Sharp & Dohme LLC
- Participant type
- Patients
- Age range
- 18-64 years, 65+ years
- Gender
- Male
- Therapeutic area
- Diseases [C] - Neoplasms [C04]
- Trial duration
- 23 Aug 2019 → 20 Aug 2025
- Decision date (initial)
- 2023-01-30
- Transition trial
- Yes
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- No
- Funding sources
- Merck Sharp & Dohme LLC
External identifiers
- EU CT number
- 2022-500785-10-00
- EudraCT number
- 2018-004117-40
- WHO UTN
- U1111-1278-1151
- ClinicalTrials.gov
- NCT03834493
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Safety, Therapy, Pharmacogenomic, Pharmacogenetic, Efficacy, Diagnosis
1. To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to overall survival (OS)
2. To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to radiographic progression-free survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by blinded independent central review (BICR)
Secondary objectives 4
- To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to the time to initiation of the first subsequent anti-cancer therapy or death (TFST)
- To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to the: prostate-specific antigen (PSA) response rate; PSA undetectable rate; and the objective response rate (ORR) and duration of response (DOR) per PCWG-modified RECIST 1.1 as assessed by BICR
- To compare pembrolizumab plus enzalutamide versus placebo plus enzalutamide with respect to the: time to PSA progression; time to first symptomatic skeletal-related event (SSRE); time to radiographic soft tissue progression per soft tissue rules of PCWG-modified RECIST 1.1, as assessed by BICR; and time to pain progression (TTPP) based on Brief Pain Inventory-Short Form (BPI-SF) Item 3 “ worst pain in 24 hours” and opiate analgesic use Analgesic Quantification Algorithm (AQA) score
- To evaluate the safety and tolerability of pembrolizumab plus enzalutamide versus placebo plus enzalutamide
Conditions and MedDRA coding
Metastatic Castration-Resistant Prostate Cancer
| Version | Level | Code | Term | System organ class |
|---|---|---|---|---|
| 21.1 | PT | 10036909 | Prostate cancer metastatic | 100000004864 |
| 21.1 | LLT | 10076506 | Castration-resistant prostate cancer | 10029104 |
Study design 1 period
| # | Title | Allocation | Blinding | Roles blinded | Arms |
|---|---|---|---|---|---|
| 1 | Overall Study A Phase 3, Randomized, Double-blind Trial of Pembrolizumab (MK-3475) Plus Enzalutamide Versus Placebo Plus Enzalutamide in Participants With Metastatic Castration-Resistant Prostate Cancer (mCRPC) (KEYNOTE-641)
|
Randomised Controlled | Double | [{"id":145159,"code":1,"name":"Subject"},{"id":145157,"code":3,"name":"Monitor"},{"id":145158,"code":2,"name":"Investigator"}] | Arm 1: Pembro + Enzalutamide Arm 2: Placebo + Enzalutamide |
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 4
- Histologically- or cytologically-confirmed adenocarcinoma of the prostate without small cell histology
- Prostate cancer progression while on androgen deprivation therapy (or post bilateral orchiectomy) within 6 months prior to randomization
- Current evidence of metastatic disease documented by either bone lesions on bone scan and/or soft tissue disease by computed tomography/magnetic resonance imaging (CT/MRI)
- Ongoing androgen deprivation with serum testosterone <50 ng/dL (<2.0 nM)
Exclusion criteria 7
- Known additional malignancy that is progressing or has required active treatment in the last 3 years
- Active autoimmune disease that has required systemic treatment in past 2 years
- Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
- Gastrointestinal disorder affecting absorption or is unable to swallow tablets/capsules
- Known active human immunodeficiency virus (HIV), concurrent active hepatitis B virus (HBV) or known active hepatitis C virus (HCV) infection
- History of seizure or any condition that may predispose to seizure
- Received prior treatment with radium or other therapeutic radiopharmaceuticals for prostate cancer
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 2
- Overall Survival (OS)
- Radiographic Progression-free Survival (rPFS) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR)
Secondary endpoints 11
- Time to Initiation of the First Subsequent Anti-Cancer Therapy or Death (TFST)
- Prostate-specific Antigen (PSA) Response Rate
- Prostate-specific Antigen (PSA) Undetectable Rate
- Objective Response Rate (ORR) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR)
- Duration of Response (DOR) per Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR)
- Time to Prostate-specific Antigen (PSA) Progression
- Time to Radiographic Soft Tissue Progression per Soft Tissue Rules of Prostate Cancer Working Group (PCWG)-modified Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR)
- Time to Pain Progression (TTPP)
- Time to First Symptomatic Skeletal-Related Event (SSRE)
- Number of Participants Who Experienced At Least One Adverse Event (AE)
- Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 2
SUB77412 · Substance
- Active substance
- Enzalutamide
- Pharmaceutical form
- CAPSULE
- Route of administration
- ORAL
- Max daily dose
- 160 mg milligram(s)
- Max total dose
- 116.8 g gram(s)
- Max treatment duration
- 24 Month(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
KEYTRUDA 25 mg/mL concentrate for solution for infusion
PRD4323105 · Product
- Active substance
- Pembrolizumab
- Substance synonyms
- Lambrolizumab, MK-3475, SCH-900475, ABP 234
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS INFUSION
- Max daily dose
- 200 mg milligram(s)
- Max total dose
- 10.4 g gram(s)
- Max treatment duration
- 36 Month(s)
- Authorisation status
- Authorised
- ATC code
- L01FF02 — -
- Marketing authorisation
- EU/1/15/1024/002
- MA holder
- MERCK SHARP & DOHME BV
- MA country
- EU
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Placebo 1
N/A · Product
- Other product name
- N/A
- Pharmaceutical form
- N/A
- Route of administration
- INTRAVENOUS INFUSION
- Max daily dose
- 0 mg milligram(s)
- Max total dose
- 0 mg milligram(s)
- Max treatment duration
- 36 Month(s)
- ATC code
- N/A — N/A
- Marketing authorisation
- N/A
- MA holder
- N/A
- MA country
- Iceland
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Merck Sharp & Dohme LLC
- Sponsor organisation
- Merck Sharp & Dohme LLC
- Address
- 1 Merck Drive, P. O. Box 100 P. O. Box 100
- City
- Whitehouse Station
- Postcode
- 08889-3400
- Country
- United States
Scientific contact point
- Organisation
- Merck Sharp & Dohme LLC
- Contact name
- Jelena Todoric
Public contact point
- Organisation
- Merck Sharp & Dohme LLC
- Contact name
- Jelena Todoric
Third parties 7
| Organisation | City, country | Duties |
|---|---|---|
| Pharmaceutical Product Development LLC ORG-100016999
|
Richmond, United States | Laboratory analysis |
| Bioclinica Inc. ORG-100033079
|
Princeton, United States | Other |
| Neogenomics Laboratories Inc. ORG-100041804
|
San Diego, United States | Laboratory analysis |
| Parexel International Corporation ORG-100007310
|
Auburndale, United States | Other |
| Labcorp Drug Development Inc. ORG-100041590
|
Princeton, United States | Laboratory analysis |
| Perceptive Eclinical Limited ORG-100041144
|
Nottingham, United Kingdom | Other |
| Signant Health Inc. ORG-100040732
|
Blue Bell, United States | E-data capture |
Locations
11 EU/EEA countries · 77 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| Austria | Ended | 27 | 2 |
| Bulgaria | Ended | 1 | 1 |
| Czechia | Ended | 6 | 2 |
| France | Ended | 70 | 18 |
| Germany | Ended | 53 | 11 |
| Hungary | Ended | 12 | 4 |
| Ireland | Ended | 16 | 3 |
| Italy | Ended | 40 | 9 |
| Netherlands | Ended | 58 | 10 |
| Poland | Ended | 50 | 4 |
| Spain | Ended | 87 | 13 |
| Rest of world
Turkey, United Kingdom, Argentina, Canada, Israel, Colombia, Brazil, Japan, Australia, Puerto Rico, United States, Chile, Russian Federation, Korea, Republic of, Ukraine
|
— | 744 | — |
Investigational sites
Country notifications
Trial-start, recruitment-start, end and early-termination notifications submitted per Member State
| Country | Trial start | Trial end | Recruitment start | Recruitment end | Early termination |
|---|---|---|---|---|---|
| Austria | 2019-09-09 | 2023-10-06 | 2019-09-22 | 2022-04-29 | |
| Bulgaria | 2021-04-06 | 2023-02-20 | 2021-05-17 | 2022-04-29 | |
| Czechia | 2021-08-16 | 2023-09-20 | 2021-08-19 | 2022-04-29 | |
| France | 2019-10-11 | 2023-10-25 | 2019-10-22 | 2022-04-29 | |
| Germany | 2020-03-06 | 2023-10-17 | 2020-03-09 | 2022-04-29 | |
| Hungary | 2020-07-24 | 2024-07-12 | 2020-08-30 | 2022-04-29 | |
| Ireland | 2020-01-10 | 2023-10-31 | 2020-01-31 | 2022-04-29 | |
| Italy | 2019-08-23 | 2023-09-28 | 2019-08-30 | 2022-04-29 | |
| Netherlands | 2019-09-09 | 2023-11-14 | 2019-10-07 | 2022-04-29 | |
| Poland | 2019-09-09 | 2023-11-24 | 2019-09-10 | 2022-04-29 | |
| Spain | 2019-09-09 | 2025-08-20 | 2019-09-12 | 2022-04-29 |
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Documents 37 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Protocol (for publication) | D1_Protocol_2022-500785-10-00_for pub | 09R |
| Protocol (for publication) | D4_Analgesic log_for publication | 12Mar19 |
| Protocol (for publication) | D4_Subject questionnaire_Analgesic Log_DEU_DE_for pub | 2.0 |
| Protocol (for publication) | D4_Subject questionnaire_english_for publication | 22jan2019 |
| Protocol (for publication) | D4_Subject questionnaire_subject facing screen report BPI-SF_DEU_DE_for pub | 1 |
| Protocol (for publication) | D4_Subject questionnaire_subject facing screen report_DEU_DE_for pub | 1 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and IC Procedure_ESP_Spanish_for publication | 25JAN2019 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and IC Procedure_HUN_EN_for pub | 05MAY2023 |
| Recruitment arrangements (for publication) | K2_Recruitment Material Patient Brochure_HUN_Hungarian_for publication | 18Jan2019 |
| Subject information and informed consent form (for publication) | L1_ICF_Genetic consent_HUN_HU_for pub | v0.01 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_HUN_HU_for pub | 0.01 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum_ESP_ES_SM12_for pub | 01 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum_HUN_HU_for pub | v0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_ESP_ES_for pub | 3.01 |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_HUN_HU_for pub | 3.01R |
| Subject information and informed consent form (for publication) | L1_ICF_Main_ESP_All_spanish_TC_for publication | 05JUL2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional addendum_ESP_Spanish_for publication_ | 12FEB2019 |
| Summary of Product Characteristics (SmPC) (for publication) | G2_SmPC quality and RSI_Enzalutamide Xtandi_for publication | 30OCT2018 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-500785-10-00_for pub | 26MAY2023 |
| Synopsis of the protocol (for publication) | D1_PPLS_AUT_DE_2022-500785-10_for pub | 1.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_CZE_CS_for pub | 1.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_DEU_DE_ 2022-500785-10-00_for pub | 1.0R |
| Synopsis of the protocol (for publication) | D1_PPLS_ESP_ES_2022-500785-10-00_for pub | 01 |
| Synopsis of the protocol (for publication) | D1_PPLS_FRA_FR_2022-500785-10_for pub | 1.0R |
| Synopsis of the protocol (for publication) | D1_PPLS_HUN_HU_2022-500785-10_for pub | v1.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_ITA_IT_202250078510_for pub | 1.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_NLD_NL_2022-500785-10_for pub | 1.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_POL_PL_2022-500785-10_for pub | 1.0 |
| Synopsis of the protocol (for publication) | D1_Protocol Plain Language Summary_AUT_German_for publication | v00 |
| Synopsis of the protocol (for publication) | D1_Protocol plain language summary_Bulgaria_Bulgarian_for publication | 02JUN2022 |
| Synopsis of the protocol (for publication) | D1_Protocol Plain Language Summary_ESP_Spanish_for publication | 02JUN2022 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_CZE_Czech_for publication | 22FEB2021 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_DEU_German_for publication | v00 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_FRA_French_for publication | 08JUL2022 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_HUN_Hungarian_for publication | 29MAR2021 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_ITA_Italian_for publication | 6.0 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_POL_2022-500785-10-00_Polish_for publication | 18JAN2019 |
Application history
12 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2022-12-15 | Netherlands | Acceptable 2023-01-24
|
2023-01-24 |
| 2 | SUBSTANTIAL MODIFICATION | SM-1 | 2023-06-23 | Netherlands | Acceptable 2023-08-22
|
2023-08-22 |
| 3 | SUBSTANTIAL MODIFICATION | SM-3 | 2023-09-27 | Acceptable | 2023-10-28 | |
| 4 | SUBSTANTIAL MODIFICATION | SM-5 | 2023-09-29 | Acceptable | 2023-11-10 | |
| 5 | SUBSTANTIAL MODIFICATION | SM-4 | 2023-10-04 | Acceptable | 2023-10-26 | |
| 6 | SUBSTANTIAL MODIFICATION | SM-6 | 2024-01-12 | Netherlands | Acceptable 2024-03-11
|
2024-03-11 |
| 7 | SUBSTANTIAL MODIFICATION | SM-8 | 2024-08-07 | Netherlands | Acceptable 2024-09-23
|
2024-09-23 |
| 8 | SUBSTANTIAL MODIFICATION | SM-10 | 2024-12-03 | Acceptable 2025-02-17
|
2025-02-18 | |
| 9 | NON SUBSTANTIAL MODIFICATION | NSM-4 | 2025-03-20 | Netherlands | Acceptable 2025-02-17
|
2025-03-20 |
| 10 | SUBSTANTIAL MODIFICATION | SM-11 | 2025-04-16 | Acceptable | 2025-05-17 | |
| 11 | SUBSTANTIAL MODIFICATION | SM-12 | 2025-07-04 | Acceptable 2025-08-19
|
2025-08-21 | |
| 12 | NON SUBSTANTIAL MODIFICATION | NSM-5 | 2025-09-10 | Netherlands | Acceptable 2025-08-19
|
2025-09-10 |