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RecruitingInterventionalPhase 2

Phase II Study of Apalutamide With Carotuximab in Metastatic, Castration-Resistant Prostate Cancer

NCT ID: NCT05534646Sponsor: Edwin Posadas, MDLast updated: 2026-02-02

Summary

This is an open-label, multi-site study of apalutamide with carotuximab in patients who have progressed on androgen receptor signaling inhibitor (ARSI) therapy. This study will begin with a safety assessment in the first 10 subjects (part 1: Safety Lead-in). If the combination is deemed safe, the trial will proceed to the Phase II stage. The purpose of this study is to compare progression free survival (PFS) between patients receiving apalutamide and apalutamide + carotuximab using Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3. The secondary objectives are to describe adverse events related to the intervention, overall response rate (ORR), proportion of patients resistant to apalutamide that benefit from the addition of carotuximab, and to determine the ORR, radiographic PFS, and biochemical PFS in the overall population.

Arms & interventions

  • DrugApalutamide

    Standard of care Apalutamide 240 mg administered orally and daily on Days 1-28 of every 28 day cycle

  • DrugCarotuximab

    Carotuximab administered intravenously at the following doses: Cycle 1 Day 1: 3 mg/kg Cycle 1 Day 4: 7 mg/kg Cycle 1 Day 8: 10 mg/kg Cycle 1 Day 15: 10 mg/kg Cycle 1 Day 22: 10 mg/kg Cycle 2 Day 1: 15 mg/kg Cycle 2 Day 15: 15 mg/kg Cycle 3+ Day 1: 15 mg/kg After completion of cycle 2, dosing of carotuximab will continue at a q4 week schedule using the 15 mg/kg dose.

Outcome measures

Primary

  • Progression free survival (rPFS) between patients receiving apalutamide and apalutamide + carotuximab

    From the start of study treatment until documented progression, per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and Prostate Cancer Working Group 3, or death due to any cause.

    Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

Secondary

  • Incidence of Adverse events (grade 3 or higher) related to carotuximab and apalutamide

    Time frame: From start of study treatment through 4 weeks on treatment

  • Overall radiographic response rate (ORR) of the combination of apalutamide + carotuximab

    Time frame: From the start of combination study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

  • Proportion of patients resistant to apalutamide benefit from the addition of carotuximab

    Time frame: From the start of combination therapy study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

  • Overall radiographic response rate (ORR) in the overall population

    Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

  • To determine the radiographic progression free survival (rPFS) in the overall population

    Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

  • To determine the biochemical PFS (by PCWG3) in the overall population

    Time frame: From the start of study treatment until documented progression, or death due to any cause, up to 30 days of follow-up after end of treatment.

Eligibility criteria

Sex: MaleAge: 18 Years and olderHealthy volunteers: No
Inclusion Criteria: * History of castration-resistant prostate cancer with rising PSA (prostate-specific antigen) on a contemporary ARSI (Androgen receptor (AR) signaling inhibitor: abiraterone, enzalutamide, darolutamide). Bicalutamide, nilutamide, and flutamide will not be considered as contemporary ARSIs * Patient must have had 1 and can have up to 2 prior AR targeted therapy with the exception of apalutamide. * Patients must decline or be ineligible for taxane therapy in the opinion of the treating physician. * All patients must agree to use an adequate method of contraception, in the opinion of the treating investigator, while on protocol treatment and for 3 months after the last dose of protocol treatment (apalutamide and/or carotuximab) Exclusion Criteria: * Non-PSA producing prostate cancers such as small cell prostate cancers or those prostate cancers which exhibit radiographic progression without PSA rise * Prior use of apalutamide * Other prior malignancy requiring active anticancer therapy * Prior exposure to carotuximab or any CD105 targeted antibody * Active bleeding or pathologic medical conditions that carries a high bleeding risk * A known diagnosis of Osler-Weber-Rendu syndrome

Study locations (3)

City of Hope

Duarte, California, 91010

Recruiting
Tanya Dorff, MD · Contact

Cedars-Sinai Medical Center

Los Angeles, California, 90048

Recruiting
Clinical Trial Recruitment Navigator · Contact
Robert Figlin, MD FACP · Sub Investigator
Jun Gong, MD · Sub Investigator
Kevin Scher, MD MBA · Sub Investigator
David Hoffman, MD · Sub Investigator
Leland Green, MD · Sub Investigator
Kristopher Wentzel, MD · Sub Investigator

Huntsman Cancer Institute and Hospital

Salt Lake City, Utah, 84112

Recruiting
Umang Swami, MD · Contact