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RNS Number : 5130G AstraZeneca PLC 29 April 2025
29 April 2025
Update on CAPItello-280 Phase III trial of Truqap in metastatic
castration-resistant prostate cancer
AstraZeneca is discontinuing the CAPItello-280 Phase III trial evaluating the
efficacy and safety of Truqap (capivasertib) in combination with docetaxel and
androgen-deprivation therapy (ADT) compared to docetaxel and ADT with placebo
in patients with metastatic castration-resistant prostate cancer (mCRPC).
This decision is based on the recommendation of the Independent Data
Monitoring Committee (IDMC) following their review of data from a
pre-specified interim analysis, which concluded that the Truqap combination
was unlikely to meet the dual primary endpoints of radiographic
progression-free survival (rPFS) and overall survival (OS) versus the
comparator arm upon trial completion. The safety profile for Truqap was
consistent with previous trials.
The Company will work with investigators to ensure the necessary follow up
with patients. Data from the trial will inform ongoing research.
Notes
Prostate cancer
Prostate cancer is the second most prevalent cancer in men and the fifth
leading cause of male cancer death globally, with an incidence of more than
1.4 million and over 397,000 deaths in 2022.(1)
Metastatic prostate cancer is associated with a significant mortality rate,
with only one third of patients surviving five years after diagnosis.(2)
Development of prostate cancer is often driven by male sex hormones called
androgens, including testosterone.(3)
Metastatic castration-resistant prostate cancer
Approximately 10-20% of men with advanced prostate cancer will develop
castration-resistant prostate cancer within five years.(4) In patients with
mCRPC, their prostate cancer grows and spreads to other parts of the body
despite the use of androgen-deprivation therapy to block the action of male
sex hormones.(3) At least 84% of these men will have metastases at the time of
CRPC diagnosis and, of those patients with no metastases at CRPC diagnosis,
33% are likely to develop metastases within two years.(4) Approximately half
of patients with mCRPC may receive only one line of active treatment, and
those that go on to receive further treatment often have diminishing benefit
of subsequent therapies.(5-6)
Despite the advances in mCRPC treatment with taxane and new hormonal agent
treatments, there is high unmet need in this population.(4,7,8)
CAPItello-280
CAPItello-280 is a Phase III, double-blind, randomised trial evaluating the
efficacy and safety of Truqap in combination with docetaxel and ADT compared
to docetaxel and ADT in combination with placebo in patients with mCRPC.
The global trial enrolled 1,033 adult patients with histologically confirmed
prostate adenocarcinoma with evidence of mCRPC with progression of disease
despite ADT. The dual primary endpoints of the CAPItello-280 trial are rPFS as
assessed by investigator and OS in the overall trial population. Key secondary
endpoints include OS and rPFS as assessed by investigator in patients with
mCRPC and PTEN-deficient tumours, OS and rPFS as assessed by investigator in
patients with mCRPC and PTEN-proficient tumours, time to pain progression
(TTPP) in the overall trial population and time to first symptomatic
skeletal-related event (SSRE) in the overall trial population.
Truqap
Truqap is a first-in-class, potent, adenosine triphosphate (ATP)-competitive
inhibitor of all three AKT isoforms (AKT1/2/3). Truqap 400mg is administered
twice daily according to an intermittent dosing schedule of four days on and
three days off. This was chosen in early phase trials based on tolerability
and the degree of target inhibition.
Truqap in combination with Faslodex (fulvestrant) is approved in the US, EU,
Japan, China and several other countries for the treatment of adult patients
with HR-positive (or estrogen receptor-positive), HER2-negative locally
advanced or metastatic breast cancer with one or more biomarker alterations
(PIK3CA, AKT1 or PTEN) following recurrence or progression on or after an
endocrine-based regimen based on the results from the CAPItello-291 trial.
Truqap is also approved in Australia for the treatment of adult patients with
HR-positive, HER2-negative locally advanced or metastatic breast cancer
following recurrence or progression on or after an endocrine based regimen
based on these trial results.
Truqap is being evaluated in ongoing Phase III trials for the treatment of
breast and prostate cancers.
Truqap was discovered by AstraZeneca subsequent to a collaboration with Astex
Therapeutics (and its collaboration with the Institute of Cancer Research and
Cancer Research Technology Limited).
AstraZeneca in oncology
AstraZeneca is leading a revolution in oncology with the ambition to provide
cures for cancer in every form, following the science to understand cancer and
all its complexities to discover, develop and deliver life-changing medicines
to patients.
The Company's focus is on some of the most challenging cancers. It is through
persistent innovation that AstraZeneca has built one of the most diverse
portfolios and pipelines in the industry, with the potential to catalyse
changes in the practice of medicine and transform the patient experience.
AstraZeneca has the vision to redefine cancer care and, one day, eliminate
cancer as a cause of death.
AstraZeneca
AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, science-led biopharmaceutical
company that focuses on the discovery, development, and commercialisation of
prescription medicines in Oncology, Rare Diseases, and BioPharmaceuticals,
including Cardiovascular, Renal & Metabolism, and Respiratory &
Immunology. Based in Cambridge, UK, AstraZeneca's innovative medicines are
sold in more than 125 countries and used by millions of patients worldwide.
Please visit astrazeneca.com (http://www.astrazeneca.com/) and follow the
Company on social media @AstraZeneca
(https://www.linkedin.com/company/astrazeneca) .
Contacts
For details on how to contact the Investor Relations Team, please click here
(https://www.astrazeneca.com/investor-relations.html#Contacts) . For Media
contacts, click here (https://www.astrazeneca.com/media-centre/contacts.html)
References
1. Bray F, et al. Global cancer statistics 2022: GLOBOCAN estimates of
incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J
Clin. 2024 Apr 4. doi: 10.3322/caac.21834.
2. Chowdhury S, et al. Real-World Outcomes in First-Line Treatment of
Metastatic Castration-Resistant Prostate Cancer: The Prostate Cancer Registry.
Target Oncol. 2020;15(3):301-315.
3. National Cancer Institute. Hormone Therapy for
Prostate Cancer Fact Sheet. Available at:
https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet
(https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cancer.gov%2Ftypes%2Fprostate%2Fprostate-hormone-therapy-fact-sheet&data=05%7C02%7Cpkukadia%40realchemistry.com%7Ca8bd27a12d904cea2f6608dcff1de650%7C6fa5bfc4f95843f8bb395d382689654b%7C0%7C0%7C638665751096351817%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=dileUkBF7UYj9sDRtGNticN5eGqn0wEtdqXBtWZlUSw%3D&reserved=0)
. Accessed April 2025.
4. Kirby M, et al. Characterising the Castration-Resistant Prostate
Cancer Population: Systematic Review. Int J of Clin Pract.
2021;65(11):1180-1192.
5. George DJ, et al. Treatment Patterns and Outcomes in Patients with
Metastatic Castration-Resistant Prostate Cancer in a Real-World Clinical
Practice Setting in the United States. Clin Genitourin Cancer.
2020;18:284-294.
6. de Wit, R, et al. Real-World Evidence of Patients with Metastatic
Castration-Resistant Prostate Cancer Treated with Cabazitaxel: Comparison with
the Randomized Clinical Study CARD. Prostate Cancer Prostatic Dis. 2022;2660.
7. UroToday. What is Changing in Advanced Prostate Cancer? Available at:
https://www.urotoday.com/journal/everyday-urology-oncology-insights/articles/122176-what-is-changing-in-advanced-prostate-cancer.html
(https://www.urotoday.com/journal/everyday-urology-oncology-insights/articles/122176-what-is-changing-in-advanced-prostate-cancer.html)
. Accessed April 2025.
8. Liu J, et al. Second-Line Hormonal Therapy for the Management of
Metastatic Castration-Resistant Prostate Cancer: A Real-World Data Study Using
a Claims Database. Sci Rep. 2020;10(1):4240.
Adrian Kemp
Company Secretary
AstraZeneca PLC
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