Skip to main content

A Study of Apalutamide in Participants With High-Risk, Localized or Locally Advanced Prostate Cancer Who Are Candidates for Radical Prostatectomy

Trial Status: Active

The purpose of this study is to determine if treatment with apalutamide plus androgen deprivation therapy (ADT) before and after radical prostatectomy with pelvic lymph node dissection (RPLND) in participants with high-risk localized or locally advanced prostate cancer results in an improvement in pathological complete response (pCR) rate and metastasis-free survival (MFS) based on conventional imaging, as compared to placebo plus ADT.

Inclusion Criteria

  • Histologically confirmed adenocarcinoma of the prostate
  • High-risk disease defined by a total Gleason Sum Score greater than equal to (>=) 4+3 (=Grade Groups [GG] 3 5) and >=1 of the following 4 criteria: a) Any combination of Gleason Score 4+3 (= 3) and Gleason Score 8 (4+4 or 5+3) in >= 6 systematic cores (with >=1 core Gleason Score 8 [4+4 or 5+3] included); b) Any combination of Gleason Score 4+3 (=GG 3) and Gleason Score 8 (4+4 or 5+3) in >=3 systematic cores and Prostate-specific antigen (PSA) >=20 ng/mL (with >= 1 core Gleason Score 8 [4+4 or 5+3] included); c) Gleason Score >=9 (=GG 5) in at least 1 systematic or targeted core; d) At least 2 systematic or targeted cores with continuous Gleason Score >=8 (=GG 4), each with > 80 percent (%) involvement
  • Candidate for radical prostatectomy with pelvic lymph node dissection as per the investigator
  • Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0 or 1
  • Contraceptive use by men and female partners of men enrolled in the study who are of childbearing potential or are pregnant) should be consistent with local regulations regarding the use of contraceptive methods for participants participating in clinical studies
  • Able to receive androgen deprivation therapy (ADT) for up to 1 year, per the investigator's assessment

Exclusion Criteria

  • Distant metastasis based on conventional imaging (clinical stage M1). Nodal disease below the iliac bifurcation (clinical stage N1) is not an exclusion. Diagnosis of distant metastasis (clinical M stage; M0 versus M1a, M1b, M1c) and pelvic nodal disease (clinical N stage; N1 versus N0) will be assessed by central radiological review. Participants are considered eligible only if the central radiological review confirms clinical stage M0
  • (a) Prior treatment with androgen receptor antagonists; (b) Treatment with gonadotropin-releasing hormone (GnRH) analogs prior to informed consent form (ICF) signature
  • History of prior systemic or local therapy for prostate cancer, including pelvic radiation for prostate cancer
  • Use of any investigational agent less than or equals to (<=)4 weeks prior to randomization or any therapeutic procedure for prostate cancer at any time
  • Major surgery <=4 weeks prior to randomization


Los Angeles
UCLA / Jonsson Comprehensive Cancer Center
Status: ACTIVE
Contact: Bashir Wyatt
Phone: 310-794-3448
USC / Norris Comprehensive Cancer Center
Status: ACTIVE
Contact: Cheryl Kefauver
Phone: 323-865-0845
UC Irvine Health / Chao Family Comprehensive Cancer Center
Status: ACTIVE
University of California Davis Comprehensive Cancer Center
Status: ACTIVE
San Diego
University of California San Diego
Status: ACTIVE


Mayo Clinic in Florida
Status: ACTIVE


Emory University Hospital / Winship Cancer Institute


University of Chicago Comprehensive Cancer Center
Status: ACTIVE


Beth Israel Deaconess Medical Center
Status: ACTIVE
Brigham and Women's Hospital
Status: ACTIVE
Dana-Farber Cancer Institute
Status: ACTIVE

New York

New York
Memorial Sloan Kettering Cancer Center
Status: ACTIVE
Contact: Deaglan McHugh
Phone: 646-334-8587

South Carolina

Medical University of South Carolina
Status: ACTIVE


Vanderbilt University / Ingram Cancer Center
Status: ACTIVE


M D Anderson Cancer Center
Status: ACTIVE

High-risk prostate cancer accounts for approximately 15 percent (%) of newly diagnosed

prostate cancers. A systemic therapy that eradicates micrometastatic disease is needed to

improve survival in high-risk participants undergoing RPLND. It is hypothesized that androgen

blockade prior to and after RPLND may improve outcomes for participants at the highest risk

for recurrence. This study is designed to evaluate if androgen blockade administered prior to

and after RPLND will increase the rate of pathological complete response (pCR) and lead to

better overall outcomes. ERLEADA (apalutamide, also known as JNJ-56021927 and ARN-509) is an

orally available, non-steroidal small molecule, which acts as a potent and selective

antagonist of the androgen receptor (AR), currently being developed for the treatment of

prostate cancer. The study includes screening phase (approximately up to 35 days before

randomization), treatment phase (up to 12 months) and follow-up phase. The end of study

(study completion) is defined as last participant assessment at study site with approximate

study duration of 8 years. Participants will undergo efficacy, pharmacokinetics and biomarker

evaluations. The safety will be monitored throughout the study.

Trial Phase Phase III

Trial Type Treatment

Lead Organization
Janssen Pharmaceuticals

  • Primary ID CR108535
  • Secondary IDs NCI-2019-04921, 2018‐001746‐34, 56021927PCR3011, 2018-001746-34
  • ID NCT03767244