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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03085095
Registration number
NCT03085095
Ethics application status
Date submitted
9/03/2017
Date registered
21/03/2017
Titles & IDs
Public title
A Study to Evaluate the Safety and Efficacy of Relugolix in Men With Advanced Prostate Cancer
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Scientific title
HERO: A Multinational Phase 3 Randomized, Open-label, Parallel Group Study to Evaluate the Safety and Efficacy of Relugolix in Men With Advanced Prostate Cancer
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Secondary ID [1]
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0
2017-000160-15
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Secondary ID [2]
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MVT-601-3201
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Universal Trial Number (UTN)
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Trial acronym
HERO
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prostate Cancer
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0
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Condition category
Condition code
Cancer
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0
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0
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Relugolix
Treatment: Drugs - Leuprolide Acetate
Experimental: Relugolix - Relugolix for 48 weeks
Active comparator: Leuprolide Acetate - Leuprolide acetate for 48 weeks
Treatment: Drugs: Relugolix
Relugolix 120-mg tablet administered orally once daily following an oral loading dose of 360 mg (3 x 120-mg tablets) on Day 1
Treatment: Drugs: Leuprolide Acetate
Leuprolide acetate depot suspension, 22.5 mg (or 11.25 mg in Japan, Taiwan, and China), every 3 months by subcutaneous injection
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Intervention code [1]
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0
Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Sustained Castration Rate
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Assessment method [1]
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Sustained castration rate defined as the cumulative probability of testosterone suppression to \< 50 nanogram (ng)/deciliter (dL). The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
The lower bound of the 95% confidence interval (CI) for the cumulative probability of sustained testosterone suppression in the relugolix treatment group must have been = 90% to meet evaluation criteria for efficacy.
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Timepoint [1]
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From Week 5 Day 1 (Day 29) to Week 49 Day 1 (Day 337)
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Secondary outcome [1]
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Castration Rate At Week 1 Day 4
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Assessment method [1]
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Castration rate was defined as the cumulative probability of testosterone suppression to \< 50 ng/dL. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [1]
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Week 1 Day 4 (Day 4)
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Secondary outcome [2]
0
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Castration Rate At Week 3 Day 1
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Assessment method [2]
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Castration rate was defined as the cumulative probability of testosterone suppression to \< 50 ng/dL. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [2]
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Week 3 Day 1 (Day 15)
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Secondary outcome [3]
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Confirmed Prostate-specific Antigen (PSA) Response Rate
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Assessment method [3]
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Confirmed PSA response defined as \> 50% reduction in PSA from baseline at Week 3 Day 1 followed with confirmation at Week 5 Day 1.
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Timepoint [3]
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Week 3 Day 1 (Day 15) and Week 5 Day 1 (Day 29)
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Secondary outcome [4]
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Profound Castration Rate At Week 3 Day 1 (Day 15)
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Assessment method [4]
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Castration rate defined as the cumulative probability of testosterone suppression to \< 20 ng/dL. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [4]
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Week 3 Day 1 (Day 15)
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Secondary outcome [5]
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Follicle-stimulating Hormone (FSH) Level
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Assessment method [5]
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To evaluate the effect of relugolix and leuprolide acetate on FSH suppression.
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Timepoint [5]
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Week 25 Day 1 (Day 169)
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Secondary outcome [6]
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PSA Response Rate At Week 3 Day 1
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Assessment method [6]
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PSA response defined as \> 50% reduction in PSA from baseline. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [6]
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Week 3 Day 1 (Day 15)
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Secondary outcome [7]
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PSA Response Rate At Week 5 Day 1
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Assessment method [7]
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PSA response defined as \> 50% reduction in PSA from baseline. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [7]
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Week 5 Day 1 (Day 29)
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Secondary outcome [8]
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Testosterone Recovery Rate
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Assessment method [8]
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The cumulative probability of testosterone recovery back to \> 280 ng/dL (lower limit of the normal range), back to = 50 ng/dL (definition of castration), and back to \> 280 ng/dL or baseline at 90 days after drug discontinuation was assessed. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [8]
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Day 90 follow-up
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Secondary outcome [9]
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Sustained Profound Castration Rate From Week 5 Day 1 Through Week 49 Day 1
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Assessment method [9]
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Sustained profound castration rate was defined as the cumulative probability of testosterone suppression to \< 20 ng/dL. The rate was estimated by the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [9]
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0
Week 5 Day 1 (Day 29) through Week 49 Day 1 (Day 337)
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Secondary outcome [10]
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0
Profound Castration Rate At Week 1 Day 4 (Day 4)
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Assessment method [10]
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Castration rate defined as the cumulative probability of testosterone suppression to \< 20 ng/dL. The rate was estimated for each treatment group using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [10]
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At Week 1 Day 4 (Day 4)
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Secondary outcome [11]
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Sustained Profound Castration Rate From Week 25 Day 1 Through Week 49 Day 1
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Assessment method [11]
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Sustained profound castration rate was defined as the cumulative probability of testosterone suppression to \< 20 ng/dL. The rate was estimated by the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [11]
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0
Week 25 Day 1 (Day 169) through Week 49 Day 1 (Day 337)
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Secondary outcome [12]
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Undetectable PSA Rate
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Assessment method [12]
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Defined as the proportion of participants with PSA concentration \< 0.02 ng/milliliter (mL).The rate was estimated by the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [12]
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Week 25 Day 1 (Day 169)
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Secondary outcome [13]
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Rate Of PSA Progression-free Survival
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Assessment method [13]
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PSA progression was defined as the first increase in PSA of 25% or greater and 2 ng/mL or greater above the nadir with confirmation by a second consecutive PSA measurement at least 3 weeks later. For participants without declining PSA from baseline, a PSA increase of = 25% and = 2 ng/mL from baseline beyond 12 weeks was considered PSA progression. The rate of progression-free survival was estimated using the Kaplan-Meier method and reported as percentage of participants.
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Timepoint [13]
0
0
Week 49 Day 1 (Day 337)
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Secondary outcome [14]
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Change From Baseline In Quality Of Life (QoL) Total Score As Assessed By The Global Health Domain Of The European Organisation Of Research And Treatment Of Cancer (EORTC)-Quality Of Life Questionnaire (QLQ)-C30
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Assessment method [14]
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The EORTC QLQ-C30 core measurement was used to capture distal outcomes, including physical, social functioning, and overall health-related quality of life. The questionnaire incorporates 30 questions comprising nine multi-item scales: 5 functional scales (physical, role, cognitive, emotional, and social); 3 symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality of life scale. All raw domain scores are linearly transformed to a 0-100 scale. The global health and quality of life domain is presented. An increase in activity or functioning scores indicates improvement (higher/healthier level of functioning) and a decrease in symptom scores indicates improvement (lower level of symptoms/problems).
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Timepoint [14]
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Baseline, Week 49 Day 1 (Day 337)
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Secondary outcome [15]
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Change From Baseline In QoL Total Score For Remaining Domain Scores As Assessed By The EORTC-QLQ-C30
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Assessment method [15]
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The EORTC QLQ-C30 core measurement was used to capture distal outcomes, including physical, social functioning, and overall health-related quality of life. The questionnaire incorporates 30 questions comprising nine multi-item scales: 5 functional scales (physical, role, cognitive, emotional, and social); 3 symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality of life scale. All raw domain scores are linearly transformed to a 0-100 scale. All domains except for the global health and quality are presented. An increase in activity or functioning scores indicates improvement (higher/healthier level of functioning) and a decrease in symptom scores indicates improvement (lower level of symptoms/problems).
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Timepoint [15]
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Baseline, Week 49 Day 1 (Day 337)
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Secondary outcome [16]
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Change From Baseline In QoL Total Score As Assessed By The EORTC-QLQ-PR25 Sexual Activity And Functioning And Hormonal-Treatment-Related Symptom Subdomains
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Assessment method [16]
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Subscales for assessment of hormonal treatment-related symptoms (6 items) and sexual activity and function (6 items) from the EORTC-QLQ-PR25 25-item prostate cancer module of the EORTC are presented. Questions used 4 point scale (1 'Not at all' to 4 'Very much'). All raw domain scores are linearly transformed to a 0-100 scale. An increase in activity or functioning scores indicates improvement (higher/healthier level of functioning) and a decrease in symptom scores indicates improvement (lower level of symptoms/problems).
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Timepoint [16]
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Baseline, Week 49 Day 1 (Day 337)
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Secondary outcome [17]
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Change From Baseline In QoL Total Score For Urinary And Bowel Symptoms Domains As Assessed By The EORTC-QLQ-PR25
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Assessment method [17]
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Subscale assessments of urinary symptoms (9 items) and bowel symptoms (4 items) from the EORTC-QLQ-PR25 25-item prostate cancer module of the EORTC are presented. Questions used 4 point scale (1 'Not at all' to 4 'Very much'). All raw domain scores are linearly transformed to a 0-100 scale. A decrease in symptom scores indicates improvement (lower level of symptoms/problems).
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Timepoint [17]
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Baseline, Week 49 Day 1 (Day 337)
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Secondary outcome [18]
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Change From Baseline In QoL Total Score As Assessed By The European Quality Of Life 5-Dimension 5-Level Questionnaire (EuroQoL EQ-5D-5L)
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Assessment method [18]
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The EuroQoL EQ-5D-5L comprises 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Each dimension has 5 levels: no problems (1 as numerical score), slight problems (2 as numerical score), moderate problems (3 as numerical score), severe problems (4 as numerical score), and extreme problems (5 as numerical score). The total score ranges from 0 to 100. A decrease in score indicates improvement.
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Timepoint [18]
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Baseline, Week 49 Day 1 (Day 337)
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Secondary outcome [19]
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Percent Change From Baseline In Serum Concentrations Of Luteinizing Hormone
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Assessment method [19]
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Blood samples were collected from participants for hormonal measurements.
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Timepoint [19]
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Week 1 Day 4 (Day 4), Week 5 Day 1 (Day 29), Week 25 Day 1 (Day 169), and Week 49 Day 1 (Day 337)
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Secondary outcome [20]
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Percent Change From Baseline In Serum Concentrations Of FSH
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Assessment method [20]
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Blood samples were collected from participants for hormonal measurements.
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Timepoint [20]
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Week 1 Day 4 (Day 4), Week 5 Day 1 (Day 29), Week 25 Day 1 (Day 169), and Week 49 Day 1 (Day 337)
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Secondary outcome [21]
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Percent Change From Baseline In Serum Concentrations Of Dihydrotestosterone
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Assessment method [21]
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Blood samples were collected from participants for hormonal measurements.
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Timepoint [21]
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Week 5 Day 1 (Day 29), Week 25 Day 1 (Day 169), and Week 49 Day 1 (Day 337)
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Secondary outcome [22]
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Percent Change From Baseline In Serum Concentrations Of Sex Hormone-Binding Globulin
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Assessment method [22]
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Blood samples were collected from participants for hormonal measurements.
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Timepoint [22]
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Week 5 Day 1 (Day 29), Week 25 Day 1 (Day 169), and Week 49 Day 1 (Day 337)
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Secondary outcome [23]
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Maximum Observed Plasma Concentration (Cmax) Of Relugolix
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Assessment method [23]
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The Cmax of relugolix was determined for single and repeat doses in subsets of participants from Japan. Single dose pharmacokinetics (PK) was assessed on Day 1 following an initial 360 mg dose of relugolix. Repeat dose PK was assessed following repeat dosing of relugolix 120 mg once daily for 2 weeks.
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Timepoint [23]
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Predose and 0.5, 1, 2, 4, 6, 8, 12, and 24 hours postdose on Day 1 and Week 2
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Secondary outcome [24]
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Area Under The Concentration-Time Curve (AUC0-t) Of Relugolix
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Assessment method [24]
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The AUC0-t of relugolix was determined for single and repeat doses in subsets of participants from Japan. Single dose PK was assessed on Day 1 following an initial 360 mg dose of relugolix. Repeat dose PK was assessed following repeat dosing of relugolix 120 mg once daily for 2 weeks.
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Timepoint [24]
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Predose and 0.5, 1, 2, 4, 6, 8, 12, and 24 hours postdose on Day 1 and Week 2
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Secondary outcome [25]
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Time To Maximum Observed Plasma Concentration (Tmax) Of Relugolix
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Assessment method [25]
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The Tmax of relugolix was determined for single and repeat doses in subsets of participants from Japan. Single dose PK was assessed on Day 1 following an initial 360 mg dose of relugolix. Repeat dose PK was assessed following repeat dosing of relugolix 120 mg once daily for 2 weeks.
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Timepoint [25]
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Predose and 0.5, 1, 2, 4, 6, 8, 12, and 24 hours postdose on Day 1 and Week 2
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Eligibility
Key inclusion criteria
Key
1. Has histologically or cytologically confirmed diagnosis of adenocarcinoma of the prostate.
2. Is a candidate for, in the opinion of the investigator, at least 1 year of continuous androgen deprivation therapy for the management of androgen-sensitive advanced prostate cancer with 1 of the following clinical disease state presentations:
1. Evidence of biochemical (PSA) or clinical relapse following local primary intervention with curative intent, such as surgery, radiation therapy, cryotherapy, or high-frequency ultrasound and not a candidate for salvage treatment by surgery; or
2. Newly diagnosed androgen-sensitive metastatic disease; or
3. Advanced localized disease unlikely to be cured by local primary intervention with either surgery or radiation with curative intent.
3. Has a serum testosterone at the Screening visit of = 150 ng/dL (5.2 nanomoles [nmol]/liter [L]).
4. Has a serum PSA concentration at the Screening visit of > 2.0 ng/milliliter (mL) (2.0 microgram [µg]/L), or, when applicable, post radical prostatectomy of > 0.2 ng/mL (0.2 µg/L) or post radiotherapy, cryotherapy, or high frequency ultrasound > 2.0 ng/mL (2.0 µg/L) above the post interventional nadir.
5. Has an Eastern Cooperative Oncology Group performance status of 0 or 1 at initial screening and at baseline.
Key
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. In the investigator's opinion, is likely to require chemotherapy or surgical therapy for symptomatic disease management within 2 months of initiating androgen deprivation therapy.
2. Previously received gonadotropin-releasing hormone analog or other form of androgen deprivation therapy (estrogen or antiandrogen) for > 18 months total duration. If androgen deprivation therapy was received for = 18 months total duration, then that therapy must have been completed at least 3 months prior to baseline. If the dosing interval of the depot is longer than 3 months, then the prior androgen deprivation therapy must have been completed at least as long as the dosing interval of the depot.
3. Previous systemic cytotoxic treatment for prostate cancer (for example, taxane-based regimen).
4. Metastases to brain per prior clinical evaluation.
5. Participants with myocardial infarction, unstable symptomatic ischemic heart disease, cerebrovascular events, or any significant cardiac condition within the prior 6 months.
6. Active conduction system abnormalities.
7. Uncontrolled hypertension.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
18/04/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
26/11/2021
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Sample size
Target
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Accrual to date
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Final
1134
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Recruitment in Australia
Recruitment state(s)
NSW,QLD
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Recruitment hospital [1]
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0
Camperdown - Camperdown
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Recruitment hospital [2]
0
0
Tweed Heads - Tweed Heads
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Recruitment hospital [3]
0
0
Wahroonga - Wahroonga
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Recruitment hospital [4]
0
0
Redcliffe - Redcliffe
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Recruitment hospital [5]
0
0
Southport - Southport
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Recruitment postcode(s) [1]
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0
2050 - Camperdown
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Recruitment postcode(s) [2]
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2485 - Tweed Heads
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Recruitment postcode(s) [3]
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2076 - Wahroonga
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Recruitment postcode(s) [4]
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0
4020 - Redcliffe
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Recruitment postcode(s) [5]
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0
4215 - Southport
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Recruitment outside Australia
Country [1]
0
0
United States of America
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State/province [1]
0
0
Arizona
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Country [2]
0
0
United States of America
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State/province [2]
0
0
California
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Country [3]
0
0
United States of America
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State/province [3]
0
0
Colorado
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Country [4]
0
0
United States of America
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State/province [4]
0
0
Florida
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Country [5]
0
0
United States of America
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State/province [5]
0
0
Indiana
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Country [6]
0
0
United States of America
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State/province [6]
0
0
Iowa
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Country [7]
0
0
United States of America
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State/province [7]
0
0
Kansas
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Country [8]
0
0
United States of America
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State/province [8]
0
0
Maryland
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Country [9]
0
0
United States of America
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State/province [9]
0
0
Michigan
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Country [10]
0
0
United States of America
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State/province [10]
0
0
Nebraska
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Country [11]
0
0
United States of America
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State/province [11]
0
0
Nevada
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0
0
United States of America
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State/province [12]
0
0
New Jersey
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Country [13]
0
0
United States of America
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State/province [13]
0
0
New Mexico
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Country [14]
0
0
United States of America
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State/province [14]
0
0
New York
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Country [15]
0
0
United States of America
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State/province [15]
0
0
North Carolina
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Country [16]
0
0
United States of America
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State/province [16]
0
0
Ohio
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Country [17]
0
0
United States of America
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State/province [17]
0
0
Oklahoma
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Country [18]
0
0
United States of America
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State/province [18]
0
0
Pennsylvania
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Country [19]
0
0
United States of America
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State/province [19]
0
0
South Carolina
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Country [20]
0
0
United States of America
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0
0
Tennessee
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Country [21]
0
0
United States of America
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State/province [21]
0
0
Texas
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Country [22]
0
0
Austria
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State/province [22]
0
0
Linz
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Country [23]
0
0
Belgium
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State/province [23]
0
0
Oost-Vlaanderen
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Country [24]
0
0
Belgium
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State/province [24]
0
0
Brussels
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Country [25]
0
0
Belgium
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State/province [25]
0
0
Kortrijk
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0
0
Brazil
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State/province [26]
0
0
Bahia
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0
0
Brazil
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0
0
Piauí
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0
0
Brazil
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0
0
Rio Grande Do Norte
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Country [29]
0
0
Brazil
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State/province [29]
0
0
Rio Grande Do Sul
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Country [30]
0
0
Brazil
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State/province [30]
0
0
Santa Catarina
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Country [31]
0
0
Brazil
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State/province [31]
0
0
Sao Paulo
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0
0
Brazil
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State/province [32]
0
0
Curitiba
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Country [33]
0
0
Canada
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State/province [33]
0
0
Alberta
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Country [34]
0
0
Canada
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0
0
British Columbia
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Country [35]
0
0
Canada
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State/province [35]
0
0
Nova Scotia
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Country [36]
0
0
Canada
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State/province [36]
0
0
Ontario
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0
0
Canada
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0
0
Quebec
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Country [38]
0
0
China
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0
0
Jiangsu
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0
0
China
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0
0
Jilin
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0
0
China
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0
0
Shanghai
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0
0
China
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State/province [41]
0
0
Shanxi
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0
0
China
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0
0
Beijing
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Country [43]
0
0
China
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State/province [43]
0
0
Chongqing
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0
0
China
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State/province [44]
0
0
Hangzhou
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0
0
China
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0
0
Lanzhou
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Country [46]
0
0
China
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State/province [46]
0
0
Nanchang
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0
0
China
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State/province [47]
0
0
Suzhou
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Country [48]
0
0
Denmark
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State/province [48]
0
0
Aalborg
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0
0
Denmark
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State/province [49]
0
0
Aarhus
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Country [50]
0
0
Denmark
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State/province [50]
0
0
Herlev
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Country [51]
0
0
Denmark
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State/province [51]
0
0
Vejle
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Country [52]
0
0
Finland
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State/province [52]
0
0
Helsinki
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Country [53]
0
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Finland
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Seinäjoki
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Finland
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Tampere
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Finland
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Turku
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Lyon
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Germany
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Italy
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Piemonte
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Italy
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Toscana
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Italy
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Milano
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Japan
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Kita
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Kyoto
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Sapporo
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Ube
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Gyeonggido
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Busan
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Seoul
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Netherlands
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Sneek
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Hamilton
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Poland
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Martin
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Šala
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A Coruna
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Madrid
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Valencia
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Malmö
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Devon
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Nottingham
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Rhyl
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Myovant Sciences GmbH
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to determine the efficacy and safety of relugolix 120 milligrams (mg) orally once daily for 48 weeks on maintaining serum testosterone suppression to castrate levels (\< 50 nanograms/deciliter \[ng/dL\]) in participants with androgen-sensitive advanced prostate cancer.
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Trial website
https://clinicaltrials.gov/study/NCT03085095
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Trial related presentations / publications
Shore ND, Saad F, Cookson MS, George DJ, Saltzstein DR, Tutrone R, Akaza H, Bossi A, van Veenhuyzen DF, Selby B, Fan X, Kang V, Walling J, Tombal B; HERO Study Investigators. Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer. N Engl J Med. 2020 Jun 4;382(23):2187-2196. doi: 10.1056/NEJMoa2004325. Epub 2020 May 29. Shore ND, Sutton J. Plain language summary of the HERO study comparing relugolix with leuprolide for men with advanced prostate cancer. Future Oncol. 2022 Jul;18(21):2575-2584. doi: 10.2217/fon-2022-0172. Epub 2022 May 19.
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Public notes
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Contacts
Principal investigator
Name
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Myovant Medical Monitor
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Address
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Myovant Sciences
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/95/NCT03085095/Prot_001.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/95/NCT03085095/SAP_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03085095