Last reviewed · How we verify

NCT04926181

Apalutamide Plus Cetrelimab in Patients With Treatment-Emergent Small Cell Neuroendocrine Prostate Cancer

Terminated Phase 2 Results posted Last updated 15 May 2025
What this trial tests

Phase 2 trial testing Apalutamide in Small Cell Neuroendocrine Carcinoma in 2 participants. Terminated before completion.

Timeline
16 March 2022
Primary endpoint
31 March 2024
31 March 2024

Quick facts

Lead sponsorRahul Aggarwal
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment2
Start date16 March 2022
Primary completion31 March 2024
Estimated completion31 March 2024
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Rahul Aggarwal — full company profile →

Who can join

18 and older, male only, with Small Cell Neuroendocrine Carcinoma or Prostate Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Proportion of Participants With Treatment-related Adverse Events (AEs) Secondary · Up to 2 years

Proportion of participants with an adverse event determined to be related to study treatment, and classified using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE version 5.0)

GroupValue95% CI
Single Arm: Apalutamide + Cetrelimab1.00
Proportion of Participants With a >=50% Decline in PSA Secondary · Up to 2 years

Defined as the proportion of participants with a demonstrated \>= 50% decline from baseline serum PSA confirmed by repeat measurement \>= 4 weeks after first time point at any time during the course of the study.

GroupValue95% CI
Single Arm: Apalutamide + Cetrelimab0.5
Proportion of Participants With a >=90% Decline in PSA Secondary · Up to 2 years

Defined as the proportion of participants with a demonstrated \>= 90% decline from baseline serum PSA confirmed by repeat measurement \>= 4 weeks after first time point at any time during the course of the study.

GroupValue95% CI
Single Arm: Apalutamide + Cetrelimab0.5
Overall Survival Rate Secondary · Up to 2 years

The overall survival rate is the percentage of participants still alive from date of initiation of study treatment until death from any cause or censored at time of study closure.

GroupValue95% CI
Single Arm: Apalutamide + Cetrelimab50

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to 2 years. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Single Arm: Apalutamide + Cetrelimab
Serious: 1/2 (50%)
Deaths: 1/2

Serious adverse events (3 terms)

ReactionSystemSingle Arm: Apalutamide + …
DiarrheaGastrointestinal disorders
Acute kidney injuryRenal and urinary disorders
SepsisInfections and infestations
Other adverse events (12 terms — click to expand)

ReactionSystemSingle Arm: Apalutamide + …
Urinary Tract infectionInfections and infestations
FatigueGeneral disorders
NauseaGastrointestinal disorders
HematuriaRenal and urinary disorders
Peripheral sensory neuropathyNervous system disorders
DysgeusiaNervous system disorders
ArthritisMusculoskeletal and connective tissue disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Weight LossInvestigations
FallInjury, poisoning and procedural complications
SepsisInfections and infestations
DiarrheaGastrointestinal disorders

Most-reported serious reactions: Diarrhea, Acute kidney injury, Sepsis.

Data from ClinicalTrials.gov NCT04926181 adverse events section.

Sponsor's own description

Despite the low androgen receptor (AR) transcriptional activity of treatment-emergent small cell neuroendocrine prostate cancer, there is persistent AR expression observed in the majority of treatment-emergent small-cell neuroendocrine prostate cancer (t-SCNC) biopsies. This indicates that epigenetic dysregulation leads to reprogramming away from an AR-driven transcriptional program. Therefore, continuation of AR blockade in the form of apalutamide may provide additive benefit compared to immune checkpoint blockade alone. The investigators hypothesize that the combination of apalutamide plus cetrelimab will achieve a clinically significant composite response rate with sufficient durability of response in mCRPC patients with evidence of treatment-emergent small cell neuroendocrine prostate cancer

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Androgen receptor blockade promotes response to BRAF/MEK-targeted therapy.
    Vellano CP, White MG, Andrews MC, Chelvanambi M, et al · · 2022 · cited 96× · PMID 35705814 · DOI 10.1038/s41586-022-04833-8
  2. Immune Checkpoint Inhibitors Combined with Targeted Therapy: The Recent Advances and Future Potentials.
    Li B, Jin J, Guo D, Tao Z, et al · · 2023 · cited 66× · PMID 37345194 · DOI 10.3390/cancers15102858
  3. Lineage plasticity and treatment resistance in prostate cancer: the intersection of genetics, epigenetics, and evolution.
    Imamura J, Ganguly S, Muskara A, Liao RS, et al · · 2023 · cited 34× · PMID 37455903 · DOI 10.3389/fendo.2023.1191311
  4. Significance of RB Loss in Unlocking Phenotypic Plasticity in Advanced Cancers.
    Venkadakrishnan VB, Yamada Y, Weng K, Idahor O, et al · · 2023 · cited 24× · PMID 37052520 · DOI 10.1158/1541-7786.mcr-23-0045
  5. The Role of Epigenetic Change in Therapy-Induced Neuroendocrine Prostate Cancer Lineage Plasticity.
    Storck WK, May AM, Westbrook TC, Duan Z, et al · · 2022 · cited 24× · PMID 35909568 · DOI 10.3389/fendo.2022.926585
  6. Immunotherapy for Prostate Cancer: A Current Systematic Review and Patient Centric Perspectives.
    Rehman LU, Nisar MH, Fatima W, Sarfraz A, et al · · 2023 · cited 21× · PMID 36835981 · DOI 10.3390/jcm12041446
  7. The Current Therapeutic Landscape for Metastatic Prostate Cancer.
    Bernal A, Bechler AJ, Mohan K, Rizzino A, et al · · 2024 · cited 18× · PMID 38543137 · DOI 10.3390/ph17030351
  8. Androgen drives melanoma invasiveness and metastatic spread by inducing tumorigenic fucosylation.
    Liu Q, Adhikari E, Lester DK, Fang B, et al · · 2024 · cited 18× · PMID 38326303 · DOI 10.1038/s41467-024-45324-w

Verify or expand the search:

Other trials of Apalutamide

Trials testing the same drug.

Other Rahul Aggarwal trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04926181.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing