Prostatic NeoplasmsPhase 3PRIMORDIUMNCT04557059
A Study of Adding Apalutamide to Radiotherapy and LHRH Agonist in High-Risk Patients With Hormone-Sensitive Prostate Cancer
A Phase 3 study testing Radiotherapy, LHRHa and Apalutamide in people with Prostatic Neoplasms, run by Janssen Pharmaceutica N.V., Belgium at 141 sites in 21 countries.
Trial summary
The main purpose of this study is to determine if the addition of apalutamide to radiotherapy (RT) plus luteinizing hormone-releasing hormone agonist (LHRHa) delays metastatic progression as assessed by prostate specific membrane antigen-positron emission tomography (PSMA-PET) or death compared with RT plus LHRHa… Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Prostatic Neoplasms
- What is being tested?
- Radiotherapy, LHRHa and Apalutamide
- Type of treatment
- Pill or oral medicine, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 691 participants
- Where
- 141 sitesin 21 countries
- Study dates
- 12 Nov 2020to 15 Sep 2031
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically confirmed adenocarcinoma of the prostate
- Previously treated with radical prostatectomy with or without lymph node dissection and either: a) for biochemical recurrence after radical prostatectomy (RP): any post-operative prostate-specific antigen (PSA) measurement of less than (<) 0.1 nanogram/milliliter (ng/mL) within 12 months after RP and without any PSA greater than and equal to (>=) 0.1 ng/mL within the 4 to 8-week period after RP or b) for persistent PSA after RP: PSA >=0.1 ng/mL within the 4 to 8-week period after RP, confirmed by additional measurement at least 3 weeks later
- Be able to swallow whole the study drug tablets or follow the instructions for admixing with apple sauce
- Results of the Prostate specific membrane antigen-positron emission tomography (PSMA-PET) at screening as determined by blinded independent, central review (BICR), must be: PSMA-PET-negative for any prostate cancer lesions (that is, no loco-regional lesion and no distant lesions); or PSMA-PET-positive for at least one loco-regional (pelvic) lesion without distant extra-pelvic lesion; or PSMA PET- positive for at least one loco--regional (pelvic) lesion with extra-pelvic lesion(s).
- High risk of developing metastasis defined as; a) for biochemical recurrence after RP: pathological Gleason score greater than or equal to (>=) 8 evaluated from prostate tissue specimen at radical prostatectomy, or prostate-specific antigen doubling time (PSADT) less than or equal to (<=) 12 months at the time of screening; b) for persistent PSA after RP: pathological Gleason score >=8, evaluated from prostate tissue specimen at radical prostatectomy
- Participants with evidence of distant metastasis on screening PSMA-PET scan must have no evidence of prostate cancer metastases on screening CT/MRI of the chest/abdomen/pelvis, Technetium 99m [99mTc] whole-body bone scan. Participants with a single bone lesion on 99mTc whole-body bone scan should have confirmatory imaging by CT or MRI; if the confirmatory scan confirms the bone lesion, the participant should be excluded from the study. Conventional images (99mTc-bone scan and CT/MRI) from the screening will be evaluated locally before randomization
- Eastern Cooperative Oncology Group Performance Status Grade 0 or 1
Who cannot join
- History of pelvic radiation for malignancy
- Previous treatment with androgen deprivation therapy (ADT) for prostate cancer
- Previously treated for biochemical recurrence (BCR) or persistent PSA after RP (previous surgical treatment of one or more loco-regional lesions is allowed)
- Prior treatment with a CYP17 inhibitor (example, oral ketoconazole, orteronel, abiraterone acetate, galeterone) or any androgen receptor (AR) antagonist including bicalutamide, flutamide, nilutamide, apalutamide, enzalutamide or darolutamide and any other medications that may lower androgen levels (estrogens, progestins, aminoglutethimide, etc.), including bilateral orchiectomy
- Known or suspected contraindications or hypersensitivity to apalutamide, Luteinizing Hormone-Releasing Hormone (LHRH) agonist or any of the components of the formulations
- Prior chemotherapy for prostate cancer
- Any evidence of prostate cancer metastasis on computed tomography/magnetic resonance imaging (CT/MRI) of the chest/abdomen/pelvis or 99mTc whole-body bone scan, at any time prior to screening
Trial locations and contacts
141 sites in 21 countries.
141 sites in 21 countries
United States13 sites
Urology Austin
Austin, Texas, 78745
MidLantic Urology
Bala-Cynwyd, Pennsylvania, 19004
The Urology Group
Cincinnati, Ohio, 45212
Urological Research Network
Hialeah, Florida, 33016
Houston Metro Urology
Houston, Texas, 77027
First Urology, PSC
Jeffersonville, Indiana, 47130
Colorado Clinical Research
Lakewood, Colorado, 80228
Arkansas Urology
Little Rock, Arkansas, 72211
Spokane Urology
Spokane, Washington, 99202
Oregon Urology Institute
Springfield, Oregon, 97477
Associated Medical Professionals of Ny
Syracuse, New York, 13210
Michigan Institute of Urology
Troy, Michigan, 48084
Arizona Urology Specialists
Tucson, Arizona, 85741
Turkey (Türkiye)12 sites
Adana Baskent Yuregir Hospital
Adana, 01250
Dr. Abdurrahman Yurtaslan Ankara Onkoloji Egitim ve Arastirma Hastanesi
Ankara, 06200
Hacettepe Universitesi Hastanesi
Ankara, 06230
Memorial Ankara Hastanesi
Ankara, 06520
Ankara University Medical Faculty
Ankara, 06590
Koc University, School of Medicine, Koc University Hospital
Istanbul, 34010
Istanbul University Cerrahpasa Medical Faculty
Istanbul, 34096
Bakirkoy Training and Research Hospital
Istanbul, 34147
Goztepe Prof Dr Suleyman Yalcin Sehir Hastanesi
Istanbul, 34722
Kartal Dr Lutfi Kirdar Egitim ve Arastirma Hastanesi
Istanbul, 34890
Dokuz Eylul Universitesi Arastirma ve Uygulama Hastanesi
Izmir, 35340
Sakarya Üniversitesi Tıp Fakültesi Hastanesi
Sakarya, 54187
Brazil11 sites
Hospital das Clínicas - Universidade Federal de Minas Gerais
Belo Horizonte, 30130 100
Hospital Erasto Gaertner- Liga Paranaense de Combate ao Cancer
Curitiba, 81520-060
Liga Norte Riograndense Contra O Cancer
Natal, 59075-740
Hospital Moinhos de Vento
Porto Alegre, 90035-001
Irmandade Santa Casa de Misericordia de Porto Alegre
Porto Alegre, 90050-170
Oncoclinicas Rio de Janeiro S A
Rio de Janeiro, 22250-905
IDOR - Regional Bahia
Salvador, 41253-190
Sociedade Beneficente de Senhoras Hospital Sirio Libanes
São Paulo, 01308 901
Hospital Alemao Oswaldo Cruz
São Paulo, 01421-000
Núcleo de Pesquisa São Camilo
São Paulo, 04014-002
Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein
São Paulo, 05652 900
Spain11 sites
Hospital Universitario Puerto Del Mar
Cadiz, 11009
Hosp. Arquitecto Marcide
Ferrol, 15405
Hosp. de Jerez de La Frontera
Jerez de la Frontera, 11407
Hosp. Univ. 12 de Octubre
Madrid, 28041
Hosp. Univ. de La Paz
Madrid, 28046
Hosp Virgen de La Victoria
Málaga, 29010
Clinica Univ. de Navarra
Pamplona, 31008
Hosp. de Navarra
Pamplona, 31008
Hosp. Virgen Del Rocio
Seville, 41013
Hosp. Univ. I Politecni La Fe
Valencia, 46026
Hosp. Clinico Univ. Lozano Blesa
Zaragoza, 50009
Poland9 sites
Centrum Onkologii im Prof F Lukaszczyka w Bydgoszczy
Bydgoszcz, 85 796
NU-MED Grupa S.A Centrum Radioterapii i Onkologii
Elblag, 82-300
Uniwersyteckie Centrum Kliniczne
Gdansk, 80 952
Szpitale Pomorskie Sp z o o
Gdynia, 81 519
Swietokrzyskie Centrum Onkologii SPZOZ w Kielcach
Kielce, 25 734
Szpital Wojewodzki im Mikolaja Kopernika w Koszalinie
Koszalin, 75 581
Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im M Kopernika w Lodzi
Lodz, 93 513
Radomskie Centrum Onkologii
Radom, 26-600
Narodowy Instytut Onkologii im Marii Sklodowskiej Curie Panstwowy Instytut Badawczy
Warsaw, 02 781
Australia8 sites
Bundaberg Hospital
Bundaberg, 4670
Hervey Bay Hospital
Bundaberg, 4670
Epworth Healthcare
East Melbourne, 3002
St Vincent's Hospital - Melbourne
Fitzroy, 3065
Genesis Care Hurstville
Hurstville, 2220
Macquarie University Hospital
North Ryde, 2109
Calvary Mater Newcastle
Waratah, 2298
GenesisCare Wembley
Wembley, 6014
Portugal8 sites
Ipo Lisboa
Lisbon, 1099-023
Hosp. Cuf Tejo
Lisbon, 1350-352
Fund. Champalimaud
Lisbon, 1400-038
Uls Lisboa Ocidental - Hosp. Sao Francisco Xavier
Lisbon, 1449-005
Hosp. Da Luz Lisboa
Lisbon, 1500 650
Uls Santa Maria - Hosp. Santa Maria
Lisbon, 1649 035
Uls Santo Antonio - Hosp. Santo Antonio
Porto, 4099-001
Uls de Entre Douro E Vouga - Hosp. Sao Sebastiao
Santa Maria da Feira, 4520-211
Russia8 sites
Ivanovo Regional Oncology Dispensary
Ivanovo, 153040
City Clinical Hospital #57
Moscow, 105077
I.M. Sechenov First Moscow State Medical University
Moscow, 119991
Hertzen Oncology Research Institute
Moscow, 125284
Leningrad Regional Oncology Dispensary
Saint Petersburg, 191104
SPb SBIH 'City Clinical Oncological Dispensary'
Saint Petersburg, 197022
Multifunctional clinical medical center 'Medical city'
Tyumen, 625041
SHI Sverdlovsk Regional Clinical Hospital #1
Yekaterinburg, 620102
Hungary7 sites
Péterfy Sándor utcai Kórház
Budapest, 1076
Budapesti Bajcsy Zsilinszky Korhaz es Rendelointezet
Budapest, 1106
Orszagos Onkologiai Intezet
Budapest, 1122
Eszak Budai Szent Janos Centrumkorhaz
Budapest, 1125
Budapesti Uzsoki Utcai Korhaz
Budapest, 1145
Jahn Ferenc Del-pesti Korhaz es Rendelointezet
Budapest, 1204
Debreceni Egyetem Klinikai Kozpont
Debrecen, 4032
Mexico7 sites
Consultorio de Especialidad en Urologia Privado
Durango, 34000
Hospital MAC Leon
León, 37530
Avix Investigacion Clinica S C
Monterrey, 64623
Oncologia Integral Satelite
Naucalpan, 53100
Centro de Investigacion Clinica de Oaxaca
Oaxaca City, 68020
Oncocenter
Puebla City, 72530
Cuidados Oncologicos
Querétaro, 76000
Slovakia7 sites
CUIMED - urologická ambulancia
Bratislava, 851 05
Východoslovenský Onkologický Ústav
Košice, 04191
Univerzitná nemocnica Martin
Martin, 036 59
Uroexam s.r.o.
Nitra, 94901
Urologicka ambulancia e.cho Poprad, s.r.o
Poprad, 05801
MILAB s.r.o.
Prešov, 08001
Privátna urologická ambulancia
Trenčín, 911 01
Germany6 sites
Vivantes Klinikum Am Urban
Berlin, 10967
Städtisches Klinikum Braunschweig gGmbH - Standort Salzdahlumer
Braunschweig, 38126
Universitatsklinikum Carl Gustav Carcus Dresden
Dresden, 01307
Universitatsklinikum Essen
Essen, D-45147
Klinikum rechts der Isar - der Technischen Universität München
München, 81675
Universitaetsklinikum Muenster
Münster, 48149
Italy6 sites
Radioterapia Oncologica, A.O.U. San'T Orsola
Bologna, 40138
Azienda Ospedaliero Universitaria Careggi
Florence, 50134
Ospedale San Raffaele
Milan, 20132
Fondazione Policlinico Tor Vergata
Roma, 00133
Istituto Nazionale Tumori Regina Elena
Roma, 00144
Azienda Ospedaliera Sant Andrea
Roma, 00189
Finland5 sites
Helsinki University Hospital
Helsinki, 00290
Oulu University Hospital
Oulu, 90220
Tampere University Hospital
Tampere, 33521
Turku University Hospital
Turku, 20520
Vaasa Central Hospital
Vaasa, 65130
Belgium4 sites
ZAS Augustinus
Antwerp, 2610
A.Z. Sint Jan
Bruges, 8000
UZ Gent
Ghent, 9000
Az Groeninge
Kortrijk, 8500
Czechia4 sites
Fakultni nemocnice Plzen, Urologicka klinika
Pilsen, 305 99
Urocentrum Praha
Prague, 120 00
Urologicka klinika 1 LF UK a VFN
Prague, 120 00
Fakultni nemocnice v Motole
Prague, 15006
Denmark4 sites
Aalborg University Hospital
Aalborg, 9000
Aarhus University Hospital
Aarhus N, 8200
Rigshospitalet
Copenhagen N, 2200
Gentofte Herlev Hospital
Herlev, 2730
Lebanon4 sites
St Georges Hospital university medical centre
Beirut, 11 00 2807
American Universitty of Beirut Medical Center
Beirut, 1107 2020
Notre Dame De Secours
Byblos, 3
Centre Hospitalier du Nord
Zghartā, 100
Austria3 sites
Ordensklinikum Linz GmbH Elisabethinen
Linz, 4020
Universitaetsklinikum Salzburg Landeskrankenhaus
Salzburg, 5020
Medizinische Universitaet Wien
Vienna, 1090
Sweden3 sites
Urologiska Mottagningen
Malmö, 205 02
Prostatacancercentrum
Stockholm, 112 19
Sodersjukhuset
Stockholm, 11883
About this study
Official title: A Randomized, Controlled, Multicenter, Open-label Study to Investigate the Efficacy and Safety of Adding Apalutamide to Radiotherapy and LHRH Agonist in High-Risk Patients With Hormone-Sensitive Prostate Cancer, Assessed by PSMA-PET With an Observational Cohort
The main purpose of this study is to determine if the addition of apalutamide to radiotherapy (RT) plus luteinizing hormone-releasing hormone agonist (LHRHa) delays metastatic progression as assessed by prostate specific membrane antigen-positron emission tomography (PSMA-PET) or death compared with RT plus LHRHa alone.
- Conditions
- Prostatic Neoplasms
- Being tested
- Radiotherapy, LHRHa, Apalutamide
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RadiotherapyRadiation
Participants will receive radiotherapy (RT) with or without optional stereotactic body radiation therapy (SBRT), which will start within 4 weeks after randomization.
LHRHaDrug
Participants will be administered with LHRHa (example, leuprolide, goserelin, triptorelin acetate) as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12 or as a 6-monthly depot preparation within 3 days after randomization.
ApalutamideDrug
Also called JNJ-56021927
Participants will receive therapeutic dose of apalutamide 240 mg once daily for 180 Days.
| Study group | Role | What they receive |
|---|---|---|
| Interventional Cohort (Group 1): RT+ LHRHa | Active comparator | Participants will receive radiotherapy (RT) which is defined as prostate-bed plus pelvic lymph node salvage external-beam radiotherapy with or without optional stereotactic body radiation therapy (SBRT), along with a luteinizing hormone-releasing hormone agonist (LHRHa) as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12, or as a 6-monthly depot preparation within 3 days after randomization. Receives: Radiation: Radiotherapy; Drug: LHRHa |
| Interventional Cohort (Group 2): RT+LHRHa + Apalutamide | Experimental | Participants will receive prostate-bed plus pelvic lymph node salvage external-beam radiotherapy (RT) with or without optional stereotactic body radiation therapy (SBRT), along with a LHRHa as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12, or as a 6-monthly depot preparation within 3 days after randomization. Participants will also receive 240 milligram (mg) of apalutamide starting within 3 days after randomization as film-coated tablets, to be swallowed whole and together once daily with or without food, for a period of 180 Days. Receives: Radiation: Radiotherapy; Drug: LHRHa; Drug: Apalutamide |
| Observational Cohort(Group3) PSMA-PET Negative Participants | No intervention | Enrollment into this cohort will be stopped further. Participants who were PSMA-PET-negative at screening and were already enrolled in the Observational Cohort will continue in this cohort. Data collected in the course of routine clinical practice during this period will include clinical evaluations, disease progression, therapies administered as per standard-of-care at the study-sites and survival status. For Observational Cohort, information will be entered into the electronic case report form (eCRF) from the medical records at least twice a year. The use of any medicinal product(s) for the treatment and management of participants will be at discretion of the treating physician. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Prostate specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) Metastatic Progression-free Survival (ppMPFS)
ppMPFS is defined as the appearance of at least one new PSMA-PET-positive distant lesion compared with the previous scan as assessed by blinded independent central review (BICR) or death.
Measured: Up to 9 years
Secondary outcomes (7)
Time to Prostate-Specific Antigen (PSA) Progression
Time to PSA progression is defined as the time from randomization to the date of first documentation of PSA progression. PSA progression is defined as a PSA concentration above the nadir of more than 0.5 nanogram per milliliter (ng/mL), confirmed by additional measurement at least 3 Weeks later.
Measured: Up to 9 years
PSA Response Rate
PSA response rate is defined as the percentage of participants with a PSA decrease of >= 50 percent (%), >= 90% or undetectable from baseline.
Measured: Up to 9 years
PSA Levels at Week 26
PSA levels at week 26 will be reported.
Measured: Week 26
Time to Loco-Regional Progression by PSMA-PET
Time to loco-regional progression by PSMA-PET as assessed by blinded independent central review (BCIR) is defined as the time from randomization to the date of the first occurrence of PSMA-PET loco-regional progression. Criteria for PSMA-PET loco-regional progression: Appearance of at least one new PSMA-PET-positive loco-regional lesion compared with the previous scan.
Measured: Up to 9 years
Overall Survival
Overall survival is defined as the time from randomization to date of death from any cause.
Measured: Up to 9 years
Prostate Cancer-Specific Survival
Prostate cancer-specific survival is defined as the time from randomization to date of death due to prostate cancer.
Measured: Up to 9 years
Number of Participants With Adverse Event (AE) and Serious Adverse Events (SAEs)
An AE is any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the study vaccine. An AE can therefore be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non-investigational) product, whether or not related to that medicinal (investigational or non-investigational) product. An SAE is any AE that results in: death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect and is a suspected transmission of any infectious agent via a medicinal product.
Measured: Up to 9 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Sep 2020
- Study start12 Nov 2020
- Primary completion27 Aug 2029 (estimated)
- Study completion15 Sep 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Prostatic NeoplasmsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 691 participants (actual)
Sponsor and investigators
- Lead sponsor
- Janssen Pharmaceutica N.V., Belgium
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Janssen Pharmaceutica N.V., Belgium Clinical Trial, Study director, Janssen Pharmaceutica N.V., Belgium
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04557059
- Sponsor's protocol ID
- CR108705
- Other IDs
- 56021927PCR3015, 2019-002957-46, 2023-505852-23-00, 2023, 2019
- Acronym
- PRIMORDIUM
- Status last verified
- Nov 2026
- First submitted
- 17 Sep 2020
- Last updated
- 3 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Controlled, Multicenter, Open-label Study to Investigate the Efficacy and Safety of Adding Apalutamide to Radiotherapy and LHRH Agonist in High-Risk Patients With Hormone-Sensitive Prostate Cancer, Assessed by PSMA-PET With an Observational Cohort
- ClinicalTrials.gov ID
- NCT04557059
- Acronym / sponsor ID
- PRIMORDIUM / CR108705
- Conditions
- Prostatic Neoplasms
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 691 participants (actual)
- Lead sponsor
- Janssen Pharmaceutica N.V., BelgiumIndustry (pharma, biotech, devices)
- Study start
- 12 Nov 2020 (actual)
- Primary completion
- 27 Aug 2029 (estimated)
- Study completion
- 15 Sep 2031 (estimated)
- First posted
- 21 Sep 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main purpose of this study is to determine if the addition of apalutamide to radiotherapy (RT) plus luteinizing hormone-releasing hormone agonist (LHRHa) delays metastatic progression as assessed by prostate specific membrane antigen-positron emission tomography (PSMA-PET) or death compared with RT plus LHRHa alone.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Interventional Cohort (Group 1): RT+ LHRHa | Active comparator | Radiation: Radiotherapy, Drug: LHRHaParticipants will receive radiotherapy (RT) which is defined as prostate-bed plus pelvic lymph node salvage external-beam radiotherapy with or without optional stereotactic body radiation therapy (SBRT), along with a luteinizing hormone-releasing hormone agonist (LHRHa) as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12, or as a 6-monthly depot preparation within 3 days after randomization. |
| Interventional Cohort (Group 2): RT+LHRHa + Apalutamide | Experimental | Radiation: Radiotherapy, Drug: LHRHa, Drug: ApalutamideParticipants will receive prostate-bed plus pelvic lymph node salvage external-beam radiotherapy (RT) with or without optional stereotactic body radiation therapy (SBRT), along with a LHRHa as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12, or as a 6-monthly depot preparation within 3 days after randomization. Participants will also receive 240 milligram (mg) of apalutamide starting within 3 days after randomization as film-coated tablets, to be swallowed whole and together once daily with or without food, for a period of 180 Days. |
| Observational Cohort(Group3) PSMA-PET Negative Participants | No intervention | –Enrollment into this cohort will be stopped further. Participants who were PSMA-PET-negative at screening and were already enrolled in the Observational Cohort will continue in this cohort. Data collected in the course of routine clinical practice during this period will include clinical evaluations, disease progression, therapies administered as per standard-of-care at the study-sites and survival status. For Observational Cohort, information will be entered into the electronic case report form (eCRF) from the medical records at least twice a year. The use of any medicinal product(s) for the treatment and management of participants will be at discretion of the treating physician. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Histologically confirmed adenocarcinoma of the prostate
- Previously treated with radical prostatectomy with or without lymph node dissection and either: a) for biochemical recurrence after radical prostatectomy (RP): any post-operative prostate-specific antigen (PSA) measurement of less than (<) 0.1 nanogram/milliliter (ng/mL) within 12 months after RP and without any PSA greater than and equal to (>=) 0.1 ng/mL within the 4 to 8-week period after RP or b) for persistent PSA after RP: PSA >=0.1 ng/mL within the 4 to 8-week period after RP, confirmed by additional measurement at least 3 weeks later
- Be able to swallow whole the study drug tablets or follow the instructions for admixing with apple sauce
- Results of the Prostate specific membrane antigen-positron emission tomography (PSMA-PET) at screening as determined by blinded independent, central review (BICR), must be: PSMA-PET-negative for any prostate cancer lesions (that is, no loco-regional lesion and no distant lesions); or PSMA-PET-positive for at least one loco-regional (pelvic) lesion without distant extra-pelvic lesion; or PSMA PET- positive for at least one loco--regional (pelvic) lesion with extra-pelvic lesion(s).
- High risk of developing metastasis defined as; a) for biochemical recurrence after RP: pathological Gleason score greater than or equal to (>=) 8 evaluated from prostate tissue specimen at radical prostatectomy, or prostate-specific antigen doubling time (PSADT) less than or equal to (<=) 12 months at the time of screening; b) for persistent PSA after RP: pathological Gleason score >=8, evaluated from prostate tissue specimen at radical prostatectomy
Key exclusion criteria (7 listed)
- History of pelvic radiation for malignancy
- Previous treatment with androgen deprivation therapy (ADT) for prostate cancer
- Previously treated for biochemical recurrence (BCR) or persistent PSA after RP (previous surgical treatment of one or more loco-regional lesions is allowed)
- Prior treatment with a CYP17 inhibitor (example, oral ketoconazole, orteronel, abiraterone acetate, galeterone) or any androgen receptor (AR) antagonist including bicalutamide, flutamide, nilutamide, apalutamide, enzalutamide or darolutamide and any other medications that may lower androgen levels (estrogens, progestins, aminoglutethimide, etc.), including bilateral orchiectomy
- Known or suspected contraindications or hypersensitivity to apalutamide, Luteinizing Hormone-Releasing Hormone (LHRH) agonist or any of the components of the formulations
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RadiotherapyParticipants will receive radiotherapy (RT) with or without optional stereotactic body radiation therapy (SBRT), which will start within 4 weeks after randomization. | Radiation | Interventional Cohort (Group 1): RT+ LHRHa, Interventional Cohort (Group 2): RT+LHRHa + Apalutamide |
| LHRHaParticipants will be administered with LHRHa (example, leuprolide, goserelin, triptorelin acetate) as a 3-monthly depot preparation within 3 days after randomization and the end of Week 12 or as a 6-monthly depot preparation within 3 days after randomization. | Drug | Interventional Cohort (Group 1): RT+ LHRHa, Interventional Cohort (Group 2): RT+LHRHa + Apalutamide |
| ApalutamideAlso: JNJ-56021927Participants will receive therapeutic dose of apalutamide 240 mg once daily for 180 Days. | Drug | Interventional Cohort (Group 2): RT+LHRHa + Apalutamide |
Primary outcome
Prostate specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) Metastatic Progression-free Survival (ppMPFS)
Time frame: Up to 9 years
ppMPFS is defined as the appearance of at least one new PSMA-PET-positive distant lesion compared with the previous scan as assessed by blinded independent central review (BICR) or death.
7 secondary outcomes
Time to Prostate-Specific Antigen (PSA) Progression
Time frame: Up to 9 years
PSA Response Rate
Time frame: Up to 9 years
PSA Levels at Week 26
Time frame: Week 26
Time to Loco-Regional Progression by PSMA-PET
Time frame: Up to 9 years
Overall Survival
Time frame: Up to 9 years
Prostate Cancer-Specific Survival
Time frame: Up to 9 years
Number of Participants With Adverse Event (AE) and Serious Adverse Events (SAEs)
Time frame: Up to 9 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2026.
- Individual participant dataSharing planned: Yes. The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Janssen Pharmaceutica N.V., Belgium Clinical Trial study director
Janssen Pharmaceutica N.V., Belgium
141 sites in 21 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Radiotherapy, LHRHa and Apalutamide in people with Prostatic Neoplasms, run by Janssen Pharmaceutica N.V., Belgium at 141 sites in 21 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 141 sites in United States, Turkey (Türkiye), Brazil, Spain, Poland and 16 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Prostate specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) Metastatic Progression-free Survival (ppMPFS) (time frame: Up to 9 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.