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AZD4635

Phase 2

Progressive Metastatic Castrate-Resistant Prostate Cancer | Small molecule | Oncology |AstraZeneca PLC|Last Updated: Apr 16, 2024

Success Probability

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Trial Design

CONTROLLED
Total Trials1
Total Enrollment30

FDA Designations

No designations recorded

Clinical trial landscape

AZD4635 · 5 trials · 8 indications

Phase 2 2Phase 1 3
NCT04495179A Study of AZD4635 With Durvalumab and With Cabazitaxel and Durvalumab in Patients With mCRPC.Progressive Metastatic Castrate-Resistant Prostate Cancer
COMPLETED30 Analytics
NCT04089553An Open-label, Phase II Study of AZD4635 in Patients With Prostate CancerProstate Cancer
COMPLETED59 Analytics
PHASE2COMPLETED
A Study of AZD4635 With Durvalumab and With Cabazitaxel and Durvalumab in Patients With mCRPC.
Progressive Metastatic Castrate-Resistant Prostate CancerUnlock trial analytics
PHASE2COMPLETED
An Open-label, Phase II Study of AZD4635 in Patients With Prostate Cancer
Prostate CancerUnlock trial analytics

Study Endpoints

Primary Endpoints

Radiographic Progression Free Survival (rPFS) in Each Arm Separately to Determine the Efficacy of AZD4635 Plus Durvalumab and of AZD4635 Plus Durvalumab Plus Cabazitaxel in Patients With Metastatic Castrate-resistant Prostate Cancer (mCRPC)
From first dose to first documented progression or death from any cause (whichever comes first) (approximately 1 year)

rPFS was defined as the time from first dose to radiographic progression, assessed by the Investigator per RECIST 1.1 (soft tissue) and PCWG3 (Prostate Cancer Working Group 3) criteria \[bone\] or death from any cause, whichever occurred first.

Percentage of Participants With Confirmed Objective Response Per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
Baseline (Day -28) through end of study (last participant last visit) (approximately 22 months)

The confirmed objective response is defined as confirmed complete response (CR) or confirmed partial response (PR) based on RECIST v1.1 guidelines, assessed by computed tomography (CT) scan/ magnetic resonance imaging (MRI) scan/ positron emission tomography (PET) scan and bone scan. The CR is defined as disappearance of all target and non-target lesions and no new lesions. The PR is defined as \>= 30% decrease in the sum of the diameters of target lesions compared to baseline and no new non-target lesion. A confirmed CR or PR is defined as 2 CRs or 2 PRs that were separated by at least 4 weeks with no evidence of progression in-between.

Percentage of Participants With Confirmed Prostate-specific Antigen (PSA) Response Per Prostate Cancer Working Group 3 (PCWG3) Criteria
Baseline (Day -28) through end of study (last participant last visit) (approximately 22 months)

A confirmed PSA response is defined as reduction in the PSA level of \>= 50% from baseline to the lowest post-baseline PSA results, measured twice, at least 3 weeks apart by the PCWG3 criteria.

Area under the plasma concentration-time curve from time zero to infinity (AUC)
Days 1-6 and Days 11-16

To assess the effect of fluvoxamine and smoking on the PK of AZD4635 following single oral dosing in healthy volunteers

Area under the plasma concentration-time curve from time zero to time of last quantifiable concentration (AUC0-t)
Days 1-6 and Days 11-16

To assess the effect of fluvoxamine and smoking on the PK of AZD4635 following single oral dosing in healthy volunteers

Maximum observed plasma concentration (Cmax)
Days 1-6 and Days 11-16

To assess the effect of fluvoxamine and smoking on the PK of AZD4635 following single oral dosing in healthy volunteers

The incidence of Adverse event and SAE
From the informed consent to 30 days post last dose

Investigate the safety and tolerability of AZD4635

The incidence of Dose-limiting toxicity (DLTs)
25 days (Cycle0 and Cycle1)

Investigate the safety and tolerability of AZD4635

The incidence of Dose-Limiting Toxicities (DLTs) in patients receiving AZD4635 monotherapy orally.
3 weeks (One Cycle)

A Bayesian Logistic Regression Model (BLRM) based approach will be used to identify the set of AZD4635 doses where the incidence of DLTs is no larger than 33%. In each arm, up to 3 patients will be initially assessed. The dose will be escalated to the next higher dose level if all 3 patients in the previous dose level complete the DLT evaluation period without a DLT. Following the first DLT, the BLRM model will be run and the output made available to the safety review committee (SRC) to guide further dosing decisions. Each dose cohort will include a maximum of 6 patients.

The incidence of Dose-Limiting Toxicities (DLTs) in patients receiving AZD4635 in combination with durvalumab.
7 weeks (Including Cycle 0)

A Bayesian Logistic Regression Model (BLRM) based approach will be used to identify the set of AZD4635 doses where the incidence of DLTs is no larger than 33%. In each arm, up to 3 patients will be initially assessed. The dose will be escalated to the next higher dose level if all 3 patients in the previous dose level complete the DLT evaluation period without a DLT. Following the first DLT, the BLRM model will be run and the output made available to the safety review committee (SRC) to guide further dosing decisions. Each dose cohort will include a maximum of 6 patients.

The incidence of Dose-Limiting Toxicities (DLTs) in patients receiving AZD4635 in combination with either abiraterone acetate or enzalutamide.
21 days (Cycle 1)

The starting dose of AZD4635 is 50 mg PO QD. Escalations of AZD4635 will be made based on emerging data, including nonclinical or clinical evidence, and assessment by the Safety Review Committee (SRC). Each dose cohort will include a maximum of 6 evaluable patients. An additional 6 patients will be treated at selected dose(s) to obtain further the safety, tolerability, and PK.

The incidence of adverse events
Patients will be followed for either 21 days in Cycles 1 and 2 or 28 days in Cycles 3 and beyond to determine the incidence of adverse events.

Safety and tolerability will be assessed in monotherapy and combination cohorts by determining the incidence of adverse events, including abnormal laboratory results, physical examination findings, vital signs, and urinalysis.

Secondary Endpoints

rPFS by Adenosine (ADO) Signalling Gene Expression in High and Low Subgroups to Determine the Efficacy of AZD4635 Plus Durvalumab Plus Cabazitaxel in Participants With mCRPC
From first dose to first documented progression or death from any cause (whichever comes first), up to two years
Overall Survival (OS) in Each Arm Separately to Determine the Efficacy of AZD4635 Plus Durvalumab and of AZD4635 Plus Durvalumab Plus Cabazitaxel in Participants With mCRPC
Arm A and B: Every 90 days from the last dose of study drug up to 2 years
Number of Participants With Objective Response in Subjects With MCRPC Who Received AZD4635 Plus Durvalumab Plus Cabazitaxel
From first dose to first documented progression or death from any cause (whichever comes first), up to two years
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Arm A: AZD4635 + durvalumabEXPERIMENTALAZD4635 plus durvalumab (Arm A) will consist of participants with mCRPC previously treated with one or more approved NHAs (eg, abiraterone acetate, enzalutamide, apalutamide and/or darolutamide), and one or more taxanes, or participants who are taxane ineligible.
Arm B: AZD4635 + durvalumab + cabazitaxelEXPERIMENTALAZD4635 plus durvalumab plus cabazitaxel (Arm B) will consist of participants with mCRPC previously treated with docetaxel and one prior NHA (either abiraterone acetate or enzalutamide but not both (prior apalutamide is not allowed in Arm B).
Module 1 (AZD4635 75 mg + Durvalumab 1500 mg)EXPERIMENTALParticipants will receive monotherapy of AZD4635 75 mg orally once daily (QD) for first 14 days and thereafter will continue to receive 75 mg orally QD in combination with durvalumab 1500 mg intravenously (IV) every 4 weeks (Q4W) until will derive clinical benefit as judged by the investigator, confirmed disease progression, unacceptable toxicity, started alternative anticancer therapy, withdrawal of consent, or lost to-follow-up, whichever occurs first.
Module 2 (AZD4635 50 / 75 mg + Oleclumab 1500 mg)EXPERIMENTALParticipants will receive combination therapy of AZD4635 (50 mg / 75 mg orally QD) and oleclumab 1500 mg IV (every 2 weeks of 28-day cycle for the first 4 doses and Q4W thereafter) until will derive clinical benefit as judged by the investigator or until confirmed disease progression, unacceptable toxicity, started alternative anticancer therapy, withdrawal of consent, or lost to-follow-up, whichever occurs first.
SmokersEXPERIMENTALPre-specified group of participants.
Non-smokersEXPERIMENTALPre-specified group of participants.
AZD4635 monotherapyEXPERIMENTALDose escalation of AZD4635 monotherapy for patients with advanced solid malignancies
Arm AEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension 125 mg BID
Arm BEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension 75 mg QD
Arm CEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension 100 mg QD
Arm DEXPERIMENTALAZD4635 as nanoparticle suspension 75 mg QD plus durvalumab
Arm EEXPERIMENTALAZD4635 as nanoparticle suspension 100 mg QD plus durvalumab
Arm EAEXPERIMENTALAZD4635 as nanoparticle suspension plus enzalutamide
Arm AAEXPERIMENTALAZD4635 as nanoparticle suspension plus abiraterone acetate
Arm FEXPERIMENTALAZD4635 as nanoparticle suspension plus durvaluamb in patients post immunotherapy with non-small cell lung cancer. Patients will be allocated randomly (1:1) between Arms F and G.
Arm GEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension in patients post immunotherapy with non-small cell lung cancer. Patients will be allocated randomly (1:1) between Arms F and G.
Arm HEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension in patients post immunotherapy with other solid tumours.
Arm IEXPERIMENTALAZD4635 as nanoparticle suspension plus durvalumab in immunotherapy naïve patients with metastatic castration resistant prostate cancer. Patients will be allocated randomly (1:1) between Arms I and J.
Arm JEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension in immunotherapy naïve patients with metastatic castration resistant prostate cancer. Patients will be allocated randomly (1:1) between Arms I and J.
Arm KEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension in immunotherapy naïve patients with colorectal carcinoma.
Arm KDEXPERIMENTALAZD4635 as nanoparticle suspension plus durvalumab in immunotherapy-naïve patients with colorectal carcinoma.
Arm LEXPERIMENTALAZD4635 monotherapy as nanoparticle suspension in immunotherapy naïve patients with other solid tumours.
Arm CAEXPERIMENTALAZD4635 capsule formulation monotherapy 75 mg, 150 mg, and 200 mg QD. A lower dose of 125 mg or 100 mg may be given. The pharmacokinetics of the single dose AZD4635 capsule formulation will be characterized on Cycle 1 Day 1 in Arm CA. Steady-state pharmacokinetics will be assessed on Cycle 1 Day 15. Cycle 1 and Cycle 2 will be administered in 3-week cycles to assess the safety and dose-limiting toxicity (DLT). After Cycle 1, PKs will be collected on Day 1 of every even numbered cycle (Cycles 2, 4, and 6).
Arm CBEXPERIMENTALAZD4635 capsule formulation 50 mg QD or 75 mg QD plus durvalumab and oleclumab. The pharmacokinetics of AZD4635 capsule formulation will be characterized on Cycle 1, 2, and 4 (Day 1) in Arm CB. Steady-state pharmacokinetics will be assessed on Cycle 2 Day 15. Cycle 1 will be administered in a 3-week cycle to assess the safety and dose-limiting toxicity (DLT). PKs will also be collected on Day 1 of Cycles 3 and 5.
Arm CCEXPERIMENTALAZD4635 capsule formulation 50 mg QD or 75 mg QD plus docetaxel. The pharmacokinetics of the single dose AZD4635 capsule formulation will be characterized on Cycle 1 Day 1 in Arm CC. Steady-state pharmacokinetics will be assessed on Cycle 1 Day 15. Cycles will be administered in 3-week cycles to assess the safety and dose-limiting toxicity (DLT). After Cycle 1, PKs will be collected on Day 1 of every even numbered cycle (Cycles 2, 4, and 6).

Interventions

NameTypeDescription
AZD4635DRUGSubjects will receive AZD4635 orally daily
DurvalumabDRUGSubjects will receive intravenous durvalumab every 4 weeks for Arm A and every 3 weeks for Arm B.
CabazitaxelDRUGSubjects will receive intravenous cabazitaxel every 3 weeks
OleclumabDRUGIn Module 2, participants will receive oleclumab 1500 mg IV (solution for infusion after dilution, 50 mg/mL) Q2W of 28-day cycle for the first 4 doses and Q4W thereafter until will derive clinical benefit as judged by the investigator or until confirmed disease progression, unacceptable toxicity, started alternative anticancer therapy, withdrawal of consent, or lost to-follow-up, whichever occurs first.
FluvoxamineDRUGDaily oral single doses of fluvoxamine are planned to be administered to healthy volunteers in Treatment Period 2.
Abiraterone AcetateDRUGAbiraterone acetate 1000 mg PO QD will be given with prednisone BID. The patient must receive abiraterone/prednisone according to the prescribing information during the DLT assessment period, Cycle 1 and Cycle 2. After Cycle 2 necessary abiraterone/ prednisone dose modifications may follow institutional standard practice. Abiraterone acetate is supplied in 250 mg tablets.
EnzalutamideDRUGEnzalutamide 160 mg PO QD will be dosed per the approved package insert. The patient must receive enzalutamide according to the prescribing information during the DLT assessment period, Cycle 1 and Cycle 2. After Cycle 2 necessary enzalutamide dose modifications may follow institutional standard practice. Enzalutamide is supplied as 40 mg soft gelatin capsules.
DocetaxelDRUGPatients in Cohort CC will receive docetaxel 75 mg/m² by IV infusion according to institutional standards of practice on Day 1 of each treatment cycle. If a patient's body surface area is greater than 2.2 m², the docetaxel dose will be adjusted to a body surface area of 2.2 m². The patient should be pre-medicated with oral dexamethasone 8 mg (or equivalent) twice daily starting the day prior to treatment for a total of 3 days, or according to institutional standards of practice.
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Eligibility Criteria

Age Range18 Years to 150 Years
SexMALE
Healthy VolunteersNo
Study Sites16

Inclusion Criteria: 1. Histologically confirmed adenocarcinoma of the prostate. 2. Known castrate-resistant disease. 3. Evidence of disease progression ≤6 months. 4. Body weight \>30 kg at screening. 5. Willingness to adhere to the study treatment-specific contraception requirements. 6. Adequate bo...

Countries:United StatesBelgiumFranceSouth KoreaSpainUnited KingdomJapan
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Frequently asked questions about AZD4635

What is AZD4635 used for?

AZD4635 is an investigational small molecule being studied for the treatment of advanced solid malignancies, including prostate cancer, metastatic castrate-resistant prostate cancer (mCRPC), non-small cell lung cancer, and colorectal carcinoma. It has been evaluated in clinical trials enrolling patients with these conditions, as well as in healthy volunteer studies.

Who is developing AZD4635?

AZD4635 is being developed by AstraZeneca PLC, a biopharmaceutical company traded on the stock exchange under the ticker symbol AZN. The company has sponsored multiple clinical trials of this investigational drug across different patient populations and geographic regions.

What phase is AZD4635 in?

AZD4635 has completed Phase 1 and Phase 2 clinical trials. The drug is investigational and has not been approved by regulatory authorities. Its development program includes early-phase studies in advanced solid malignancies and later-phase studies specifically in prostate cancer and metastatic castrate-resistant prostate cancer.

What clinical trials is AZD4635 in?

AZD4635 has been studied in several completed clinical trials, including NCT02740985, a Phase 1 study in patients with advanced solid malignancies; NCT03980821, a Phase 1 study in Japanese patients; NCT04089553, a Phase 2 study in prostate cancer; and NCT04495179, a Phase 2 study combining AZD4635 with durvalumab and cabazitaxel in mCRPC.

Is AZD4635 the same as any other drug?

AZD4635 is the primary name used in clinical trial registrations and scientific literature. No alternative names have been reported for this investigational agent. It is a distinct small molecule being developed by AstraZeneca for oncology indications.