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Triptorelin

Decapeptyl, Trelstar, Gonapeptyl, Pamorelin

Quick Stats
Studies 178
Trials 100
Recruiting PHASE2 INTERVENTIONAL NCT06922318

The COSMYC Trial (COmbined Suppression of MYC)

View on ClinicalTrials.gov Updated Dec 15, 2025

Brief Summary

This research is being done to determine if receiving the combination of testosterone and ZEN-3694 followed by the combination of enzalutamide plus ZEN-3694 will decrease the size of tumors in patients with prostate cancer that has become resistant to castration and other therapies. The investigators also want to determine if dosing first with the combination of testosterone and ZEN-3694 may cause enzalutamide and ZEN-3694 to work more effectively.

Detailed Description

The primary objectives of the study are first to determine if treatment with the combination of ZEN-3694 and Bipolar Androgen Therapy (i.e. BATZEN) will improve the progression-free survival in patients with metastatic castrate-resistant prostate cancer (mCRPC) compared with historical controls. The second primary objective is to determine if treatment with ZEN-3694 and Enzalutamide (i.e. ZENZA) after progression on Bipolar Androgen Therapy (BAT) will improve PSA-progression-free survival compared to historical controls. Asymptomatic patients with mCRPC without pain due to prostate cancer will be treated on an open label study to evaluate effectiveness of sequential treatment with the combination of ZEN-3694 and high dose testosterone in sequence with enzalutamide and ZEN-3694 to improve primary and secondary outcomes. Eligible patients are those with mCRPC who have progressive disease after treatment with a second-generation AR-axis inhibitor (Abiraterone, Enzalutamide, Darolutamide, or Apalutamide) used as treatment for castration-sensitive or castration-resistant disease. Patients will continue on Androgen Deprivation Therapy (ADT) with LHRH agonist (i.e. Zoladex, Trelstar, Eligard, or Lupron) or LHRH antagonist (Degarelix or Relugolix) if not surgically castrated throughout the duration of the study to inhibit endogenous testosterone production. One cycle of treatment will be 28 days.

Interventions

Name: ZEN-3694
Type: DRUG
Description: One ZEN-3694 pill (48 mg) will be taken each day of each BATZEN cycle.
Name: Testosterone cypionate
Type: DRUG
Description: On day 1 of each BATZEN cycle testosterone cypionate (400 mg) injection to the buttocks will be administered.
Name: Enzalutamide
Type: DRUG
Description: Enzalutamide 160 mg (four 40 mg capsules) taken daily by mouth on each ZENZA cycle.
Name: Luteinizing hormone-releasing hormone (LHRH) analogue
Type: DRUG
Description: Patients will continue on ADT with LHRH agonist (i.e. Zoladex, Trelstar, Eligard or Lupron) or LHRH antagonist (Degarelix or Relugolix) if not surgically castrated throughout the duration of the study to inhibit endogenous testosterone production.

Primary Outcomes

Measure: Clinical/radiographic progression free survival (PFS) with BATZEN
TimeFrame: 2 years
Description: Median time from the first date of BATZEN to the date of first documented radiological progression per RECIST 1.1 for soft tissue or per Prostate Cancer Working Group 3 (PCWG3) for bone lesions, the development of symptoms or complications attributable to cancer progression, or death, whichever occurs first.
Measure: Prostate specific antigen (PSA)-Progression free survival (PFS) with ZENZA
TimeFrame: 2 years
Description: PSA-PFS on ZENZA is the median time from start of ZENZA to time of PSA progression according to PCWG3 criteria ,or censored at the last date of PSA assessment for patients without PSA progression.

Trial Information

NCT ID

NCT06922318

Status

Recruiting

Study Type

INTERVENTIONAL

Phases

PHASE2

Sponsor

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Last Updated

December 15, 2025