Androgen Deprivation Therapy in Treating Patients With Prostate Cancer

NCT ID: NCT00110162

Last Updated: 2013-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

2000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-10-31

Brief Summary

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RATIONALE: Androgens can cause the growth of prostate cancer cells. Androgen deprivation therapy may stop the adrenal glands from making androgens.

PURPOSE: This randomized phase III trial is studying how well androgen deprivation therapy works in treating patients with prostate cancer.

Detailed Description

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OBJECTIVES:

Primary

* Compare overall survival (with acceptable morbidity) of patients with prostate cancer treated with delayed vs immediate androgen deprivation therapy (ADT).

Secondary

* Compare cancer-specific survival of patients treated with these regimens.
* Compare clinical progression in patients treated with these regimens.
* Compare time to first androgen independence in patients treated with these regimens.
* Compare complication rate incidence and timing (e.g., cord compression or pathological failure) in patients treated with these regimens.
* Compare treatment-related morbidity (including cognitive morbidity or osteoporosis) in patients treated with these regimens.
* Compare quality of life of patients treated with these regimens.
* Determine prognostic factors for progression in patients treated with delayed ADT.

OUTLINE: This is a multicenter, randomized, controlled study. Patients in group 1 are stratified according to prior therapy (prostatectomy vs radiotherapy vs prostatectomy and radiotherapy), relapse-free interval (\< 2 years vs ≥ 2 years), type of planned androgen deprivation therapy (ADT) (continuous vs intermittent), and participating center. Patients in group 2 are stratified according to type of planned ADT (continuous vs intermittent), disease type (localized vs metastatic), and participating center. Patients in both groups are randomized to 1 of 2 treatment arms.

* Arm I (delayed ADT): Beginning at least 2 years after study entry or after exhibiting evidence of significant disease progression\*, patients receive either continuous ADT OR intermittent ADT comprising either bilateral orchiectomy OR luteinizing hormone-releasing hormone agonist with or without oral antiandrogen therapy.
* Arm II (immediate ADT): Beginning immediately after randomization, patients receive either continuous ADT OR intermittent ADT as in arm I.

NOTE: \*Patients in group 1 begin delayed ADT at least 2 years after study entry unless 1 of the following clinical criteria is present: prostate-specific antigen (PSA) doubling time of \< 12 months with PSA ≥ 10 ng/mL OR PSA doubling time of ≤ 6 months based on 3 consecutive measurements obtained ≥ 2 months apart OR development of metastases or symptoms. Patients in group 2 begin delayed ADT at least 2 years after study entry unless 1 of the following clinical criteria is present: development of symptoms OR PSA ≥ 60 ng/mL OR PSA doubling time of ≤ 6 months based on 3 consecutive measurements obtained ≥ 2 months apart.

After 9 months of ADT, all patients are assessed for response. Patients with PSA \< 4 ng/mL may discontinue ADT. These patients are followed every 3 months. Treatment may be restarted when PSA is \> 20 ng/mL OR PSA is \> the PSA level at study entry OR at clinical progression.

Quality of life is assessed at baseline, every 6 months for 2 years, and then annually for 3 years.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then periodically thereafter at the discretion of the principal investigator.

PROJECTED ACCRUAL: A total of 300-2,000 patients will be accrued for this study within 2-5 years.

Conditions

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Prostate Cancer

Keywords

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adenocarcinoma of the prostate stage I prostate cancer stage IIB prostate cancer stage IIA prostate cancer stage III prostate cancer stage IV prostate cancer recurrent prostate cancer

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Interventions

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antiandrogen therapy

Intervention Type DRUG

releasing hormone agonist therapy

Intervention Type DRUG

orchiectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the prostate
* Prostate-specific antigen (PSA) relapse OR incurable disease diagnosed within the past 2 months AND meets criteria for either of the following groups:

* Group 1

* In PSA relapse after definitive radical treatment (prostatectomy or radiotherapy), as evidenced by 1 the following:

* Post-prostatectomy PSA level ≥ 0.2 ng/mL
* At least 3 rising PSA levels (post-radiotherapy) obtained ≥ 1 month apart, with the last PSA obtained within the past 2 months
* No metastatic disease by bone scan or abdomino-pelvic CT scan
* Group 2

* Not suitable for radical treatment at primary diagnosis
* Not planning to receive curative treatment
* Localized or metastatic disease

* No symptomatic disease requiring radiotherapy or immediate hormonal therapy
* No symptomatic disease requiring therapy

PATIENT CHARACTERISTICS:

Age

* Any age

Performance status

* Not specified

Life expectancy

* At least 5 years

Hematopoietic

* Not specified

Hepatic

* Not specified

Renal

* Not specified

Other

* No other significant comorbid condition that would limit life expectancy to \< 5 years

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* Not specified

Endocrine therapy

* At least 12 months since prior androgen deprivation therapy (ADT) administered in the neoadjuvant or concurrent (with radiotherapy) setting (group 1)
* No prior ADT (group 2)

Radiotherapy

* See Disease Characteristics
* See Endocrine therapy

Surgery

* See Disease Characteristics

Other

* No concurrent enrollment in TROG-96.01 or TROG-RADAR protocols
Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Peter MacCallum Cancer Centre, Australia

OTHER

Sponsor Role lead

Principal Investigators

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Gillian M. Duchesne, MD, FRCR

Role: STUDY_CHAIR

Peter MacCallum Cancer Centre, Australia

Locations

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Cancer Therapy Centre at Campbelltown Hospital

Campbelltown, New South Wales, Australia

Site Status RECRUITING

Concord Repatriation General Hospital

Concord, New South Wales, Australia

Site Status RECRUITING

Nepean Cancer Care Centre at Nepean Hospital

Kingswood, New South Wales, Australia

Site Status RECRUITING

Cancer Therapy Centre at Liverpool Hospital

Liverpool, New South Wales, Australia

Site Status RECRUITING

Sydney Cancer Centre at Royal Prince Alfred Hospital

Sydney, New South Wales, Australia

Site Status RECRUITING

Westmead Institute for Cancer Research at Westmead Hospital

Westmead, New South Wales, Australia

Site Status RECRUITING

Royal Brisbane and Women's Hospital

Brisbane, Queensland, Australia

Site Status RECRUITING

Princess Alexandra Hospital

Brisbane, Queensland, Australia

Site Status RECRUITING

Mater Adult Hospital

South Brisbane, Queensland, Australia

Site Status RECRUITING

East Coast Cancer Centre

Tugun, Queensland, Australia

Site Status RECRUITING

Urological Solutions

Ashford, South Australia, Australia

Site Status RECRUITING

Repatriation General Hospital

Daws Park, South Australia, Australia

Site Status RECRUITING

Peter MacCallum Cancer Centre

East Melbourne, Victoria, Australia

Site Status RECRUITING

Geelong Hospital

Geelong, Victoria, Australia

Site Status RECRUITING

Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

West Gippsland Hospital

Warragul, Victoria, Australia

Site Status RECRUITING

Christchurch Hospital

Christchurch, , Australia

Site Status RECRUITING

Dunedin Hospital

Dunedin, , New Zealand

Site Status RECRUITING

Waikato Hospital

Hamilton, , New Zealand

Site Status RECRUITING

Palmerston North Hospital

Palmerston North, , New Zealand

Site Status RECRUITING

Countries

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Australia New Zealand

Facility Contacts

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Martin P. Berry

Role: primary

George Hruby, MD

Role: primary

Viet Do

Role: primary

Andrew Kneebone

Role: primary

George Hruby, MD

Role: primary

Sandra Turner

Role: primary

Lizbeth Kenny, MD

Role: primary

Margot Lehman

Role: primary

Guy Bryant

Role: primary

David Christie, MD

Role: primary

Graham Sinclair, MD

Role: primary

Alan Stapleton

Role: primary

Gillian M. Duchesne, MD, FRCR

Role: primary

Michael Francis, MBBS, FRACR

Role: primary

Jeremy Millar

Role: primary

William Straffon, MD

Role: primary

Chris Atkinson

Role: primary

John North

Role: primary

Leanne Tyrie

Role: primary

Johan S. Nel, MD

Role: primary

References

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Duchesne GM, Woo HH, King M, Bowe SJ, Stockler MR, Ames A, D'Este C, Frydenberg M, Loblaw A, Malone S, Millar J, Tai KH, Turner S. Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial. Lancet Oncol. 2017 Sep;18(9):1192-1201. doi: 10.1016/S1470-2045(17)30426-6. Epub 2017 Jul 28.

Reference Type DERIVED
PMID: 28760403 (View on PubMed)

Duchesne GM, Woo HH, Bassett JK, Bowe SJ, D'Este C, Frydenberg M, King M, Ledwich L, Loblaw A, Malone S, Millar J, Milne R, Smith RG, Spry N, Stockler M, Syme RA, Tai KH, Turner S. Timing of androgen-deprivation therapy in patients with prostate cancer with a rising PSA (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial. Lancet Oncol. 2016 Jun;17(6):727-737. doi: 10.1016/S1470-2045(16)00107-8. Epub 2016 May 4.

Reference Type DERIVED
PMID: 27155740 (View on PubMed)

Other Identifiers

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CDR0000413706

Identifier Type: REGISTRY

Identifier Source: secondary_id

PMCC-TROG-0306

Identifier Type: -

Identifier Source: secondary_id

PMCC-VCOG-PR-0103

Identifier Type: -

Identifier Source: org_study_id