Samarium-153 With Neoadjuvant Hormonal and Radiation Therapy for Locally Advanced Prostate Cancer

NCT ID: NCT00328614

Last Updated: 2025-05-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-03-31

Study Completion Date

2011-06-30

Brief Summary

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The purpose of this study is to determine the safety and effectiveness of Samarium-153 when given in combination with hormonal and external beam radiation therapy in men with high risk prostate cancer.

Detailed Description

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The likelihood of prostate cancer cells metastasizing to bone has an early and important influence on the natural history of prostate cancer. Bone-targeted therapy, when given sequentially with hormonal therapy (androgen suppression) and radiation therapy, prolongs the progression of the disease in clinically non-metastatic prostate cancer patients.

The use of Samarium-153 EDTMP in conjunction with hormonal therapy and external beam radiation therapy has never been previously evaluated in high risk clinically localized prostate cancer. Many patients with high-risk prostate cancer develop progressive disease within 2 years of therapy indicating that subclinical metastatic disease may be present at the time of initial diagnosis. In these high-risk patients, there may be a therapeutic benefit of combining hormonal therapy with external beam radiation therapy and Samarium-153 EDTMP to treat localized and subclinical bony disease, respectively.

Conditions

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Prostate Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Samarium-153 (0.25 mCi/kg)

Cohort 1: Patients receive 0.25 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Samarium-153 (0.5 mCi/kg)

Cohort 2: Patients receive 0.5 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Samarium-153 (0.75 mCi/kg)

Cohort 3: Patients receive 0.75 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Samarium-153 (1.0 mCi/kg)

Cohort 4: Patients receive 1.0 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Samarium-153 (1.5 mCi/kg)

Cohort 5: Patients receive 1.5 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Samarium-153 (2.0 mCi/kg)

Cohort 6: Patients receive 2.0 mCi/kg of Samarium-153, hormonal therapy, and radiation therapy

Group Type EXPERIMENTAL

Samarium-153

Intervention Type DRUG

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Total Androgen Suppression (TAS) with Bicalutamide

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Total androgen suppression (TAS) with Goserelin Acetate

Intervention Type DRUG

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Radiation Therapy

Intervention Type DEVICE

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Interventions

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Samarium-153

Samarium-153 will be administered as a single dose after one month of hormonal therapy. The dose level of Samarium-153 may change to determine maximum tolerated dose (MTD).

Intervention Type DRUG

Total Androgen Suppression (TAS) with Bicalutamide

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Intervention Type DRUG

Total androgen suppression (TAS) with Goserelin Acetate

Patients will receive 5 months of total androgen suppression (TAS) consisting of Zoladex and Casodex. Total androgen suppression will begin 3 months prior to initiation of irradiation.

Intervention Type DRUG

Radiation Therapy

Radiation therapy will begin 3 months following the initiation of hormone administration. Daily tumor doses will be given 5 days per week for 7-8 weeks.

Intervention Type DEVICE

Other Intervention Names

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Samarium-153-ethylene diamine tetramethylene phosphonate Samarium (153Sm) lexidronam Quadramet Casodex Zoladex XRT Radiotherapy

Eligibility Criteria

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Inclusion Criteria

* PSA 20-150 and Gleason score greater than or equal to 7 or clinical stage greater than or equal to T2, Gleason greater than or equal to 8, PSA less than or equal to 150
* Pathologically positive lymph nodes
* Pretreatment must be prior to study entry and prior to any hormonal therapy
* Zubrod 0-1
* Adequate hematologic function

Exclusion Criteria

* Patients with PSA equal to or greater than 150
* Neuroendocrine features on histologic examination
* Radiologic evidence of metastatic disease
* Previous malignancy within last 5 years
* Prior pelvic radiation therapy or orchiectomy
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Cytogen Corporation

INDUSTRY

Sponsor Role collaborator

Sidney Kimmel Cancer Center at Thomas Jefferson University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Edouard Trabulsi, MD

Role: PRINCIPAL_INVESTIGATOR

Thomas Jefferson University

Richard Valicenti, MD, MA

Role: STUDY_CHAIR

UC Davis School of Medicine

Locations

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Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Related Links

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https://www.jeffersonhealth.org/clinical-specialties/cancer

Kimmel Cancer Center at Thomas Jefferson University, an NCI-Designated Cancer Center

http://www.JeffersonHospital.org

Thomas Jefferson University Hospitals

Other Identifiers

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2001-114

Identifier Type: OTHER

Identifier Source: secondary_id

JT 1013

Identifier Type: OTHER

Identifier Source: secondary_id

02C.172

Identifier Type: -

Identifier Source: org_study_id

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