A Phase III Study of Radium-223 Dichloride in Patients With Symptomatic Hormone Refractory Prostate Cancer With Skeletal Metastases

NCT ID: NCT00699751

Last Updated: 2016-05-27

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

921 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-06-30

Study Completion Date

2014-02-28

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

ALSYMPCA (ALpharadin in SYMPtomatic Prostate CAncer) is an international Phase III clinical study to evaluate the efficacy and safety of Radium-223 dichloride in patients with hormone refractory prostate cancer and skeletal metastases.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The aim of the study was to compare, in patients with symptomatic hormone refractory prostate cancer (HRPC) and skeletal metastases, the efficacy of best standard of care plus Radium-223 dichloride versus best standard of care plus placebo, with the primary efficacy endpoint being overall survival (OS).

Patients were randomised in a 2:1 allocation ratio (Radium-223 dichloride:Placebo). The study treatment consisted of 6 intravenous administrations of Radium-223 dichloride or placebo (saline) each separated by an interval of 4 weeks. The patient were followed until 3 years after first study drug administration.

Within the U.S., the trial was conducted under an IND sponsored by Bayer HealthCare Pharmaceuticals.

All patients received BSoC (Best Standard of Care).

This study has the original PCD as 14 October 2010, when a total of 316 deaths had been observed; this resulted in the Independent Data Monitoring Committee's (IDMC's) recommendation to stop the study as the primary efficacy analysis of overall survival had crossed the pre-specified boundary for efficacy. Later an updated analysis of primary endpoint in the first addendum was done with cut-off of 15 July 2011.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hormone Refractory Prostate Cancer Bone Metastases

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Radium-223 dichloride (Xofigo, BAY88-8223)

Participants received radium-223 50 kilo Becquerel (kBq)/kg body weight (b.w.) for 6 intravenous (IV) administrations separated by 4 weeks intervals plus Best Standard of Care (BSoC).

Group Type EXPERIMENTAL

Radium-223 dichloride (Xofigo, BAY88-8223)

Intervention Type DRUG

Radium-223 dichloride 50 kBq/kg b.w., 6 IV administrations separated by 4 weeks intervals.

Best standard of care (BSoC)

Intervention Type DRUG

Best standard of care is regarded as the routine standard of care at each center, for example local EBRT (External Beam Radiation Therapy), corticosteroids, antiandrogens, estrogens (e.g., stilboestrol), estramustine or ketoconazole.

Placebo

Participants received isotonic saline for 6 IV administrations separated by 4 weeks intervals plus Best Standard of Care (BSoC).

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Isotonic saline 6 IV administrations separated by 4 weeks intervals.

Best standard of care (BSoC)

Intervention Type DRUG

Best standard of care is regarded as the routine standard of care at each center, for example local EBRT (External Beam Radiation Therapy), corticosteroids, antiandrogens, estrogens (e.g., stilboestrol), estramustine or ketoconazole.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Radium-223 dichloride (Xofigo, BAY88-8223)

Radium-223 dichloride 50 kBq/kg b.w., 6 IV administrations separated by 4 weeks intervals.

Intervention Type DRUG

Placebo

Isotonic saline 6 IV administrations separated by 4 weeks intervals.

Intervention Type DRUG

Best standard of care (BSoC)

Best standard of care is regarded as the routine standard of care at each center, for example local EBRT (External Beam Radiation Therapy), corticosteroids, antiandrogens, estrogens (e.g., stilboestrol), estramustine or ketoconazole.

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Alpharadin

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Histologically or cytologically confirmed adenocarcinoma of the prostate
* Known hormone refractory disease
* Multiple skeletal metastases (≥ 2 hot spots) on bone scintigraphy
* No intention to use cytotoxic chemotherapy within the next 6 months
* Either regular (not occasional) analgesic medication use for cancer related bone pain or treatment with EBRT (External Beam Radiation Therapy) for bone pain

Exclusion Criteria

* Treatment with an investigational drug within previous 4 weeks, or planned during the treatment period
* Eligible for first course of docetaxel, i.e. patients who are fit enough, willing and where docetaxel is available
* Treatment with cytotoxic chemotherapy within previous 4 weeks, or planned during the treatment period, or failure to recover from adverse events due to cytotoxic chemotherapy administered more than 4 weeks ago
* Systemic radiotherapy with strontium-89, samarium-153, rhenium-186 or rhenium-188 for the treatment of bony metastases within previous 24 weeks
* Other malignancy treated within the last 5 years (except non-melanoma skin cancer or low-grade superficial bladder cancer)
* History of visceral metastasis, or visceral metastases as assessed by abdominal/pelvic CT or chest x-ray within previous 8 weeks
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Bayer

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Christopher Parker, MD

Role: STUDY_CHAIR

The Royal Marsden Hospital, UK

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Los Angeles, California, United States

Site Status

Roseville, California, United States

Site Status

Tampa, Florida, United States

Site Status

New Orleans, Louisiana, United States

Site Status

St Louis, Missouri, United States

Site Status

Las Vegas, Nevada, United States

Site Status

Philadelphia, Pennsylvania, United States

Site Status

Liverpool, New South Wales, Australia

Site Status

Randwick, New South Wales, Australia

Site Status

St Leonards, New South Wales, Australia

Site Status

Sydney, New South Wales, Australia

Site Status

Wahroonga, New South Wales, Australia

Site Status

Wollongong, New South Wales, Australia

Site Status

Brisbane, Queensland, Australia

Site Status

Toowoomba, Queensland, Australia

Site Status

Adelaide, South Australia, Australia

Site Status

Adelaide, South Australia, Australia

Site Status

Hobart, Tasmania, Australia

Site Status

Fitzroy, Victoria, Australia

Site Status

Nedlands, Western Australia, Australia

Site Status

Kortrijk, , Belgium

Site Status

Ottignies, , Belgium

Site Status

Salvador, Estado de Bahia, Brazil

Site Status

Belo Horizonte, Minas Gerais, Brazil

Site Status

Rio de Janeiro, Rio de Janeiro, Brazil

Site Status

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Barretos, São Paulo, Brazil

Site Status

Piracicaba, São Paulo, Brazil

Site Status

São Paulo, São Paulo, Brazil

Site Status

Belo Horizonte, , Brazil

Site Status

Edmonton, Alberta, Canada

Site Status

London, Ontario, Canada

Site Status

Ottawa, Ontario, Canada

Site Status

Toronto, Ontario, Canada

Site Status

Brno, , Czechia

Site Status

Chomutov, , Czechia

Site Status

Olomouc, , Czechia

Site Status

Ostrava, , Czechia

Site Status

Plzen - Bory, , Czechia

Site Status

Prague, , Czechia

Site Status

Ústí nad Labem, , Czechia

Site Status

La Roche-sur-Yon, , France

Site Status

Montbéliard, , France

Site Status

Saint-Cloud, , France

Site Status

Ulm, Baden-Wurttemberg, Germany

Site Status

Hamburg, City state of Hamburg, Germany

Site Status

Frankfurt am Main, Hesse, Germany

Site Status

Marburg, Hesse, Germany

Site Status

Göttingen, Lower Saxony, Germany

Site Status

Hanover, Lower Saxony, Germany

Site Status

Dortmund, North Rhine-Westphalia, Germany

Site Status

Mainz, Rhineland-Palatinate, Germany

Site Status

Berlin, State of Berlin, Germany

Site Status

Berlin, State of Berlin, Germany

Site Status

Chai Wan, , Hong Kong

Site Status

Hong Kong, , Hong Kong

Site Status

Kowloon, , Hong Kong

Site Status

Zrifin, Israel, Israel

Site Status

Beersheba, , Israel

Site Status

Kfar Saba, , Israel

Site Status

Tel Aviv, , Israel

Site Status

Meldola, Forlì, Italy

Site Status

Candiolo, Torino, Italy

Site Status

Bergamo, , Italy

Site Status

Milan, , Italy

Site Status

Reggio Emilia, , Italy

Site Status

Alkmaar, , Netherlands

Site Status

Nijmegen, , Netherlands

Site Status

Rotterdam, , Netherlands

Site Status

Ålesund, , Norway

Site Status

Bergen, , Norway

Site Status

Bodø, , Norway

Site Status

Kristiansand, , Norway

Site Status

Oslo, , Norway

Site Status

Oslo, , Norway

Site Status

Tromsø, , Norway

Site Status

Trondheim, , Norway

Site Status

Bydgoszcz, , Poland

Site Status

Gliwice, , Poland

Site Status

Kielce, , Poland

Site Status

Krakow, , Poland

Site Status

Luiblin, , Poland

Site Status

Warsaw, , Poland

Site Status

Wroclaw, , Poland

Site Status

Wroclaw, , Poland

Site Status

Singapore, , Singapore

Site Status

Singapore, , Singapore

Site Status

Banská Bystrica, , Slovakia

Site Status

Bratislava, , Slovakia

Site Status

Bratislava, , Slovakia

Site Status

Martin, , Slovakia

Site Status

Prešov, , Slovakia

Site Status

Trnava, , Slovakia

Site Status

Santiago de Compostela, A Coruña, Spain

Site Status

Barcelona, Barcelona, Spain

Site Status

Barcelona, Barcelona, Spain

Site Status

Barcelona, Barcelona, Spain

Site Status

Córdoba, Córdoba, Spain

Site Status

Alcorcón, Madrid, Spain

Site Status

Pamplona, Pamplona, Spain

Site Status

Valencia, Valencia, Spain

Site Status

Barakaldo, Vizcaya, Spain

Site Status

Zaragoza, Zaragoza, Spain

Site Status

Gothenburg, , Sweden

Site Status

Jönköping, , Sweden

Site Status

Kalmar, , Sweden

Site Status

Malmo, , Sweden

Site Status

Sandviken, , Sweden

Site Status

Stockholm, , Sweden

Site Status

Sundsvall, , Sweden

Site Status

Umeå, , Sweden

Site Status

Bristol, Bristol, United Kingdom

Site Status

Romford, Essex, United Kingdom

Site Status

Leicester, Leicestershire, United Kingdom

Site Status

Manchester, Manchester, United Kingdom

Site Status

Bebington, Merseyside, United Kingdom

Site Status

Nottingham, Nottinghamshire, United Kingdom

Site Status

Taunton, Somerset, United Kingdom

Site Status

Ipswich, Suffolk, United Kingdom

Site Status

Guildford, Surrey, United Kingdom

Site Status

Sutton, Surrey, United Kingdom

Site Status

Coventry, Warwickshire, United Kingdom

Site Status

Birmingham, West Midlands, United Kingdom

Site Status

Belfast, , United Kingdom

Site Status

Brighton, , United Kingdom

Site Status

Cardiff, , United Kingdom

Site Status

Derby, , United Kingdom

Site Status

Hull, , United Kingdom

Site Status

Leeds, , United Kingdom

Site Status

Northwood, , United Kingdom

Site Status

Plymouth, , United Kingdom

Site Status

Sheffield, , United Kingdom

Site Status

Southampton, , United Kingdom

Site Status

Wolverhampton, , United Kingdom

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Australia Belgium Brazil Canada Czechia France Germany Hong Kong Israel Italy Netherlands Norway Poland Singapore Slovakia Spain Sweden United Kingdom

References

Explore related publications, articles, or registry entries linked to this study.

Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, Fossa SD, Chodacki A, Wiechno P, Logue J, Seke M, Widmark A, Johannessen DC, Hoskin P, Bottomley D, James ND, Solberg A, Syndikus I, Kliment J, Wedel S, Boehmer S, Dall'Oglio M, Franzen L, Coleman R, Vogelzang NJ, O'Bryan-Tear CG, Staudacher K, Garcia-Vargas J, Shan M, Bruland OS, Sartor O; ALSYMPCA Investigators. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013 Jul 18;369(3):213-23. doi: 10.1056/NEJMoa1213755.

Reference Type RESULT
PMID: 23863050 (View on PubMed)

Hoskin P, Sartor O, O'Sullivan JM, Johannessen DC, Helle SI, Logue J, Bottomley D, Nilsson S, Vogelzang NJ, Fang F, Wahba M, Aksnes AK, Parker C. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. Lancet Oncol. 2014 Nov;15(12):1397-406. doi: 10.1016/S1470-2045(14)70474-7. Epub 2014 Oct 17.

Reference Type RESULT
PMID: 25439694 (View on PubMed)

Sartor O, Coleman R, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, Fossa SD, Chodacki A, Wiechno P, Logue J, Widmark A, Johannessen DC, Hoskin P, James ND, Solberg A, Syndikus I, Vogelzang NJ, O'Bryan-Tear CG, Shan M, Bruland OS, Parker C. Effect of radium-223 dichloride on symptomatic skeletal events in patients with castration-resistant prostate cancer and bone metastases: results from a phase 3, double-blind, randomised trial. Lancet Oncol. 2014 Jun;15(7):738-46. doi: 10.1016/S1470-2045(14)70183-4. Epub 2014 May 13.

Reference Type RESULT
PMID: 24836273 (View on PubMed)

Delacruz A, Arauz G, Curley T, Lindo A, Jensen T. Nursing management of patients with castration-resistant prostate cancer undergoing radium-223 dichloride treatment. Clin J Oncol Nurs. 2015 Apr;19(2):E31-5. doi: 10.1188/15.CJON.E31-E35.

Reference Type RESULT
PMID: 25840395 (View on PubMed)

Humm JL, Sartor O, Parker C, Bruland OS, Macklis R. Radium-223 in the treatment of osteoblastic metastases: a critical clinical review. Int J Radiat Oncol Biol Phys. 2015 Apr 1;91(5):898-906. doi: 10.1016/j.ijrobp.2014.12.061.

Reference Type RESULT
PMID: 25832684 (View on PubMed)

Nilsson S. Alpha-emitter radium-223 in the management of solid tumors: current status and future directions. Am Soc Clin Oncol Educ Book. 2014:e132-9. doi: 10.14694/EdBook_AM.2014.34.e132.

Reference Type RESULT
PMID: 24857093 (View on PubMed)

Den RB, Doyle LA, Knudsen KE. Practical guide to the use of radium 223 dichloride. Can J Urol. 2014 Apr;21(2 Supp 1):70-6.

Reference Type RESULT
PMID: 24775727 (View on PubMed)

Shirley M, McCormack PL. Radium-223 dichloride: a review of its use in patients with castration-resistant prostate cancer with symptomatic bone metastases. Drugs. 2014 Apr;74(5):579-86. doi: 10.1007/s40265-014-0198-4.

Reference Type RESULT
PMID: 24610703 (View on PubMed)

Wissing MD, van Leeuwen FW, van der Pluijm G, Gelderblom H. Radium-223 chloride: Extending life in prostate cancer patients by treating bone metastases. Clin Cancer Res. 2013 Nov 1;19(21):5822-7. doi: 10.1158/1078-0432.CCR-13-1896. Epub 2013 Sep 19.

Reference Type RESULT
PMID: 24052017 (View on PubMed)

Joung JY, Ha YS, Kim IY. Radium Ra 223 dichloride in castration-resistant prostate cancer. Drugs Today (Barc). 2013 Aug;49(8):483-90. doi: 10.1358/dot.2013.49.8.1968670.

Reference Type RESULT
PMID: 23977665 (View on PubMed)

Parker C, Zhan L, Cislo P, Reuning-Scherer J, Vogelzang NJ, Nilsson S, Sartor O, O'Sullivan JM, Coleman RE. Effect of radium-223 dichloride (Ra-223) on hospitalisation: An analysis from the phase 3 randomised Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial. Eur J Cancer. 2017 Jan;71:1-6. doi: 10.1016/j.ejca.2016.10.020. Epub 2016 Dec 6.

Reference Type DERIVED
PMID: 27930924 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.clinicaltrialsregister.eu/

Click here to find information about studies related to Bayer Healthcare products conducted in Europe.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

BC1-06

Identifier Type: OTHER

Identifier Source: secondary_id

2007-006195-11

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

15245

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.