Androgen Ablation With or Without Docetaxel in Treating Patients With Advanced Prostate Cancer

NCT ID: NCT00796458

Last Updated: 2013-08-12

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE3
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2005-04-30

Brief Summary

RATIONALE: Androgens can cause the growth of prostate cancer cells. Androgen ablation therapy may lessen the amount of androgens made by the body. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. It is not yet known whether giving androgen ablation therapy together with docetaxel is more effective than giving androgen ablation therapy alone in treating patients with advanced prostate cancer.

PURPOSE: This randomized phase III trial is studying androgen ablation and docetaxel to see how well they work compared with androgen ablation alone in treating patients with advanced prostate cancer.

Detailed Description

OBJECTIVES:

Primary

• Compare the 2-year progression-free survival rate (biological progression and/or clinical progression) in patients with advanced prostate cancer treated with androgen ablation with vs without docetaxel.

Secondary

• Compare the overall survival of patients treated with these regimens.
• Compare the time to treatment failure in patients treated with these regimens.
• Compare the toxicity profiles of these regimens in these patients.
• Compare the PSA response rate in patients treated with these regimens.
• Compare the response rate in patients with measurable disease treated with these regimens.
• Compare the percentage of patients who undergo PSA normalization.
• Compare the quality of life of patients treated with these regimens.
• Compare the efficacy of these regimens in controlling bone pain in these patients.
• Compare the changes in chromogranin A levels in patients treated with these regimens.
• Compare the total cost of care of patients treated with these regimens.

OUTLINE: This is a multicenter study.

Patients receive luteinizing hormone-releasing hormone analogue (LHRH-A) therapy for 6 months. Patients also receive antiandrogen therapy during the first 5 weeks of LHRH-A therapy. After 6 months of LHRH-A therapy, patients with PSA response are randomized to 1 of 2 treatment arms.

• Arm I: Patients continue to receive LHRH-A therapy until disease progression.
• Arm II:Patients receive LHRH-A therapy as in arm I. Patients also receive docetaxel IV on day 1. Treatment with docetaxel repeats every 21 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Patients complete questionnaires during treatment to assess bone pain. Quality of life is also assessed.

After completion to study therapy, patients are followed for ≥ 2 years.

Conditions

Pain; Prostate Cancer

Keywords

pain; adenocarcinoma of the prostate; recurrent prostate cancer; stage IV prostate cancer; stage III prostate cancer

Study Design

• Allocation Method: RANDOMIZED
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Arm I

Patients continue to receive LHRH-A therapy until disease progression.

Group Type: ACTIVE_COMPARATOR

releasing hormone agonist therapy

Intervention Type: DRUG

Patients receive luteinizing hormone-releasing hormone analogue therapy until disease progression.

Arm II

Patients receive LHRH-A therapy as in arm I. Patients also receive docetaxel IV on day 1. Treatment with docetaxel repeats every 21 days for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Group Type: EXPERIMENTAL

docetaxel

Intervention Type: DRUG

Given IV

releasing hormone agonist therapy

Intervention Type: DRUG

Patients receive luteinizing hormone-releasing hormone analogue therapy until disease progression.

Interventions

docetaxel

Given IV

Intervention Type: DRUG

releasing hormone agonist therapy

Patients receive luteinizing hormone-releasing hormone analogue therapy until disease progression.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the prostate
• Meets one of the following criteria

• Metastatic disease
• Systemic progressive disease after locoregional therapy (surgery or radiotherapy)
• No metastatic disease AND meets one of the following criteria:

• Circulating PSA levels ≥ 50 ng/mL (confirmed by ≥ 2 subsequent evaluations)
• Biochemical progression with a PSA doubling time < 6 months (with ≥ 3 measurements taken 1 month apart) after primary locoregional treatment (radical prostatectomy or radiotherapy) with curative intent
• Prostate-confined tumor with high-risk features whose therapy of choice is androgen deprivation
• No symptomatic brain metastases or leptomeningeal disease

PATIENT CHARACTERISTICS:

• ECOG or Zubrod performance status 0-2
• Life expectancy ≥ 6 months
• ANC ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Hemoglobin ≥ 10 g/dL
• Bilirubin ≤ 2.0 mg/dL
• AST/ALT ≤ 1.5 times upper limit of normal
• Creatinine ≤ 1.5 mg/dL
• No active infection requiring IV antibiotics
• No active ulcer, unstable diabetes mellitus, or other contraindication to corticotherapy
• None of the following cardiovascular conditions:

• Uncompensated heart failure (ejection fraction < 40%)
• Myocardial infarction or revascularization procedure within the past 6 months
• Unstable angina pectoris
• Uncontrolled cardiac arrhythmia
• No other severe clinical condition that, in the judgment of the local investigator, would place the patient at undue risk or interfere with the study
• Not a prisoner
• No prior malignancy, except for non-melanoma skin cancer, in situ cervical carcinoma, or other cancer that was curatively treated with no evidence of disease for ≥ 5 years
• No familial, social, or geographical condition or significant neurologic or psychiatric disorder that would preclude understanding or rendering informed consent or fully complying with study treatment and follow-up

PRIOR CONCURRENT THERAPY:

• At least 5 years since prior radiotherapy outside the prostate
• Prior hormonal therapy allowed provided it was administered for ≤ 6 months
• At least 12 months since prior hormonal therapy
• More than 30 days since prior participation in another clinical trial involving investigational agents
• No prior surgical castration
• Concurrent androgen deprivation for prostate cancer allowed provided it was started ≤ 3 months prior to initiation of study treatment
• Concurrent anticoagulant treatment allowed
• No other concurrent investigational drugs

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

A.O.U. San Giovanni Battista di Torino, Italy

OTHER

Sponsor Role: lead

Principal Investigators

Oscar Bertetto, MD

Role: PRINCIPAL_INVESTIGATOR

Azienda Sanitaria Ospedale San Giovanni Battista Molinette di Torino

Isabella Chiappino, MD

Role:

A.O.U. San Giovanni Battista di Torino, Italy

Locations

Rete Oncologica Piemontese - Azienda Sanitaria Ospedale San Giovanni Battista Molinette di Torino

Turin, , Italy

Site Status: RECRUITING

Countries

Italy

Facility Contacts

Isabella Chiappino, MD

Role: primary

Other Identifiers

CDR0000626194

Identifier Type: REGISTRY

Identifier Source: secondary_id

EUDRACT 2004-003495-11

Identifier Type: -

Identifier Source: secondary_id

EU-20892

Identifier Type: -

Identifier Source: secondary_id

GOUP-01/04

Identifier Type: -

Identifier Source: org_study_id