Prostate Cancer, Androgen Deprivation Withdrawal and Intermittent Chemotherapy

NCT ID: NCT01224405

Last Updated: 2010-10-20

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

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-04-30

Study Completion Date

2016-04-30

Brief Summary

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The study includes the recruitment of patients with advanced prostate cancer resistant to chemical castration This is a multicenter prospective trial randomized phase III

Detailed Description

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The study includes the recruitment of patients with advanced prostate cancer resistant to chemical castration This is a multicenter prospective trial randomized phase III This study design that includes a double randomizzzazione aims generally demonstrating non-inferiority in terms of survival of the suspension dell'ormonoterapia versus the maintenance and / or administration of intermittent versus continuous administration of chemotherapy in patients with prostate cancer resistant to chemical castration I started to line chemotherapy with Docetaxel.

Conditions

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Advanced Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment arm

ten docetaxel cycles + maintenance androgen deprivation.

Group Type ACTIVE_COMPARATOR

Docetaxel + LH-RH analogues

Intervention Type DRUG

Docetaxel will be administered at a dose of 75 mg/m2 per square meter as a 1-hour intravenous infusion on day 1 every 21 days in association to 5 mg of prednisone orally twice daily.

In patients randomised to arms A up to 10 cycles of docetaxel will be planned in association to maintenance of LH-RH analogues administration.

suspension arm

Ten Docetaxel cycles + stop androgen deprivation therapy

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Docetaxel will be administered at a dose of 75 mg/m2 per square meter as a 1-hour intravenous infusion on day 1 every 21 days in association to 5 mg of prednisone orally twice daily.

In patients randomised to arms B up to 10 cycles of docetaxel will be planned, in association to stopping LH-RH analogues.

intermittent arm

Intermittent Docetaxel

Group Type EXPERIMENTAL

Docetaxel

Intervention Type DRUG

Patients randomised in the arms AB1 (intermittent docetaxel) will suspend treatment after at least 4 cycles if their PSA level will be reduced \>50%. Docetaxel treatment will be resumed when the serum PSA will rise by \>50% from the lowest PSA level recorded and will be \>10 ng/mL or when there will be other evidence of disease progression. PSA progression must to be confirmed with a second assessment after 2 weeks before deciding to resume docetaxel administration.

Continuous arm

Continuous Docetaxel

Group Type ACTIVE_COMPARATOR

Continuous Docetaxel

Intervention Type DRUG

Patients randomised in the arms AB2 (continuous docetaxel) will continue treatment up to ten cycles after even if their PSA level at 4 cycles will be reduced \>50% or will reach a level \<4 ng/mL.

Continuous Docetaxel

Intervention Type DRUG

Patients randomised in the arms AB1(intermittent docetaxel) will continue treatment up to ten cycles even if their PSA level after 4 cycles will be reduced \>50% or will reach a level \<4 ng/mL.

Interventions

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Docetaxel + LH-RH analogues

Docetaxel will be administered at a dose of 75 mg/m2 per square meter as a 1-hour intravenous infusion on day 1 every 21 days in association to 5 mg of prednisone orally twice daily.

In patients randomised to arms A up to 10 cycles of docetaxel will be planned in association to maintenance of LH-RH analogues administration.

Intervention Type DRUG

Docetaxel

Docetaxel will be administered at a dose of 75 mg/m2 per square meter as a 1-hour intravenous infusion on day 1 every 21 days in association to 5 mg of prednisone orally twice daily.

In patients randomised to arms B up to 10 cycles of docetaxel will be planned, in association to stopping LH-RH analogues.

Intervention Type DRUG

Docetaxel

Patients randomised in the arms AB1 (intermittent docetaxel) will suspend treatment after at least 4 cycles if their PSA level will be reduced \>50%. Docetaxel treatment will be resumed when the serum PSA will rise by \>50% from the lowest PSA level recorded and will be \>10 ng/mL or when there will be other evidence of disease progression. PSA progression must to be confirmed with a second assessment after 2 weeks before deciding to resume docetaxel administration.

Intervention Type DRUG

Continuous Docetaxel

Patients randomised in the arms AB2 (continuous docetaxel) will continue treatment up to ten cycles after even if their PSA level at 4 cycles will be reduced \>50% or will reach a level \<4 ng/mL.

Intervention Type DRUG

Continuous Docetaxel

Patients randomised in the arms AB1(intermittent docetaxel) will continue treatment up to ten cycles even if their PSA level after 4 cycles will be reduced \>50% or will reach a level \<4 ng/mL.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. age over 18 years,
2. histologically documented adenocarcinoma of the prostate,
3. written informed consent to the study,
4. Castrate resistant metastatic prostate cancer in the presence of castrate levels of testosterone (\<50 ng/ml) and eligible to docetaxel chemotherapy. The condition of castrate resistant prostate cancer is the defined either as the documentation of a new metastasis or PSA increase more than 50% or increase more than 25% from a lower PSA value during previous hormone therapy in case of disease response or stabilization to previous hormone therapy, respectively. Absolute PSA increase should be greater than 5 ng/ml,
5. an elevated PSA level must have been documented within 4 weeks of initiating docetaxel chemotherapy,
6. more than 4 weeks since major surgery and fully recovered,
7. more than 4 weeks since any prior radiation with any toxicity attributable to radiation resolved to grade 1 or less,
8. more than 8 weeks since the last dose of strontium or samarium,
9. ECOG Performance Status more than/equal to 2,
10. life expectancy \>6 months,
11. required initial laboratory values: absolute neutrophil count \> 1500/ul Platelets \> 100,000/ul., Hemoglobin \> 8.0 g/dl, Creatinine, SGOT, SGPT less than 2.0 X upper limit of normal, Bilirubin less than/equal to upper limit of normal (ULN).
12. Appropriate patient compliance

Exclusion Criteria

1. Patients with increased serum PSA levels with negative bone scan and CT scan.
2. Prior systemic chemotherapy for prostate cancer. Prior neoadjuvant or adjuvant chemotherapy is permitted if there was no evidence of disease relapse within 12 months of the last dose of chemotherapy,
3. Peripheral neuropathy \>grade 1,
4. myocardial infarction or significant change in anginal pattern within the last 6 months, symptomatic congestive heart failure (NYHA Class III or higher) or uncontrolled cardiac arrhythmia,
5. patients with a history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80,
6. poorly controlled diabetes (fasting blood glucose \>250) despite optimization of medical therapy, peptic ulcers or other contraindications to steroid therapy,
7. previous history of malignant disease with the exception of non melanoma skin cancer curatively treated,
8. significant neurologic or psychiatric diseases preventing patients to give a valid informed consent,
9. brain metastases,
10. prisoner status
11. because patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy, HIV-positive patients receiving combination anti-retroviral therapy are excluded.

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Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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University of Turin, Italy

OTHER

Sponsor Role lead

Responsible Party

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Dipartimento Scienze Cliniche e Biologiche Università di Torino

Principal Investigators

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Alfredo Berruti, PHD

Role: STUDY_CHAIR

Medical Oncology - Hospital San Luigi Gonzaga Orbassano (TO) - Italy

Bruno Castagneto, MD

Role: STUDY_DIRECTOR

Medical Oncology - Hospital San Giacomo of Novi Ligure (AL) Italy

Marcello Tucci, MD

Role: PRINCIPAL_INVESTIGATOR

Medical Oncology - Hospital San Luigi Gonzaga of Orbassano (TO) - Italy

Locations

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Davide Perroni

Saluzzo, Cuneo, Italy

Site Status

Roberto Faggiuolo

Alba, , Italy

Site Status

Franco Testore

Asti, , Italy

Site Status

Mario Clerico

Biella, , Italy

Site Status

Andrea Martoni

Bologna, , Italy

Site Status

Massimo Aglietta

Candiolo (Torino), , Italy

Site Status

Alberto Muzio

Casale Monferrato, , Italy

Site Status

Mario Botta

Casale Monferrato, , Italy

Site Status

Rodolfo Passalacqua

Cremona, , Italy

Site Status

Marco Merlano

Cuneo, , Italy

Site Status

Luigi Toniolo

Garbagnate Milanese, , Italy

Site Status

Sergio Bretti

Ivrea, , Italy

Site Status

Giovanni Ucci

Lodi, , Italy

Site Status

Pierfranco Conte

Modena, , Italy

Site Status

Carla Sculli

Mondovì, , Italy

Site Status

Oscar Alabiso

Novara, , Italy

Site Status

Bruno Castagneto

Novi Ligure, , Italy

Site Status

Giovanna Succu

Nuoro, , Italy

Site Status

Alfredo Berruti

Orbassano (Torino), , Italy

Site Status

Luigi Dogliotti

Orbassano (Torino), , Italy

Site Status

Luigi Cavanna

Piacenza, , Italy

Site Status

Giorgio Cruciani

Ravenna, , Italy

Site Status

Corrado Boni

Reggio Emilia, , Italy

Site Status

Riccardo Ratti

Sanremo, , Italy

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Francesco Ferrau

Taormina, , Italy

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Fausto Roila

Terni, , Italy

Site Status

Carlo Alberto Raucci

Torino, , Italy

Site Status

Guido Vietti Ramus

Torino, , Italy

Site Status

Libero Ciuffreda

Torino, , Italy

Site Status

Gianpiero Fasola

Udine, , Italy

Site Status

Sergio Cozzi

Verbania, , Italy

Site Status

Domenico Amoroso

Viareggio, , Italy

Site Status

Countries

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Italy

Other Identifiers

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EudraCT 2010-019004-24

Identifier Type: -

Identifier Source: org_study_id