The Efficacy and Safety of Prostatectomy for Castration-Naive Oligometastatic Prostate Cancer

NCT ID: NCT04992026

Last Updated: 2024-12-05

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

130 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2024-12-02

Brief Summary

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This randomized, controlled, multi-center clinical trial aims to evaluate the efficacy and safety of prostatectomy for castration-Naive oligometastatic prostate cancer

Detailed Description

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Conditions

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Prostatectomy Oligometastatic Prostate Cancer Abiraterone

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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ADT plus abiraterone + surgery

After 6 cycles of first-line treatment (Androgen deprivation therapy + abiraterone acetate along with prednisone) , patients will receive robot assisted laparoscopic prostatectomy + enlarged pelvic lymph node dissection (ePLND) within 9 months of being diagnosed. The ADT+abiraterone treatment will be maintained after surgery.

Group Type EXPERIMENTAL

robot assisted laparoscopic prostatectomy + enlarged pelvic lymph node dissection

Intervention Type PROCEDURE

Robot assisted laparoscopic prostatectomy + enlarged pelvic lymph node dissection will be performed.

1.Abiraterone Acetate Tablets

Intervention Type DRUG

1000mg(4 tablets, 250mg per tablet) daily for 6 cycles

Prednisone Acetate Tablets

Intervention Type DRUG

5 mg oral low dose prednisone taken along with Abiraterone Acetate Tablets

Luteinizing Hormone-Releasing Hormone Analog

Intervention Type DRUG

Hypodermic injection of Luteinizing Hormone-Releasing Hormone Analog every 4 weeks including goserelin, leuprolide, triptorelin ect.

ADT plus abiraterone

Patients will be only treated with Androgen deprivation therapy + abiraterone acetate along with prednisone. Prostatectomy won't be performed.

Group Type ACTIVE_COMPARATOR

1.Abiraterone Acetate Tablets

Intervention Type DRUG

1000mg(4 tablets, 250mg per tablet) daily for 6 cycles

Prednisone Acetate Tablets

Intervention Type DRUG

5 mg oral low dose prednisone taken along with Abiraterone Acetate Tablets

Luteinizing Hormone-Releasing Hormone Analog

Intervention Type DRUG

Hypodermic injection of Luteinizing Hormone-Releasing Hormone Analog every 4 weeks including goserelin, leuprolide, triptorelin ect.

Interventions

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robot assisted laparoscopic prostatectomy + enlarged pelvic lymph node dissection

Robot assisted laparoscopic prostatectomy + enlarged pelvic lymph node dissection will be performed.

Intervention Type PROCEDURE

1.Abiraterone Acetate Tablets

1000mg(4 tablets, 250mg per tablet) daily for 6 cycles

Intervention Type DRUG

Prednisone Acetate Tablets

5 mg oral low dose prednisone taken along with Abiraterone Acetate Tablets

Intervention Type DRUG

Luteinizing Hormone-Releasing Hormone Analog

Hypodermic injection of Luteinizing Hormone-Releasing Hormone Analog every 4 weeks including goserelin, leuprolide, triptorelin ect.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients must be ≥ 40 and ≤75 years of age.
* All patients must have a histologically or cytologically diagnosis of prostate cancer.
* All patients must have been diagnosed oligometastatic prostate cancer which meet the following criteria. (1) ≤5 metastatic lesions are found by imaging examination (2)No visceral metastasis was found (3) The diameter of a single lesion ≤5cm or the surface area ≤250cm2.
* Patients previously treated with surgical castration or androgen deprivation therapy must maintain a testosterone level of \<50ng/dl or \<1.7nmol/L during treatment. Also the treatment duration should be less than 9 months. Patients were previously treated with at least 6 cycles of abiraterone.
* PSA\<2ng/ml before enrollment.
* There was no PSA progression or radiographic progression during previous treatment.
* Primary lesion must be eligible for radical prostatectomy based on random radiographic assessment. ( Preoperative clinical staging \<T4 or achievable complete resection agreed by experienced surgeons is deemed as eligible for radical prostatectomy)
* Eastern Cooperative Oncology Group (ECOG) physical condition score ≤ 1.
* Patients must have adequate hematologic function, within 28 days prior to registration as evidenced by: white blood cell (WBC) ≥ 4.0 × 109 /L, platelets≥ 100 × 109 / L, hemoglobin ≥ 9g / dL, and international normalized ratio (INR) \< 1.5.
* Patients must have adequate hepatic function, within 28 days prior to registration, as evidenced by: total bilirubin (TBIL)≤1.5 x upper limit of normal (ULN),and SGOT (AST) and SGPT (ALT) ≤ 2.5 x ULN.
* Patients must have adequate renal function, within 28 days prior toregistration, as evidenced by serum creatinine ≤2×ULN
* Patients must participate voluntarily and sign an informed consent form(ICF), indicating that they understand the purpose and required procedures of the study, and are willing to participate in. Patients must be willing to obey the prohibitions and restrictions specified in the research protocol.

Exclusion Criteria

* Patients with neuroendocrine, small cell, or signet ring cell histological features are not eligible.
* Patients with visceral metastasis or more than 5 metastatic lesions are excluded.
* Patients were diagnosed metastatic castration-naive prostate cancer for more than 9 months or showed biochemical or radiographic progression before enrollment.
* Patients with unresectable primary lesion before enrollment based on CT/MRI.
* Patients received local treatments such as pre-focal treatment, radiotherapy and palliative endoscopic resection.
* Patients with severe or uncontrolled concurrent infections are not eligible.
* Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration.
* Patients must not have uncontrolled severe hypertension, persistent uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection.
* Patients must not have had other malignancies other than prostate cancer in the past 5 years, but cured basal cell or squamous cell skin cancers can be enrolled.
* Patients with mental illness, mental disability or inability to give informed consent are not eligible.
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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The Affiliated Hospital of Xuzhou Medical University

OTHER

Sponsor Role collaborator

The First People's Hospital of Changzhou

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Soochow University

OTHER

Sponsor Role collaborator

Wuxi People's Hospital

OTHER

Sponsor Role collaborator

The Affiliated Hospital of Nantong University

UNKNOWN

Sponsor Role collaborator

The Affiliated Hospital of Yangzhou University

UNKNOWN

Sponsor Role collaborator

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

OTHER

Sponsor Role lead

Responsible Party

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Hongqian Guo

Chief Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hongqian Guo, MD

Role: PRINCIPAL_INVESTIGATOR

Nanjing Drum Tower Hospital, affiliated to medical school of Nanjing University

Locations

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The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

Nanjing, Jiangsu, China

Site Status

Countries

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China

Other Identifiers

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IUNU-PC-108

Identifier Type: -

Identifier Source: org_study_id