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Androgen Deprivation Therapy in Treating Patients With Prostate Cancer

Phase 3
Conditions
Prostate Cancer
Registration Number
NCT00110162
Lead Sponsor
Peter MacCallum Cancer Centre, Australia
Brief Summary

RATIONALE: Androgens can cause the growth of prostate cancer cells. Androgen deprivation therapy may stop the adrenal glands from making androgens.

PURPOSE: This randomized phase III trial is studying how well androgen deprivation therapy works in treating patients with prostate cancer.

Detailed Description

OBJECTIVES:

Primary

* Compare overall survival (with acceptable morbidity) of patients with prostate cancer treated with delayed vs immediate androgen deprivation therapy (ADT).

Secondary

* Compare cancer-specific survival of patients treated with these regimens.

* Compare clinical progression in patients treated with these regimens.

* Compare time to first androgen independence in patients treated with these regimens.

* Compare complication rate incidence and timing (e.g., cord compression or pathological failure) in patients treated with these regimens.

* Compare treatment-related morbidity (including cognitive morbidity or osteoporosis) in patients treated with these regimens.

* Compare quality of life of patients treated with these regimens.

* Determine prognostic factors for progression in patients treated with delayed ADT.

OUTLINE: This is a multicenter, randomized, controlled study. Patients in group 1 are stratified according to prior therapy (prostatectomy vs radiotherapy vs prostatectomy and radiotherapy), relapse-free interval (\< 2 years vs ≥ 2 years), type of planned androgen deprivation therapy (ADT) (continuous vs intermittent), and participating center. Patients in group 2 are stratified according to type of planned ADT (continuous vs intermittent), disease type (localized vs metastatic), and participating center. Patients in both groups are randomized to 1 of 2 treatment arms.

* Arm I (delayed ADT): Beginning at least 2 years after study entry or after exhibiting evidence of significant disease progression\*, patients receive either continuous ADT OR intermittent ADT comprising either bilateral orchiectomy OR luteinizing hormone-releasing hormone agonist with or without oral antiandrogen therapy.

* Arm II (immediate ADT): Beginning immediately after randomization, patients receive either continuous ADT OR intermittent ADT as in arm I.

NOTE: \*Patients in group 1 begin delayed ADT at least 2 years after study entry unless 1 of the following clinical criteria is present: prostate-specific antigen (PSA) doubling time of \< 12 months with PSA ≥ 10 ng/mL OR PSA doubling time of ≤ 6 months based on 3 consecutive measurements obtained ≥ 2 months apart OR development of metastases or symptoms. Patients in group 2 begin delayed ADT at least 2 years after study entry unless 1 of the following clinical criteria is present: development of symptoms OR PSA ≥ 60 ng/mL OR PSA doubling time of ≤ 6 months based on 3 consecutive measurements obtained ≥ 2 months apart.

After 9 months of ADT, all patients are assessed for response. Patients with PSA \< 4 ng/mL may discontinue ADT. These patients are followed every 3 months. Treatment may be restarted when PSA is \> 20 ng/mL OR PSA is \> the PSA level at study entry OR at clinical progression.

Quality of life is assessed at baseline, every 6 months for 2 years, and then annually for 3 years.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then periodically thereafter at the discretion of the principal investigator.

PROJECTED ACCRUAL: A total of 300-2,000 patients will be accrued for this study within 2-5 years.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
2000
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Death from any cause at 8 years
Secondary Outcome Measures
NameTimeMethod
Cancer specific survival
Clinical progression
Time to first androgen independence
Complication rate incidence and timing (e.g., cord compression, pathological fracture)
Treatment-related morbidity (including cognitive, osteoporosis)
Prognostic factors for progression (delayed group)
EORTC Quality of life - general QLQC30 and prostate module for Quality of life annually for 5 years
CTC v3.0 Survival endpoints: actuarial analysis at eight years
Morbidity continuously

Trial Locations

Locations (20)

Sydney Cancer Centre at Royal Prince Alfred Hospital

🇦🇺

Sydney, New South Wales, Australia

Concord Repatriation General Hospital

🇦🇺

Concord, New South Wales, Australia

Mater Adult Hospital

🇦🇺

South Brisbane, Queensland, Australia

Cancer Therapy Centre at Campbelltown Hospital

🇦🇺

Campbelltown, New South Wales, Australia

Nepean Cancer Care Centre at Nepean Hospital

🇦🇺

Kingswood, New South Wales, Australia

Repatriation General Hospital

🇦🇺

Daws Park, South Australia, Australia

Christchurch Hospital

🇦🇺

Christchurch, Australia

Princess Alexandra Hospital

🇦🇺

Brisbane, Queensland, Australia

Peter MacCallum Cancer Centre

🇦🇺

East Melbourne, Victoria, Australia

West Gippsland Hospital

🇦🇺

Warragul, Victoria, Australia

Palmerston North Hospital

🇳🇿

Palmerston North, New Zealand

Geelong Hospital

🇦🇺

Geelong, Victoria, Australia

Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

Westmead Institute for Cancer Research at Westmead Hospital

🇦🇺

Westmead, New South Wales, Australia

Waikato Hospital

🇳🇿

Hamilton, New Zealand

Cancer Therapy Centre at Liverpool Hospital

🇦🇺

Liverpool, New South Wales, Australia

Royal Brisbane and Women's Hospital

🇦🇺

Brisbane, Queensland, Australia

East Coast Cancer Centre

🇦🇺

Tugun, Queensland, Australia

Urological Solutions

🇦🇺

Ashford, South Australia, Australia

Dunedin Hospital

🇳🇿

Dunedin, New Zealand

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