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Radiation-hormone and Docetaxel VS Radiation-hormone in Patients With High-Risk Localized Prostate Cancer

Phase 2
Conditions
Prostate Cancer Stage III
Prostate Cancer Stage IV
Interventions
Biological: Hormone and radiation therapy
Radiation: Radiation therapy
Registration Number
NCT03432780
Lead Sponsor
Spanish Oncology Genito-Urinary Group
Brief Summary

A prospective, multicenter, parallel-group, open-label, randomized, phase II Clinical Study of Radiation Therapy, Hormone Therapy and Docetaxel Versus Radiation Therapy and Hormone Therapy in Patients with High-Risk Localized Prostate Cancer (Stage III and IV) whose primary objective is determine the percentage of patients free of biochemical recurrence within 5 years of receiving a combination of radiation therapy with docetaxel associated with hormone therapy or the standard of care of radiation therapy and hormone therapy in patients with stage III and IV localized prostate cancer with a poor prognosis.

Detailed Description

Randomized Phase II Clinical Study of Radiation Therapy, Hormone Therapy and Chemotherapy with Docetaxel Versus Radiation Therapy and Hormone Therapy in Patients with High-Risk Localized Prostate Cancer (Stage III and IV) Primary Objective: To determine the percentage of patients free of biochemical recurrence within 5 years of receiving a combination of radiation therapy with docetaxel associated with hormone therapy or the standard of care of radiation therapy and hormone therapy in patients with stage III and IV localized prostate cancer with a poor prognosis.

Design: A prospective, multicenter, multidisciplinary, parallel-group, open-label study with randomized group assignment.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
134
Inclusion Criteria
  1. Histological confirmation of adenocarcinoma of the prostate.

  2. Age > 18 years.

  3. Localized high-risk prostate cancer, defined as:

    • Stage III: T3 N0 M0, Gleason grade 8, 9, or 10, or
    • Stage IV: T4 N0 M0, any Gleason grade or Tx N1 M0, any Gleason grade
  4. PSA > 20 ng/mL.

  5. Karnofsky index ≥ 70%

  6. Good bone marrow reserve, with white blood cell count > 3000/mm3, hemoglobin >9.5 g/dL and platelets > 150,000/mm3.

  7. Absence of hepatic abnormality, with bilirubin values < 1.5 mg/dL and with SGOT/SGPT values up to 2 times the upper limit of normality for each site.

  8. Absence of abnormality in renal function, with creatinine levels up to 2 times the upper limit of normality for each site.

  9. Having given informed consent in writing.

Exclusion Criteria
  1. Previous hormone treatment during more than 3 months.
  2. Previous surgical treatment, pelvic radiation therapy, or chemotherapy for the current illness.
  3. Concomitant second neoplasm or history of neoplastic disease in the last 5 years, except for cutaneous basal cell carcinoma.
  4. Metabolic disease or uncontrolled systemic disease.
  5. Previous history of grade III-IV neuropathy (NCI CTCAE v3).
  6. Psychological, social, family, or geographical conditions that may compromise compliance with or follow-up of the study.
  7. Having received treatment with an investigational medicinal product during the 30 days prior to inclusion in the study.
  8. Inflammatory bowel disease.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Docetaxel, hormone and radiation therapyHormone and radiation therapyRadiation therapy combined with weekly docetaxel (20 mg/m2) and hormone therapy.
Docetaxel, hormone and radiation therapyRadiation therapyRadiation therapy combined with weekly docetaxel (20 mg/m2) and hormone therapy.
Hormone and radiation therapyRadiation therapyRadiation therapy and hormone therapy
Hormone and radiation therapyHormone and radiation therapyRadiation therapy and hormone therapy
Docetaxel, hormone and radiation therapyDocetaxelRadiation therapy combined with weekly docetaxel (20 mg/m2) and hormone therapy.
Primary Outcome Measures
NameTimeMethod
Percentage of patients free of biochemical recurrence within 5 years of receiving a combination of radiation therapy with docetaxel associated with hormone therapy or the standard of care of radiation therapy and hormone therapy5 years of randomization

Percentage of patients free of elevation of PSA by 2 ng/mL above the minimum level reached since treatment (biochemical reccurrence), calculating the at-call event, i.e., the date of last confirmatory test (Phoenix criteria).

Secondary Outcome Measures
NameTimeMethod
Percentage of patients with biochemical recurrence-free survival5 years

The duration of survival, in months, between randomization of the patient in the study and the date of recurrence by PSA. In the remaining patients, the last available follow-up will be taken as the last control

Percentage of patients with progression-free survival5 years

The duration of survival, in months, between randomization of the patient in the study and the date of recurrence by PSA, clinical manifestations or death due to disease. In the remaining patients, the last available follow-up will be taken as the last control

Percentage of patients with overall survival.5 years

Defined as the time that elapses, in months, between randomization of the patient in the study and the date of death, regardless of the cause. In the remaining patients, the last available follow-up will be taken as the last control.

Clinical response rate5 years

The clinical response rate: percentage of patients with partial and complete response, according to RECIST criteria.

Biochemical response rate.5 years

Biochemical response rate: percentage of patients with partial and complete response, according to PSA levels.

Quality of life of the patientsscreening and week 9

Change from baseline in the Quality of Life Questionnaire C30 scale (QLQ-C30) to week 9. The QLQ-c30 has five functional scales (physical, role, cognitive, emotional, and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. They are assigned values between 1 and 4 (1: nothing, 2: a few, 3: enough, 4: a lot) according to the patient's responses to the item, only in items 29 and 30 are assessed with a score from 1 to 7 (1: terrible, 7: excellent). The obtained scores are summed and standardized and gets a score between 0 and 100

Safety profile of the treatment.5 years

Numbers of events evaluated according to NCI criteria CTCAE v3

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