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Hormone Suppression and Radiation Therapy for 6 Months With/Without Docetaxel for High Risk Prostate Cancer

Phase 3
Completed
Conditions
Prostate Cancer
Interventions
Drug: Androgen Hormonal Suppression and Radiation
Drug: Androgen Suppression Therapy and Radiation Therapy
Registration Number
NCT00116142
Lead Sponsor
Dana-Farber Cancer Institute
Brief Summary

This randomized study is looking at the benefits of using docetaxel (chemotherapy) added to one of the standard treatments (radiation and hormones) for men with high-risk prostate cancer.

Detailed Description

Radiation therapy plus six months of hormone therapy is one standard way of treating men with high-risk prostate cancer. In this study, we want to see whether or not adding the chemotherapy drug docetaxel (Taxotere)will make this treatment more effective. Docetaxel has shown a benefit in median survival when given to men who have become resistant to hormonal therapy and in men who have metastatic prostate cancer (spread to other areas of the body).

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
350
Inclusion Criteria
  • Biopsy proven prostate cancer
  • Clinical Tumor Category T1b, T1c, T2a and PSA greater than (>) 10 or Gleason score equal or greater than 4+3=7 or PSA velocity > 2.0 ng/ml per year and also eligible patients with tumor category T2c, T3a, T3b, or T4 as per 2002 AJCC guidelines. Any minor tertiary grade of Gleason 5; Biopsy Proven or Radiographic (erMRI Seminal Vesicle Invasion); Gleason = or > 3+4=7 with 50% or more cores positive
  • Negative bone scan
  • Lymph node assessment by CT or MR
  • Adequate hematologic function (Blood Counts)
  • Adequate liver functions (blood tests)
  • ECOG performance Status 0 or 1
  • Peripheral neuropathy must be =< grade 1
  • PSA obtained within 3 months of entry
Exclusion Criteria
  • Prior history of malignancy that are < 5 years except for cancers found to be "in-situ" and would not likely impact a patient's life expectancy with appropriate medical management.
  • Prior pelvic radiation therapy
  • Prior hormonal therapy (up to 4 weeks prior to enrollment allowed)
  • Individuals unable to tolerate lying still 5 - 10 minutes
  • Patients with a history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 90.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm1: Androgen Suppression Therapy + Radiation TherapyAndrogen Hormonal Suppression and RadiationAndrogen Suppression Therapy and Radiation therapy
Arm 2: Docetaxel + Androgen Suppression Therapy + Radiation TherapyAndrogen Hormonal Suppression and RadiationDocetaxel plus androgen suppression therapy and radiation therapy
Arm 2: Docetaxel + Androgen Suppression Therapy + Radiation TherapyAndrogen Suppression Therapy and Radiation TherapyDocetaxel plus androgen suppression therapy and radiation therapy
Arm1: Androgen Suppression Therapy + Radiation TherapyAndrogen Suppression Therapy and Radiation TherapyAndrogen Suppression Therapy and Radiation therapy
Arm 2: Docetaxel + Androgen Suppression Therapy + Radiation TherapyDocetaxelDocetaxel plus androgen suppression therapy and radiation therapy
Primary Outcome Measures
NameTimeMethod
10-Year Restricted Mean Survival Time for Overall SurvivalFollowing the end of RT patients were seen for follow up every 6 months for 5 years and annually thereafter, 10 years.

Overall survival (OS) was measured from the date of random assignment to death from any cause, censored at the date of last follow-up in surviving patients. The 10-Year Restricted Mean Survival Time was calculated as the area under the Kaplan Meier plot for OS, from randomization to 10-years follow-up

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Acute Adverse EventsDuring study treatment or within 30 days of the last dose of study, up to 7.2 months from randomization

Adverse acute events were reported via the clinical database only for toxicities considered reportable via the SAE mechanism (those of grade 2 and grade 3 events that are unexpected and possibly, probably, or definitely related/associated with treatment; or all grade 4 and grade 5 events). Common Toxicity Criteria Volume 3.0 (CTCAE) is used for this study.

10-year Prostate Cancer MortalityFollowing the end of RT patients were seen for follow up every 6 months for 5 years and annually thereafter, 10 years.

Measured from the date of random assignment to date of death from prostate cancer, or censored at the date of last follow-up in surviving patients. Patients who died due to other reasons were counted as competing risk in a competing risk model.

10-year Biochemical Recurrence (PSA Failure)PSA was measured following the end of RT, then every 6 months for 5 years and annually thereafter, 10 years

Time to biochemical recurrence was defined as the time from date of random assignment to the earliest of PSA failure or initiation of salvage therapy, or censored at the date of last disease assessment for those without PSA failure. PSA failure was defined according to the 2006 RTOG-ASTRO Phoenix definition (i.e., A PSA rise by 2 ng/mL or more above the nadir).

10-year biochemical recurrence rate was estimated from a competing risk model where non-prostate cancer death was counted as competing risk.

Number of Participants With Late Adverse Events, Any Grade and AttributionEvery 6 months post radiation therapy for 5 years (+/-90 days), then annually, up to 13.9 years from randomization

Late adverse events will be focused on GU/GI including Urinary/Fecal Incontinence, Hematuria, Diarrhea, Rectal Bleeding and other.

Trial Locations

Locations (1)

Dana-Farber Cancer Institute and (Sanofi-Aventis Consortium)

🇺🇸

Boston, Massachusetts, United States

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