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Randomized Trial of Adjuvant Hormonal Therapy in Surgically Treated Prostate Cancer Patients at High Risk for Recurrence

Primary Purpose

Prostate Cancer

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Flutamide
Leuprolide Acetate
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring stage I prostate cancer, stage II prostate cancer

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria: Organ confined prostate cancer (stage T1-T2c) subsequent to clinical staging Radical prostatectomy and bilateral lymph node dissection performed Pathologic assessment of surgical specimens by MDACC pathologist High risk of clinical or biochemical failure post prostatectomy (must fulfill one of the following criteria): pathology; a) Gleason grade sum score greater than or equal to 8, b) Seminal vesicle involvement, c) Extraprostatic extension with positive surgical margins and Gleason greater than or equal to 7 Radical prostatectomy performed within 90 days of enrollment and serum PSA level < 0.1ng/ml Written informed consent Exclusion Criteria: Any evidence of metastatic disease confirmed prior to enrollment Inability to confirm pathologic risk factors or inadequate prostatectomy (see item 4.1.5). Hormonal ablation for greater than 3 months or radiotherapy for prostate cancer Failure to achieve prostate specific antigen level of less than 0.1ng/ml prior to enrollment in study Elevation of liver function tests 2x normal Contraindication to the use of LH-RH agonists or antiandrogens Active secondary malignancy (other than squamous or basal cell skin cancer) within five years prior to enrollment in study Any concomitant medical condition that would make it undesirable for the 7patient to participate in the trial or jeopardize compliance with the protocol

Sites / Locations

  • University of Texas - MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Arm I - Leuprolide + Flutamide

Arm II - No Treatment

Arm Description

Arm I: Patients receive leuprolide intramuscularly once every 3 months and oral flutamide three times daily for 1 year.

Arm II: Patients receive no initial treatment.

Outcomes

Primary Outcome Measures

Number of Participants With Disease Free Survival at 5 Years
To determine if one year of adjuvant hormonal ablation in node negative radical prostatectomy patients at high risk for progression will result in an improvement in disease-free survival at five years.

Secondary Outcome Measures

Full Information

First Posted
November 1, 1999
Last Updated
April 20, 2020
Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI), Eastern Cooperative Oncology Group, AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT00003645
Brief Title
Randomized Trial of Adjuvant Hormonal Therapy in Surgically Treated Prostate Cancer Patients at High Risk for Recurrence
Official Title
A Phase III Randomized Prospective Trial of Adjuvant Hormonal Therapy in Surgically Treated Prostate Cancer Patients at High Risk for Recurrence
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Terminated
Why Stopped
Per PI request
Study Start Date
June 14, 1999 (Actual)
Primary Completion Date
March 20, 2017 (Actual)
Study Completion Date
March 20, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
M.D. Anderson Cancer Center
Collaborators
National Cancer Institute (NCI), Eastern Cooperative Oncology Group, AstraZeneca

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Testosterone can stimulate the growth of prostate cancer cells. Hormone therapy using leuprolide and flutamide may fight prostate cancer by reducing the production of testosterone. It is not yet known whether receiving leuprolide and flutamide is more effective than receiving no further therapy. PURPOSE: Randomized phase III trial to determine the effectiveness of hormone therapy in treating patients who have stage I or stage II prostate cancer that is at high risk of recurrence and who have already undergone surgery.
Detailed Description
OBJECTIVES: Determine the effect of one year of adjuvant hormonal ablation on disease-free survival at 5 years in node-negative radical prostatectomy patients at high risk for progression. Determine the effect of this treatment on the incidence of androgen independent prostate cancer and on disease specific and overall survival. Determine the impact of one year of total androgen ablation on quality of life and serum testosterone levels. Assess differences in quality of life between wives of patients in the androgen ablation condition compared to wives of patients in the control condition. Obtain blood samples from patients at high risk for failure post-prostatectomy to evaluate serum markers of prognosis. OUTLINE: This is a randomized study. Patients are randomized to one of two treatment arms. Arm I: Patients receive leuprolide intramuscularly once every 3 months and oral flutamide three times daily for 1 year. Arm II: Patients receive no initial treatment. Quality of life is assessed every 6 months for 5 years. Quality of life of wives/partners of patients is assessed every 6 months for two years. Patients are followed every 3 months for 1 year and then every 6 months for 4 years. PROJECTED ACCRUAL: A total of 496 patients (248 per treatment arm) will be accrued for this study within 3.5 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
stage I prostate cancer, stage II prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
64 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I - Leuprolide + Flutamide
Arm Type
Experimental
Arm Description
Arm I: Patients receive leuprolide intramuscularly once every 3 months and oral flutamide three times daily for 1 year.
Arm Title
Arm II - No Treatment
Arm Type
No Intervention
Arm Description
Arm II: Patients receive no initial treatment.
Intervention Type
Drug
Intervention Name(s)
Flutamide
Other Intervention Name(s)
Goserelin, Zoladex
Intervention Description
10.8 mg intramuscularly once every 3 months for 12 months
Intervention Type
Drug
Intervention Name(s)
Leuprolide Acetate
Other Intervention Name(s)
Casodex, Bicalutamide
Intervention Description
50 mg tablet orally daily for 12 months
Primary Outcome Measure Information:
Title
Number of Participants With Disease Free Survival at 5 Years
Description
To determine if one year of adjuvant hormonal ablation in node negative radical prostatectomy patients at high risk for progression will result in an improvement in disease-free survival at five years.
Time Frame
Beginning of the study up to 5 years
Other Pre-specified Outcome Measures:
Title
Number of Wives of the Participants Having Better Than or Equal to a "Good" Quality of Life
Description
To measure the differences in quality of life between wives of participants in the androgen ablation condition compared to wives of patients in the control condition by using quality of life assessments. The following questionnaires were completed in the clinic setting and used to assess Health related (HRQoL): Medical Outcomes Study 36-Item Short Form (SF-36), University of California-Los Angeles Sexual Function Scale (UCLA-SFS), and Southwest Oncology Group Treatment-Specific Symptoms Scale (SWOG-TSSS). The SF-36 was analysed using a composite score for each of physical health and mental health. SF-36, UCLA-SFS, SWOGTSSS were combined to classify participants' quality of life.
Time Frame
2 years
Title
Quality of Life for Participants
Description
To determine the impact of one year of total androgen ablation on quality of life mentally, physically and sexual function. The following questionnaires were completed by patients in the clinic setting and used to assess HRQoL: Medical Outcomes Study 36-Item Short Form (SF-36) and University of California-Los Angeles Sexual Function Scale (UCLA-SFS). To score the SF-36, scales are standardized with a scoring algorithm or by the SF-36v2 scoring software to obtain a score ranging from 0 to 100. Higher scores indicate better quality of life.
Time Frame
1 year
Title
Markers of Prognosis
Description
To obtain blood/tissue samples from patients at high risk for failure post prostatectomy to evaluate markers of prognosis.
Time Frame
1 year after treatment

10. Eligibility

Sex
Male
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Organ confined prostate cancer (stage T1-T2c) subsequent to clinical staging Radical prostatectomy and bilateral lymph node dissection performed Pathologic assessment of surgical specimens by MDACC pathologist High risk of clinical or biochemical failure post prostatectomy (must fulfill one of the following criteria): pathology; a) Gleason grade sum score greater than or equal to 8, b) Seminal vesicle involvement, c) Extraprostatic extension with positive surgical margins and Gleason greater than or equal to 7 Radical prostatectomy performed within 90 days of enrollment and serum PSA level < 0.1ng/ml Written informed consent Exclusion Criteria: Any evidence of metastatic disease confirmed prior to enrollment Inability to confirm pathologic risk factors or inadequate prostatectomy (see item 4.1.5). Hormonal ablation for greater than 3 months or radiotherapy for prostate cancer Failure to achieve prostate specific antigen level of less than 0.1ng/ml prior to enrollment in study Elevation of liver function tests 2x normal Contraindication to the use of LH-RH agonists or antiandrogens Active secondary malignancy (other than squamous or basal cell skin cancer) within five years prior to enrollment in study Any concomitant medical condition that would make it undesirable for the 7patient to participate in the trial or jeopardize compliance with the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Curtis A. Pettaway, MD
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Michael O. Koch, MD
Organizational Affiliation
Indiana University Melvin and Bren Simon Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
University of Texas - MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030-4009
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.mdanderson.org
Description
University of Texas MD Anderson Cancer Center Official Website

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Randomized Trial of Adjuvant Hormonal Therapy in Surgically Treated Prostate Cancer Patients at High Risk for Recurrence

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