Surgery With or Without Docetaxel and Leuprolide or Goserelin in Treating Patients With High-Risk Localized Prostate Cancer
Prostate Cancer
About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring stage I prostate cancer, stage IIB prostate cancer, stage IIA prostate cancer, stage III prostate cancer, adenocarcinoma of the prostate
Eligibility Criteria
Histologic documentation - Histologic documentation of prostatic adenocarcinoma.
Patients with small cell, neuroendocrine, or transitional cell carcinomas are not eligible.
All eligible patients must have a known Gleason sum based on biopsy or TURP at the time of registration.
Clinically localized disease - Patients must have clinical stage T1-T3a and no radiographic evidence of metastatic disease as demonstrated by:
- EITHER CT or MRI of the abdomen and pelvis, OR endorectal MRI of the pelvis that demonstrate no nodes > 1.5 cm. If one or more pelvic lymph node(s) measures > 1.5 cm, a negative biopsy is required. If more than one lymph node is > 1.5 cm, the largest or most accessible node should be biopsied.
AND
- Negative bone scan (with plain films and/or MRI and/or CT scan confirmation, if necessary). Positive PET and Prostascint scans are not considered proof of metastatic disease.
Determination of high-risk status: Patients must have either:
- A Kattan nomogram predicted probability of being free from biochemical progression at 5 years after surgery of < 60%.
OR
- Prostate biopsy Gleason sum ≥ 8 (NOTE: The Kattan nomogram probability must be calculated for all patients, including those eligible based on Gleason sum ≥ 8 only.)
Prior treatment - No prior treatment for prostate cancer including prior surgery (excluding TURP), pelvic lymph node dissection, radiation therapy, or chemotherapy.
Patients may have received up to 4 months of androgen deprivation therapy (LHRH agonists, antiandrogens, or both) prior to being enrolled on the study.
- Appropriate surgical candidates - Patients must be appropriate candidates for radical prostatectomy with an estimated life expectancy > 10 years as determined by a urologist. Evidence of underlying cardiac disease should be evaluated prior to enrollment to ensure that patients are not at high risk of cardiac complications.
- Clotting history - Patients with a history of deep venous thrombosis, pulmonary embolism, and/or cerebrovascular accident or currently requiring systemic anticoagulation are eligible provided they are determined to be candidates for radical prostatectomy.
- ECOG performance status: 0-2
- Age: ≥ 18 years of age
Required Initial Laboratory Values:
- ANC ≥ 1500/μL
- Platelet count ≥ 150,000/μL
- Creatinine ≤ 2.0 mg/dL
- Pre-registration serum PSA level ≤ 100 ng/mL
- Bilirubin ≤ 1.5XULN (2.5XULN in patients with Gilbert's disease)
- AST/ALT ≤1.5XULN
Sites / Locations
- Providence Cancer Center
- Fairbanks Cancer Treatment Center at Fairbanks Memorial Hospital
- Alta Bates Summit Comprehensive Cancer Center
- Peninsula Medical Center
- USC/Norris Comprehensive Cancer Center and Hospital
- Sutter Health - Western Division Cancer Research Group
- University of California Davis Cancer Center
- Naval Medical Center - San Diego
- California Pacific Medical Center - Pacific Campus
- Sutter Pacific Medical Foundation
- Tahoe Forest Cancer Center
- Sutter Solano Medical Center
- University of Colorado Cancer Center at UC Health Sciences Center
- Denver Health Medical Center
- Veterans Affairs Medical Center - Denver
- Shaw Regional Cancer Center
- Valley View Hospital Cancer Center
- Montrose Memorial Hospital Cancer Center
- Helen and Harry Gray Cancer Center at Hartford Hospital
- Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center
- Yale Cancer Center
- Eastern Connecticut Hematology and Oncology Associates
- Veterans Affairs Medical Center - West Haven
- Tunnell Cancer Center at Beebe Medical Center
- CCOP - Christiana Care Health Services
- Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
- Ella Milbank Foshay Cancer Center at Jupiter Medical Center
- CCOP - Mount Sinai Medical Center
- Florida Hospital Cancer Institute at Florida Hospital Orlando
- H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
- Cleveland Clinic Florida - Weston
- Kapiolani Medical Center at Pali Momi
- OnCare Hawaii, Incorporated - Lusitana
- Queen's Cancer Institute at Queen's Medical Center
- Straub Clinic and Hospital, Incorporated
- Hawaii Medical Center - East
- OnCare Hawaii, Incorporated - Kuakini
- Kapiolani Medical Center for Women and Children
- Castle Medical Center
- Kauai Medical Clinic
- Maui Memorial Medical Center
- Pacific Cancer Institute - Maui
- Idaho Urologic Institute, PA
- University of Chicago Cancer Research Center
- Louis A. Weiss Memorial Hospital
- Decatur Memorial Hospital Cancer Care Institute
- Delnor Hospital - Geneva
- Veterans Affairs Medical Center - Hines
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Regional Cancer Center at Memorial Medical Center
- Central Dupage Cancer Center
- Elkhart Clinic, LLC
- Michiana Hematology-Oncology, PC - Elkhart
- Elkhart General Hospital
- Howard Community Hospital
- Center for Cancer Therapy at LaPorte Hospital and Health Services
- Michiana Hematology-Oncology, PC - South Bend
- Saint Joseph Regional Medical Center
- Michiana Hematology Oncology PC - Plymouth
- CCOP - Northern Indiana CR Consortium
- Memorial Hospital of South Bend
- Michiana Hematology Oncology PC - La Porte
- Hematology Oncology Associates of the Quad Cities
- Genesis Regional Cancer Center at Genesis Medical Center
- Holden Comprehensive Cancer Center at University of Iowa
- St. Rose Ambulatory and Surgery Center
- Hays Medical Center
- Hutchinson Hospital Corporation
- Kansas City Cancer Centers - West
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- Kansas City Cancer Centers - Southwest
- Mount Carmel Regional Cancer Center
- Tammy Walker Cancer Center at Salina Regional Health Center
- Kansas City Cancer Center - Shawnee Mission
- St. Francis Comprehensive Cancer Center
- Pennington Cancer Center at Baton Rouge General
- Mary Bird Perkins Cancer Center - Baton Rouge
- MBCCOP - LSU Health Sciences Center
- Medical Center of Louisiana - New Orleans
- Maine Center for Cancer Medicine and Blood Disorders - Scarborough
- Union Hospital of Cecil County
- Peninsula Regional Medical Center
- Tufts Medical Center Cancer Center
- Berkshire Hematology Oncology, PC
- Saint Joseph Mercy Cancer Center
- CCOP - Michigan Cancer Research Consortium
- Mecosta County Medical Center
- Oakwood Cancer Center at Oakwood Hospital and Medical Center
- Josephine Ford Cancer Center at Henry Ford Hospital
- Genesys Hurley Cancer Institute
- Hurley Medical Center
- CCOP - Grand Rapids
- Lacks Cancer Center at Saint Mary's Health Care
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Foote Memorial Hospital
- Sparrow Regional Cancer Center
- St. Mary Mercy Hospital
- Mercy General Health Partners
- St. Joseph Mercy Oakland
- Mercy Regional Cancer Center at Mercy Hospital
- Spectrum Health Reed City Hospital
- Seton Cancer Institute at Saint Mary's - Saginaw
- Lakeland Regional Cancer Care Center - St. Joseph
- Lakeside Cancer Specialists, PLLC
- Munson Medical Center
- St. John Macomb Hospital
- Fairview Ridges Hospital
- Mercy and Unity Cancer Center at Mercy Hospital
- Fairview Southdale Hospital
- Mercy and Unity Cancer Center at Unity Hospital
- Hutchinson Area Health Care
- HealthEast Cancer Care at St. John's Hospital
- Minnesota Oncology - Maplewood
- Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
- Hennepin County Medical Center - Minneapolis
- Masonic Cancer Center at University of Minnesota
- New Ulm Medical Center
- Humphrey Cancer Center at North Memorial Outpatient Center
- CentraCare Clinic - River Campus
- Coborn Cancer Center
- CCOP - Metro-Minnesota
- Park Nicollet Cancer Center
- Regions Hospital Cancer Care Center
- United Hospital
- St. Francis Cancer Center at St. Francis Medical Center
- Lakeview Hospital
- Ridgeview Medical Center
- Willmar Cancer Center at Rice Memorial Hospital
- Minnesota Oncology - Woodbury
- University of Mississippi Cancer Clinic
- Truman Medical Center - Hospital Hill
- Veterans Affairs Medical Center - Kansas City
- Kansas City Cancer Centers - South
- Kansas City Cancer Centers - North
- Kansas City Cancer Centers - East
- Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
- CCOP - Montana Cancer Consortium
- St. Vincent Healthcare Cancer Care Services
- Hematology-Oncology Centers of the Northern Rockies - Billings
- Billings Clinic
- Bozeman Deaconess Cancer Center
- St. James Healthcare Cancer Care
- Benefis Healthcare - Sletten Cancer Institute
- Great Falls Clinic - Main Facility
- St. Peter's Hospital
- Kalispell Regional Medical Center
- Montana Cancer Specialists at Montana Cancer Center
- Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
- CCOP - Missouri Valley Cancer Consortium
- Methodist Estabrook Cancer Center
- Immanuel Medical Center
- Lakeside Hospital
- Creighton University Medical Center
- University Medical Center of Southern Nevada
- CCOP - Nevada Cancer Research Foundation
- New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care
- New Hampshire Oncology - Hematology, PA - Hooksett
- Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
- Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
- Carol G. Simon Cancer Center at Morristown Memorial Hospital
- Somerset Medical Center
- Frederick R. and Betty M. Smith Cancer Treatment Center
- Overlook Hospital
- Fox Chase Virtua Health Cancer Program at Virtua West Jersey
- Hematology Oncology Associates, PC
- Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital
- University of New Mexico Cancer Center
- Roswell Park Cancer Institute
- New York Weill Cornell Cancer Center at Cornell University
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- SUNY Upstate Medical University Hospital
- Veterans Affairs Medical Center - Syracuse
- Presbyterian Cancer Center at Presbyterian Hospital
- Duke Cancer Institute
- Wayne Memorial Hospital, Incorporated
- Kinston Medical Specialists
- Carolinas Medical Center - Union
- Rutherford Hospital
- Cleveland Regional Medical Center
- Iredell Memorial Hospital
- Forsyth Regional Cancer Center at Forsyth Medical Center
- Wake Forest University Comprehensive Cancer Center
- Ohio State University Medical Center
- St. Rita's Medical Center
- Oklahoma University Cancer Institute
- Bay Area Hospital
- Kaiser Permanente Health Care - Portland
- Mercy Fitzgerald Hospital
- Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
- Fox Chase Cancer Center - Philadelphia
- AnMed Health Cancer Center
- Roper St. Francis Cancer Center at Roper Hospital
- CCOP - Greenville
- CCOP - Upstate Carolina
- Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
- Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center
- MBCCOP - Meharry Medical College - Nashville
- Mountainview Medical
- Fletcher Allen Health Care - University Health Center Campus
- Lynchburg Hematology-Oncology Clinic
- Southwest Virginia Regional Cancer Center at Wellmonth Health
- Providence Centralia Hospital
- St. Francis Hospital
- Cascade Cancer Center at Evergreen Hospital Medical Center
- Seattle Cancer Care Alliance at EvergreenHealth
- Providence St. Peter Hospital Regional Cancer Center
- Good Samaritan Cancer Center
- CCOP - Virginia Mason Research Center
- Virginia Mason Medical Center
- Pacific Medical Center
- Rockwood Clinic Cancer Treatment Center
- Franciscan Cancer Center at St. Joseph Medical Center
- CCOP - Northwest
- MultiCare Regional Cancer Center at Tacoma General Hospital
- Madigan Army Medical Center - Tacoma
- St. Clare Hospital
- West Virginia University Health Sciences Center - Charleston
- Edwards Comprehensive Cancer Center at Cabell Huntington Hospital
- Gundersen Lutheran Center for Cancer and Blood
- Rocky Mountain Oncology
- Welch Cancer Center at Sheridan Memorial Hospital
- Tom Baker Cancer Centre - Calgary
- University of British Columbia
- London Regional Cancer Program at London Health Sciences Centre
- Princess Margaret Hospital
- Hopital Notre-Dame du CHUM
Arms of the Study
Arm 1
Arm 2
Experimental
Other
Arm A: docetaxel + LHRH agonist + surgical intervention
Arm B: surgical intervention
Patients receive six cycles of docetaxel administered every 3 weeks combined with 18-24 weeks of androgen deprivation therapy. During each cycle of chemotherapy, all patients should undergo premedication with dexamethasone 8 mg orally prior to docetaxel. Dexamethasone may also be given intravenously according to institutional guidelines. Patients will also receive androgen deprivation for 18-24 weeks of an LHRH agonist (eg, leuprolide acetate, goserelin acetate). Additional premedication and antiemetics may be given at the physician's discretion and as defined by the protocol. Patients will undergo standard surgical intervention. The surgical procedures will be performed within 60 days of the completion of neoadjuvant therapy. Patients are allowed to receive adjuvant external beam radiation at the discretion of the treating physician and as defined per the protocol. It must be initiated within 6 months of the date of surgery.
All patients undergo standard surgical intervention. The surgical procedures will be performed within 60 days of randomization. Patients are allowed to receive adjuvant external beam radiation at the discretion of the treating physician and as defined per the protocol. Adjuvant radiation must be initiated within 6 months of the date of surgery.