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A Prospective Randomized Phase III Study Comparing Hormonal Therapy +/-Docetaxel (RisingPSA)

Primary Purpose

Adenocarcinoma of the Prostate

Status
Unknown status
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Docetaxel + hormonal treatment (LH-RH agonist)
Hormonal treatment (LH-RH agonist)
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adenocarcinoma of the Prostate focused on measuring PSA (biochemical), Progression- free Survival, Clinical progress, Overall survival, Tolerance to the treatment, Quality of Live

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically documented adenocarcinoma of the prostate
  • Previous treatment with either radical prostatectomy or radiation therapy
  • Salvage radiotherapy for local relapse allowed
  • Neoadjuvant or per radiotherapy Hormonal therapy allowed in case of more than 6 months free-interval before first rising PSA
  • Life expectancy of more than 12 months
  • Non metastatic disease documented by imaging including radionuclide bone scan
  • ECOG performance status 0-1
  • ANC > 1,500/mm3
  • Platelet counts > 100,000/mm3
  • SGOT and/or SGPT may be up to 2.5 x ULN

Patients at high risk of biological relapse defined by:

  • Gleason > 8
  • PSA-DT < 6 months
  • Positive surgical margins
  • PSA velocity > 0.75 ng/mL/year
  • Pathological pelvic lymph nodes involvement (pN+)
  • Time from initial treatment until inclusion < 12 months

Exclusion Criteria:

  • Prior chemotherapy by taxanes and estramustine phosphate
  • Documented local recurrence of prostate cancer or documented metastatic disease
  • History of other malignancy within the last 5 years other than curatively treated basal cell carcinoma of the skin
  • Active infection
  • Significant cardiac disease, angina pectoris or myocardial infarction within twelve months
  • Clinically significant neuropathy
  • Medical condition requiring the use of concomitant corticosteroids
  • Prohibited concomitant therapy with experimental drug.
  • Participation in another clinical trial for the period < 30 days

Sites / Locations

  • Service Oncologie Médicale, Hopital Europeen Georges Pompidou

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Outcomes

Primary Outcome Measures

The primary endpoint was the PSA (biochemical) progression-free survival (PFS) of high-risk metastasis-free PC patients, treated with LH-RH agonist for one year with or without docetaxel after prior radical prostatectomy (RP) or radiotherapy (RT).

Secondary Outcome Measures

Secondary endpoints were metastasis-free survival, PSA response (decrease > 50 % of the PSA), overall survival, cancer specific survival, safety and quality of life (QoL).

Full Information

First Posted
September 30, 2008
Last Updated
September 30, 2008
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
ARTIC group (oncologists and urologists association)
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1. Study Identification

Unique Protocol Identification Number
NCT00764166
Brief Title
A Prospective Randomized Phase III Study Comparing Hormonal Therapy +/-Docetaxel
Acronym
RisingPSA
Official Title
Non-Metastatic High-Risk Prostate Cancer Patients With Biochemical Relapse Only After Local Treatment. A Prospective Randomized Phase III Study Comparing Hormonal Therapy +/-Docetaxel
Study Type
Interventional

2. Study Status

Record Verification Date
September 2008
Overall Recruitment Status
Unknown status
Study Start Date
June 2003 (undefined)
Primary Completion Date
November 2009 (Anticipated)
Study Completion Date
November 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
ARTIC group (oncologists and urologists association)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective was to evaluate the PSA (biochemical) progression-free survival (PFS) of high-risk metastasis-free PC patients, treated with LH-RH agonist for one year with or without docetaxel after prior radical prostatectomy (RP) or radiotherapy (RT). The study was powered at 80% to detect a 25% improvement in biochemical PFS for a total sample size estimated at 252 patients, with a two-sided type I error rate of 5% (non-parametric methods.
Detailed Description
Docetaxel was shown to be active in metastatic hormone-refractory prostate cancer (PC) in phase III trials (1-2). It is likely to demonstrate a substantial role in the management of early-stage PC patients in the neoadjuvant and adjuvant settings, where clinical trials are underway.•53% of all men who undergo radical prostatectomy will develop prostate-specific antigen (PSA) elevations in the 10 years following surgery, with approximately 77% of these recurrences occurring within the first 2 years.A prospective, multicenter, national, randomized, two-arm, phase III study comparing hormonal treatment (LH-RH agonist alone) with or without docetaxel was designed to evaluate the interest of chemotherapy in non-metastatic prostate cancer patients at high risk of systemic recurrence after initial treatment (radical prostatectomy or radiotherapy). PETRYLAK DP, et al: Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 351:1513-1520, 2004 TANNOCK IF, de Wit R, Berry WR, et al: Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351:1502-1512, 2004

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma of the Prostate
Keywords
PSA (biochemical), Progression- free Survival, Clinical progress, Overall survival, Tolerance to the treatment, Quality of Live

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
254 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Title
2
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Docetaxel + hormonal treatment (LH-RH agonist)
Intervention Description
Docetaxel will be administered: To D1 of every cycle in the dose of 70 mg/m², Perfusion IV of 60 minutes diluted in 250 ml with physiological serum or with serum glucoside from a peripheral or central vein, Every 3 weeks during 6 cycles (except when unacceptable tolerance). Triptorelin was given by injection for 4 times every 3 months Bicalutamide was given at the same time with LH-RH agonist for 3 weeks ; taken orally
Intervention Type
Drug
Intervention Name(s)
Hormonal treatment (LH-RH agonist)
Intervention Description
Triptorelin was given by injection for 4 times every 3 months. Bicalutamide given at the same time with LH-RH agonist for 3 weeks ; taken orally.
Primary Outcome Measure Information:
Title
The primary endpoint was the PSA (biochemical) progression-free survival (PFS) of high-risk metastasis-free PC patients, treated with LH-RH agonist for one year with or without docetaxel after prior radical prostatectomy (RP) or radiotherapy (RT).
Time Frame
Every month during 5 years.
Secondary Outcome Measure Information:
Title
Secondary endpoints were metastasis-free survival, PSA response (decrease > 50 % of the PSA), overall survival, cancer specific survival, safety and quality of life (QoL).
Time Frame
Every month during 5 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically documented adenocarcinoma of the prostate Previous treatment with either radical prostatectomy or radiation therapy Salvage radiotherapy for local relapse allowed Neoadjuvant or per radiotherapy Hormonal therapy allowed in case of more than 6 months free-interval before first rising PSA Life expectancy of more than 12 months Non metastatic disease documented by imaging including radionuclide bone scan ECOG performance status 0-1 ANC > 1,500/mm3 Platelet counts > 100,000/mm3 SGOT and/or SGPT may be up to 2.5 x ULN Patients at high risk of biological relapse defined by: Gleason > 8 PSA-DT < 6 months Positive surgical margins PSA velocity > 0.75 ng/mL/year Pathological pelvic lymph nodes involvement (pN+) Time from initial treatment until inclusion < 12 months Exclusion Criteria: Prior chemotherapy by taxanes and estramustine phosphate Documented local recurrence of prostate cancer or documented metastatic disease History of other malignancy within the last 5 years other than curatively treated basal cell carcinoma of the skin Active infection Significant cardiac disease, angina pectoris or myocardial infarction within twelve months Clinically significant neuropathy Medical condition requiring the use of concomitant corticosteroids Prohibited concomitant therapy with experimental drug. Participation in another clinical trial for the period < 30 days
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephane Oudard, MD PhD
Organizational Affiliation
European Georges Pompidou Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Service Oncologie Médicale, Hopital Europeen Georges Pompidou
City
Paris
ZIP/Postal Code
75015
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
30703190
Citation
Oudard S, Latorzeff I, Caty A, Miglianico L, Sevin E, Hardy-Bessard AC, Delva R, Rolland F, Mouret L, Priou F, Beuzeboc P, Gravis G, Linassier C, Gomez P, Voog E, Muracciole X, Abraham C, Banu E, Ferrero JM, Ravaud A, Krakowski I, Lagrange JL, Deplanque G, Zylberait D, Bozec L, Houede N, Culine S, Elaidi R. Effect of Adding Docetaxel to Androgen-Deprivation Therapy in Patients With High-Risk Prostate Cancer With Rising Prostate-Specific Antigen Levels After Primary Local Therapy: A Randomized Clinical Trial. JAMA Oncol. 2019 May 1;5(5):623-632. doi: 10.1001/jamaoncol.2018.6607.
Results Reference
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A Prospective Randomized Phase III Study Comparing Hormonal Therapy +/-Docetaxel

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