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Radiation-hormone and Docetaxel VS Radiation-hormone in Patients With High-Risk Localized Prostate Cancer (QRT-SOGUG)

Primary Purpose

Prostate Cancer Stage III, Prostate Cancer Stage IV

Status
Active
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Docetaxel
Hormone and radiation therapy
Radiation therapy
Sponsored by
Spanish Oncology Genito-Urinary Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Prostate Cancer Stage III

Eligibility Criteria

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

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.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Docetaxel, hormone and radiation therapy

    Hormone and radiation therapy

    Arm Description

    Radiation therapy combined with weekly docetaxel (20 mg/m2) and hormone therapy.

    Radiation therapy and hormone therapy

    Outcomes

    Primary Outcome Measures

    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
    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

    Percentage of patients with biochemical recurrence-free survival
    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 survival
    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.
    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 rate
    The clinical response rate: percentage of patients with partial and complete response, according to RECIST criteria.
    Biochemical response rate.
    Biochemical response rate: percentage of patients with partial and complete response, according to PSA levels.
    Quality of life of the patients
    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.
    Numbers of events evaluated according to NCI criteria CTCAE v3

    Full Information

    First Posted
    January 15, 2018
    Last Updated
    January 20, 2021
    Sponsor
    Spanish Oncology Genito-Urinary Group
    Collaborators
    Pivotal S.L.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03432780
    Brief Title
    Radiation-hormone and Docetaxel VS Radiation-hormone in Patients With High-Risk Localized Prostate Cancer
    Acronym
    QRT-SOGUG
    Official Title
    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)"
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2021
    Overall Recruitment Status
    Active, not recruiting
    Study Start Date
    December 18, 2008 (Actual)
    Primary Completion Date
    November 14, 2023 (Anticipated)
    Study Completion Date
    November 14, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Spanish Oncology Genito-Urinary Group
    Collaborators
    Pivotal S.L.

    4. Oversight

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

    5. Study Description

    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.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Prostate Cancer Stage III, Prostate Cancer Stage IV

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    A prospective, multicenter, multidisciplinary, parallel-group, open-label study with randomized group assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    134 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Docetaxel, hormone and radiation therapy
    Arm Type
    Experimental
    Arm Description
    Radiation therapy combined with weekly docetaxel (20 mg/m2) and hormone therapy.
    Arm Title
    Hormone and radiation therapy
    Arm Type
    Active Comparator
    Arm Description
    Radiation therapy and hormone therapy
    Intervention Type
    Drug
    Intervention Name(s)
    Docetaxel
    Other Intervention Name(s)
    Taxotere
    Intervention Type
    Biological
    Intervention Name(s)
    Hormone and radiation therapy
    Intervention Type
    Radiation
    Intervention Name(s)
    Radiation therapy
    Primary Outcome Measure Information:
    Title
    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
    Description
    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).
    Time Frame
    5 years of randomization
    Secondary Outcome Measure Information:
    Title
    Percentage of patients with biochemical recurrence-free survival
    Description
    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
    Time Frame
    5 years
    Title
    Percentage of patients with progression-free survival
    Description
    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
    Time Frame
    5 years
    Title
    Percentage of patients with overall survival.
    Description
    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.
    Time Frame
    5 years
    Title
    Clinical response rate
    Description
    The clinical response rate: percentage of patients with partial and complete response, according to RECIST criteria.
    Time Frame
    5 years
    Title
    Biochemical response rate.
    Description
    Biochemical response rate: percentage of patients with partial and complete response, according to PSA levels.
    Time Frame
    5 years
    Title
    Quality of life of the patients
    Description
    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
    Time Frame
    screening and week 9
    Title
    Safety profile of the treatment.
    Description
    Numbers of events evaluated according to NCI criteria CTCAE v3
    Time Frame
    5 years

    10. Eligibility

    Sex
    Male
    Gender Based
    Yes
    Gender Eligibility Description
    prostate cancer is present only in male
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Histological confirmation of adenocarcinoma of the prostate. Age > 18 years. 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 PSA > 20 ng/mL. Karnofsky index ≥ 70% Good bone marrow reserve, with white blood cell count > 3000/mm3, hemoglobin >9.5 g/dL and platelets > 150,000/mm3. 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. Absence of abnormality in renal function, with creatinine levels up to 2 times the upper limit of normality for each site. Having given informed consent in writing. Exclusion Criteria: Previous hormone treatment during more than 3 months. Previous surgical treatment, pelvic radiation therapy, or chemotherapy for the current illness. Concomitant second neoplasm or history of neoplastic disease in the last 5 years, except for cutaneous basal cell carcinoma. Metabolic disease or uncontrolled systemic disease. Previous history of grade III-IV neuropathy (NCI CTCAE v3). Psychological, social, family, or geographical conditions that may compromise compliance with or follow-up of the study. Having received treatment with an investigational medicinal product during the 30 days prior to inclusion in the study. Inflammatory bowel disease.

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    26309896
    Citation
    Armstrong CM, Gao AC. Drug resistance in castration resistant prostate cancer: resistance mechanisms and emerging treatment strategies. Am J Clin Exp Urol. 2015 Aug 8;3(2):64-76. eCollection 2015.
    Results Reference
    result
    PubMed Identifier
    12126818
    Citation
    Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, Mattelaer J, Lopez Torecilla J, Pfeffer JR, Lino Cutajar C, Zurlo A, Pierart M. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet. 2002 Jul 13;360(9327):103-6. doi: 10.1016/s0140-6736(02)09408-4.
    Results Reference
    result
    PubMed Identifier
    9276357
    Citation
    Lawton CA, Winter K, Byhardt R, Sause WT, Hanks GE, Russell AH, Rotman M, Porter A, McGowan DG, DelRowe JD, Pilepich MV. Androgen suppression plus radiation versus radiation alone for patients with D1 (pN+) adenocarcinoma of the prostate (results based on a national prospective randomized trial, RTOG 85-31). Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys. 1997 Jul 15;38(5):931-9. doi: 10.1016/s0360-3016(97)00288-5.
    Results Reference
    result
    PubMed Identifier
    15143084
    Citation
    Kumar P, Perrotti M, Weiss R, Todd M, Goodin S, Cummings K, DiPaola RS. Phase I trial of weekly docetaxel with concurrent three-dimensional conformal radiation therapy in the treatment of unfavorable localized adenocarcinoma of the prostate. J Clin Oncol. 2004 May 15;22(10):1909-15. doi: 10.1200/JCO.2004.02.001.
    Results Reference
    result
    PubMed Identifier
    15470213
    Citation
    Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, Oudard S, Theodore C, James ND, Turesson I, Rosenthal MA, Eisenberger MA; TAX 327 Investigators. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004 Oct 7;351(15):1502-12. doi: 10.1056/NEJMoa040720.
    Results Reference
    result
    PubMed Identifier
    15470214
    Citation
    Petrylak DP, Tangen CM, Hussain MH, Lara PN Jr, Jones JA, Taplin ME, Burch PA, Berry D, Moinpour C, Kohli M, Benson MC, Small EJ, Raghavan D, Crawford ED. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med. 2004 Oct 7;351(15):1513-20. doi: 10.1056/NEJMoa041318.
    Results Reference
    result
    PubMed Identifier
    8620502
    Citation
    Hennequin C, Giocanti N, Favaudon V. Interaction of ionizing radiation with paclitaxel (Taxol) and docetaxel (Taxotere) in HeLa and SQ20B cells. Cancer Res. 1996 Apr 15;56(8):1842-50.
    Results Reference
    result
    PubMed Identifier
    9815644
    Citation
    Mason KA, Hunter NR, Milas M, Abbruzzese JL, Milas L. Docetaxel enhances tumor radioresponse in vivo. Clin Cancer Res. 1997 Dec;3(12 Pt 1):2431-8.
    Results Reference
    result
    PubMed Identifier
    16985954
    Citation
    Kumar P. A new paradigm for the treatment of high-risk prostate cancer: radiosensitization with docetaxel. Rev Urol. 2003;5 Suppl 3(Suppl 3):S71-7.
    Results Reference
    result
    Links:
    URL
    https://gco.iarc.fr/
    Description
    GLOBOCAN 2002
    URL
    https://gco.iarc.fr/
    Description
    Base de datos de Mortalidad de la OMS
    URL
    http://www.nccn.org/professionals/physician_gls/PDF/prostate.pdf
    Description
    Nacional Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology - v2.2005 (prostate cancer).

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

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