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Phase III Randomized Study of Total Androgen Blockade With or Without Pelvic Irradiation in Patients With Locally Advanced Adenocarcinoma of the Prostate
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
Hormone Therapy With or Without Surgery or Radiation Therapy in Treating Patients With Prostate Cancer
Basic Trial Information
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Phase
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Type
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Status
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Age
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Sponsor
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Protocol IDs
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Phase III
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Treatment
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Closed
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Under 80
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NCI
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CAN-NCIC-PR3 CALGB-9593, ECOG-JPR03, MRC-PR07, SWOG-JPR3, EU-99013, NCI-T94-0110O, ISRCTN24991896, T94-0110, NCT00002633, PR3
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Objectives - Compare the overall survival and time to progression in patients with locally advanced adenocarcinoma of the prostate treated with total androgen suppression with or without pelvic irradiation.
- Compare the symptomatic control as measured by the rates of surgical interventions needed for control of local disease (e.g., transurethral resections, stent insertions, nephrostomies, and colostomies) in patients treated with these regimens.
- Compare the quality of life of patients treated with these regimens.
- Compare the sensitivity of the EORTC-QLQ-C30+3 and a trial-specific checklist (PR17) with the FACT-P questionnaire in measuring changes in quality of life of patients treated with these regimens.
Entry Criteria Disease Characteristics:
- Histologically proven locally advanced adenocarcinoma of the prostate, defined as 1 of the following:
- T3-4, N0 or NX, M0
- T2, PSA greater than 40 µg/L
- T2, PSA greater than 20 µg/L AND Gleason score at least 8
- Diagnosis made within the past 6 months
- Gleason score and PSA known
- Pelvic lymph nodes must be clinically negative
- Lymph nodes no more than 1.5 cm in greatest diameter
by CT scan or MRI of the pelvis
- Negative needle aspirate required for any lymph node
more than 1.5 cm
- If a lymph node dissection was performed, it must be histologically negative
- No small cell or transitional cell carcinoma by biopsy
- No bony metastases by bone scan
Prior/Concurrent Therapy:
Biologic therapy: Chemotherapy: Endocrine therapy: - Prior hormonal therapy within the past 12 weeks allowed provided the following conditions are
met:
- Negative bone scan before beginning any hormonal
therapy
- Extracapsular extension remains palpable on rectal re-exam
- Baseline PSA known before beginning any hormonal therapy
- At least 4-6 weeks since prior 5-alpha-reductase inhibitor
(e.g., finasteride) for benign prostatic hypertrophy
Radiotherapy: - No prior pelvic irradiation
Surgery: - No prior radical prostatectomy
- Prior transurethral resection of the prostate
allowed
Other: - No prior cytotoxic anticancer therapy
- No other prior treatment for prostate cancer
- No other concurrent anticancer therapy unless documented
disease progression
Patient Characteristics:
Age: Performance status: Life expectancy: - At least 5 years excluding malignancy
Hematopoietic: - Hemoglobin at least 10.0 g/dL
- WBC at least 2,000/mm3
- Platelet count at least 100,000/mm3
Hepatic: - Bilirubin less than 2 times upper limit of normal
(ULN)
- SGOT and SGPT less than 2 times ULN
- Alkaline phosphatase less than 2 times ULN
- No history of chronic liver disease
Renal: - Creatinine less than 2 times ULN
Other: - No contraindication to wide-field pelvic irradiation (e.g.,
inflammatory bowel disease or severe bladder irritability)
- No other malignancy within the past 5 years except
nonmelanoma skin cancer
- Fertile patients must use effective contraception
Expected Enrollment 1200A total of 1,200 patients will be accrued for this study within 7.5 years. Outcomes Primary Outcome(s)Overall survival
Secondary Outcome(s)Time to disease progression Symptomatic local control measured by surgical intervention rate Quality of life assessed by EORTC-QLQ-C30 + 3 and a trial-specific checklist (PR17) or the FACT-P questionnaire
Outline This a randomized, multicenter study. Patients are stratified according
to center, initial PSA level (less than 20 vs 20-50 vs greater than 50 ng/mL),
method of node staging (clinical [no CT scan] vs radiological [CT scan negative] vs surgical), Gleason score (less than 8 vs
8-10), prior hormonal therapy (excluding orchiectomy) (yes vs no), and choice of hormonal therapy (bilateral orchiectomy with or without antiandrogen vs luteinizing hormone-releasing hormone [LHRH] with antiandrogen).
Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients receive antiandrogen therapy comprising oral flutamide
every 8 hours, oral nilutamide every 8 hours for 1 month and then once daily,
or oral bicalutamide once daily. Patients also choose to undergo bilateral
orchiectomy or LHRH agonist therapy comprising goserelin subcutaneously (SC)
every 4 weeks (short-acting formulation) or every 3 months (long-acting
formulation), leuprolide intramuscularly every 4 weeks (short-acting
formulation) or every 3 months (long-acting formulation), or buserelin SC
every 8 weeks or every 12 weeks. Patients choosing orchiectomy may receive an antiandrogen for
at least 6 weeks before surgery to counter any flare phenomenon and may
continue the antiandrogen after surgery (at the physician's discretion).
- Arm II: Patients undergo total androgen ablation as in arm I. Patients
with node-negative dissection undergo radiotherapy 5 days a week for 6.5-7
weeks. All other patients undergo radiotherapy 5 days a week for 5 weeks,
followed by boost radiotherapy 5 days a week for 2-2.4 weeks.
Hormonal therapy on both arms continues in the absence of disease
progression or unacceptable toxicity. Quality of life is assessed at baseline, on the last day of
radiotherapy, at 6 months, and then every 6 months thereafter. Patients are followed at 1, 2, and 6 months and then every 6 months
thereafter.
Trial Contact Information
Trial Lead Organizations NCIC-Clinical Trials Group ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Padraig Warde, MB, MRCPI, FRCPC, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) |
Eastern Cooperative Oncology Group ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Richard Whittington, MD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) |
Cancer and Leukemia Group B ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Srinivasan Vijayakumar, MD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) |
Southwest Oncology Group ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Patricia Lillis-Hearne, MD, Protocol chair(Contact information may not be current) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) |
Medical Research Council Clinical Trials Unit ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Malcolm Mason, MD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) |
Registry Information | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Official Title | | Phase III Randomized Trial Comparing Total Androgen Blockade Versus Total Androgen Blockade Plus Pelvic Irradiation in Clinical Stage T3-4, N0, M0 Adenocarcinoma of the Prostate | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Trial Start Date | | 1995-03-08 | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Trial Completion Date | | 2011-08-01 (estimated) | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Registered in ClinicalTrials.gov | | NCT00002633 | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Date Submitted to PDQ | | 1995-02-15 | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | Information Last Verified | | 2007-06-02 | ![](https://webarchive.library.unt.edu/eot2008/20081017215428im_/http://www.cancer.gov/images/spacer.gif) | NCI Grant/Contract Number | | CM17107 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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