A Phase 3 Trial of Androgen Ablation Alone vs. Chemo/Hormonal Therapy as Initial Treatment of Unresectable/Metastatic Adenocarcinoma of the Prostate
Bicalutamide
+ Flutamide
+ Nilutamide
Maladies génito-urinaires+7
+ Maladies Génitales
+ Maladies génitales masculines
Étude thérapeutique
Résumé
Date de début de l'étude : 1 août 1996
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Determine the clinical benefit, as measured by time to progression and overall survival, of chemo/hormonal therapy compared to androgen ablation alone, when given as the initial systemic treatment in patients with acinar adenocarcinoma of the prostate that is not amenable to local therapy. Validate the clinical significance of PSA criteria for progression. OUTLINE: This is a randomized study. Patients are randomized to 1 of 2 treatment arms. Arm I: Patients are treated with medical or surgical castration followed by an anti-androgen therapy with either flutamide, bicalutamide, or nilutamide. Arm II: Patients receive chemo/hormonal therapy for 3 eight week courses, followed by total androgen blockade. Each course consists of 6 weeks of cytotoxic therapy with doxorubicin, ketoconazole, vinblastine, and estramustine followed by 2 weeks of rest. These patients are also maintained on hydrocortisone both during treatment and during rest. Patients in arm II have a long-term central venous access device inserted. PROJECTED ACCRUAL: A total of 368 patients will be accrued for this study.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.306 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Homme
Le sexe biologique des participants éligibles à s'inscrire.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: Histologically proven acinar adenocarcinoma of the prostate Metastatic or locally advanced disease that either is not appropriately treated with surgery or radiation, or has recurred following previous "definitive" local therapy No CNS metastases No histologic subtypes, such as pure ductal or any component of small cell carcinoma Elevated PSA (at least 1.0 ng/mL in patients with prior prostatectomy or 4.0 ng/mL in those with prostate in place) PATIENT CHARACTERISTICS: Age: Not specified Performance status: Zubrod 0-2 Life expectancy: At least 3 years Hematopoietic: Absolute neutrophil count greater than 1,500/mm^3 Platelet count greater than 100,000/mm^3 Hepatic: Conjugated bilirubin no greater than 0.8 mg/dL or total bilirubin no greater than 1.5 mg/dL Transaminase no greater than 4 times upper limit of normal Renal: Creatinine clearance at least 40 mL/min Cardiovascular: No evidence of bifascicular block on EKG No evidence of active ischemia on EKG No prior history of transient ischemic attack No evidence of congestive heart failure Other: No active peptic ulcer disease No regular use of antacid or H2 blockers No known or predicted achlorhydria No concurrent use of terfenadine, astemizole, omeprazole, or cisapride No second malignancy unless curatively treated No history of deep venous thrombosis No history of pulmonary embolism No serious co-morbidity HIV negative PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior cytotoxic systemic therapy Endocrine therapy: Prior androgen deprivation therapy allowed if given for no more than 6 months to downstage primary No androgen deprivation therapy within 1 year prior to study Radiotherapy: No prior cytotoxic systemic therapy (including systemic strontium-89 irradiation) Prior definitive radiotherapy to the prostate and/or one metastatic site allowed At least 8 weeks since radiotherapy to the pelvis At least 3 weeks since radiotherapy to a single metastatic site Surgery: Prior prostatectomy allowed Other: No concurrent anti-anginal therapy or aggressive anticoagulants
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.2 groupes d'intervention sont désignés dans cette étude
Cette étude ne comporte pas de groupe placebo.
Groupes de traitement
Groupe I
ExpérimentalGroupe II
ExpérimentalObjectifs de l'étude
Objectifs principaux
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 1 site
University of Texas - MD Anderson Cancer Center
Houston, United StatesOuvrir University of Texas - MD Anderson Cancer Center dans Google Maps