Docetaxel and Estramustine Versus Mitoxantrone and Prednisone for Advanced, Hormone Refractory Prostate Cancer
docetaxel
+ estramustine
+ mitoxantrone
Urogenital Diseases+7
+ Genital Diseases
+ Genital Diseases, Male
Treatment Study
Summary
Study start date: October 1, 1999
Actual date on which the first participant was enrolled.OBJECTIVES: Compare the overall survival and progression-free survival in patients with hormone-refractory, metastatic adenocarcinoma of the prostate treated with docetaxel and estramustine vs mitoxantrone and prednisone. Compare the qualitative and quantitative toxic effects of these regimens in this patient population. Compare the quality of life, including palliation of metastatic bone pain and global quality of life, of patients treated with these regimens. Record prostate-specific antigen values for future correlations with response and survival in patients treated with these regimens. Compare the responses in patients with bidimensionally measurable disease treated with these regimens. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease status (measurable or evaluable disease progression vs rising PSA only), NCI Common Toxicity Criteria version 2.X pain scale (grade 2 or greater vs less than 2), and SWOG performance status (0-1 vs 2-3). Patients are randomized to one of two treatment arms. Arm I: Patients receive oral estramustine 3 times daily on days 1-5 and docetaxel IV over 1 hour on day 2. Arm II: Patients receive mitoxantrone IV over 30 minutes on day 1 and oral prednisone twice daily on days 1-21. Treatment in both arms repeats every 3 weeks for a maximum of 12 courses in the absence of unacceptable toxicity or disease progression. Quality of life is assessed at baseline, after courses 4 and 8, and then at 1 year after randomization. Patients are followed every 6 months for 2 years and then annually for 1 year. PROJECTED ACCRUAL: A total of 620 patients (310 per arm) will be accrued for this study within 3.5 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.770 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Male
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: Histologically confirmed metastatic adenocarcinoma of the prostate Unresponsive or refractory to hormonal therapy, as defined by at least 1 of the following criteria: Progression of bidimensionally measurable disease Progression of evaluable but not measurable disease (bone scan) At least 2 consecutive rises in PSA and a PSA level of at least 5 ng/mL No minimum PSA required for measurable disease or non-PSA evaluable disease Soft tissue disease that has been irradiated within the past 2 months is not considered measurable disease Prior orchiectomy OR Medical castration using leuprolide or goserelin Luteinizing hormone-releasing hormone (LHRH) agonist therapy must continue during study Prior nonsteroidal antiandrogens (flutamide, ketoconazole, bicalutamide, or nilutamide) allowed if disease progression occurred No third-space fluid accumulation such as ascites or symptomatic pleural effusion No brain metastases PATIENT CHARACTERISTICS: Age: 18 and over Performance status: SWOG 0-3 Performance status 3 must be due to pain secondary to bone metastases Life expectancy: Not specified Hematopoietic: No hypercoagulability Hepatic: Not specified Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No history of myocardial infarction No history of congestive heart failure unless well controlled No history of cerebrovascular accident or atrial fibrillation No active thrombophlebitis Left ventricular ejection fraction (LVEF) at least 50% by Multi Gated Acquisition Scan (MUGA) scan or 2-D echocardiogram Pulmonary: No history of pulmonary embolus Other: Recovered from major infections No other significant active medical illness No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer currently in complete remission PRIOR CONCURRENT THERAPY: Biologic therapy: At least 4 weeks since prior biologic therapy and recovered No more than 1 prior biologic therapy regimen No concurrent biological response modifiers Chemotherapy: At least 4 weeks since prior chemotherapy and recovered No more than 1 prior chemotherapy regimen No prior estramustine, taxanes, anthracyclines, or mitoxantrone No other concurrent chemotherapy Endocrine therapy: See Disease Characteristics At least 4 weeks since prior flutamide or ketoconazole (6 weeks for bicalutamide or nilutamide) No concurrent corticosteroids or hormonal therapy (except megestrol for hot flashes or continuing LHRH treatment) Radiotherapy: See Disease Characteristics Prior samarium Sm 153 lexidronam pentasodium allowed At least 4 weeks since prior radiotherapy and recovered No prior radiotherapy to 30% or more of bone marrow No prior strontium chloride Sr 89 No concurrent radiotherapy Surgery: See Disease Characteristics At least 3 weeks since prior surgery and recovered Other: At least 4 weeks since prior bisphosphonates No prior anticoagulation therapy (i.e., warfarin), except aspirin No concurrent bisphosphonates
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.2 intervention groups are designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalGroup II
Active ComparatorStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 16 locations
CCOP - Scottsdale Oncology Program
Scottsdale, United StatesOpen CCOP - Scottsdale Oncology Program in Google MapsMayo Clinic
Jacksonville, United StatesCCOP - Illinois Oncology Research Association
Peoria, United StatesCCOP - Carle Cancer Center
Urbana, United States