Adjuvant Androgen Deprivation Versus Mitoxantrone Plus Prednisone Plus Androgen Deprivation in Selected High-Risk Prostate Cancer Patients Following Radical Prostatectomy
bicalutamide
+ goserelin
+ bicalutamide
Urogenital Diseases+7
+ Genital Diseases
+ Genital Diseases, Male
Treatment Study
Summary
Study start date: October 15, 1999
Actual date on which the first participant was enrolled.OBJECTIVES: Compare the overall and disease-free survival of patients with high-risk adenocarcinoma of the prostate treated with adjuvant androgen deprivation therapy with or without mitoxantrone and prednisone after radical prostatectomy. Compare the qualitative and quantitative toxic effects of these regimens in this patient population. Compare the prostate-specific antigen (PSA) progression-free survival rate in patient treated with these regimens. Determine whether PSA progression is a surrogate endpoint for survival or disease-free survival in this patient population. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to surgical extent of disease (organ confined vs not organ confined, but N0 vs N1), Gleason's sum (less than 7 vs 7 vs greater than 7), and planned radiotherapy (yes vs no). Patients are randomized to one of two treatment arms. Arm I:Patients receive goserelin subcutaneously once every 13 weeks (8 injections total) and oral bicalutamide once daily for 2 years in the absence of disease progression or unacceptable toxicity. Arm II:Patients receive mitoxantrone IV over 30 minutes on day 1 and oral prednisone twice daily on days 1-21. Treatment repeats every 3 weeks for 6 courses in the absence of disease progression or unacceptable toxicity. Patients also receive hormonal therapy as in arm I beginning concurrently with the initiation of mitoxantrone and prednisone. Patients may undergo radiotherapy 5 days a week for 6.5-7.8 weeks beginning anytime (arm I) or after completion of chemotherapy (arm II), at the discretion of the physician, in the absence of disease progression or unacceptable toxicity. Patients are offered the possibility to participate in biomarker research by allowing their tissue/blood to be studied. Patients are followed every 6 months for 2 years and then annually for up to 13 years. PROJECTED ACCRUAL: A total of 1,360 patients (680 per treatment arm) will be accrued for this study within 9.5 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.983 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.From 18 to 120 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 stage T1-T3 adenocarcinoma of the prostate before radical prostatectomy and lymph node dissection Must have undergone prostatectomy within the past 120 days Must meet at least 1 of the following pathologic criteria: Gleason sum at least 8 pT3b (seminal vesicle), pT4, or N1 Gleason sum of 7 and positive margin Preoperative PSA greater than 15 ng/mL, Gleason score greater than 7, or PSA level greater than 10 ng/mL and Gleason score greater than 6 Must have an undetectable PSA (no greater than 0.2 ng/mL) documented after surgery or prior to adjuvant hormonal therapy (for patients initiating adjuvant hormonal therapy prior to study) No evidence of metastatic disease on bone scan if PSA is 20 ng/mL or greater at clinical diagnosis No distant metastatic disease PATIENT CHARACTERISTICS: Performance status: SWOG 0-1 Life expectancy: Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Cardiovascular: No uncontrolled congestive heart failure If history of cardiac disease, LVEF at least 50% by MUGA scan or 2-D echocardiogram Other: No HIV positivity No other prior malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer that is currently in complete remission PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: Not specified Endocrine therapy: Prior neoadjuvant hormonal therapy of no more than 4 months duration before radical prostatectomy allowed Other concurrent adjuvant hormonal therapy allowed if initiated prior to study Concurrent low-dose megestrol (less than 40 mg/day) for hot flashes allowed Radiotherapy: No prior radiotherapy No concurrent whole pelvis irradiation Concurrent radiotherapy allowed at the discretion of the physician Surgery: See Disease Characteristics See Endocrine therapy Recovered from prior surgery Other: No other prior or concurrent therapy for adenocarcinoma of the prostate
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
Active ComparatorGroup II
ExperimentalStudy 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 234 locations
Alaska Regional Hospital Cancer Center
Anchorage, United StatesOpen Alaska Regional Hospital Cancer Center in Google MapsProvidence Cancer Center
Anchorage, United StatesBanner Thunderbird Medical Center
Glendale, United StatesBanner Good Samaritan Medical Center
Phoenix, United States