Antiandrogen Therapy and Radiation Therapy With or Without Docetaxel in Treating Patients With Prostate Cancer That Has Been Removed by Surgery

Official Title

Phase II-III Trial of Adjuvant Radiation Therapy Following Radical Prostatectomy With or Without Adjuvant Docetaxel

Summary:

This randomized phase II/III trial studies docetaxel, antiandrogen therapy, and radiation therapy to see how well it works compared with antiandrogen therapy and radiation therapy alone in treating patients with prostate cancer that has been removed by surgery. Androgen can cause the growth of prostate cells. Antihormone therapy may lessen the amount of androgen made by the body. Radiation therapy uses high energy x-rays to kill tumour cells and shrink tumours. Drugs used in chemotherapy, such as docetaxel, work in different ways to stop the growth of tumour cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving antiandrogen therapy and radiation therapy with or without docetaxel after surgery may kill any remaining tumour cells.

Trial Description

Primary Outcome:

• Freedom from progression (FFP) (Phase II)
• Metastasis free survival (MFS) (Phase III)

Secondary Outcome:

• Overall survival
• Time to local progression
• Proportions of patients with Grade 3 through Grade 5 adverse events that are either related to study drug or not graded according to NCI CTCAE version 3.0
• Proportion of undetectable PSA with a non-castrate testosterone

PRIMARY OBJECTIVES:

• To assess the benefit of docetaxel as measured by improvement in freedom from progression (phase II) and subsequently metastasis free survival (phase III) when given in combination with radiation and androgen deprivation in treatment of high risk prostate cancer post-radical prostatectomy.

SECONDARY OBJECTIVES:

• To assess overall survival.
• To assess local time to progression.
• To assess undetectable prostate-specific antigen (PSA) with a non-castrate testosterone at 2.5 years post treatment.
• To assess the utility of genomic profiling in making adjuvant therapy decisions post-prostatectomy.
• To assess toxicity of docetaxel in the post-operative setting when combined with radiation and androgen deprivation therapy.
• To assess treatment response by genomically defined sub-groups of prostate cancer patients.

OUTLINE:
Patients are randomized to 1 of 2 arms.

ARM I: Patients receive androgen deprivation therapy comprising leuprolide acetate, goserelin acetate, bicalutamide, flutamide, or nilutamide for 6 months. Beginning 8 weeks after the start of androgen deprivation therapy, patients receive external beam radiation therapy (EBRT) for 7.5 weeks.

ARM II: Patients receive androgen deprivation therapy and EBRT as in Arm I. Within 4-6 weeks after completion of radiation therapy, patients receive docetaxel intravenously (IV) on day 1 of every 21 days for 6 courses in the absence of disease progression or unexpected toxicity. After completion of study treatment, patients are followed up every 3 months for 2 years, then every 6 months for 3 years, and then yearly.

View this trial on ClinicalTrials.gov