Hormone Therapy Compared With Combination Chemotherapy in Treating Patients With Prostate Cancer
RATIONALE: Androgens can stimulate the growth of prostate cancer cells. Drugs such as ketoconazole may stop the production of androgens. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether hormone therapy is more effective than combination chemotherapy in treating prostate cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of hormone therapy with that of combination chemotherapy in treating patients who have prostate cancer that has been previously treated with androgen suppression.
|Prostate Cancer||Drug: docetaxel Drug: estramustine phosphate sodium Drug: ketoconazole Drug: therapeutic hydrocortisone||Phase 3|
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||A Phase III Randomized Trial for Evaluating Second Line Hormonal Therapy (Ketoconazole/Hydrocortisone) Versus Paclitaxel/Estramustine Combination Chemotherapy on Progression Free Survival in Asymptomatic Patients With a Rising PSA After Hormonal Therapy for Prostate Cancer|
|Study Start Date:||May 2003|
|Primary Completion Date:||December 2004 (Final data collection date for primary outcome measure)|
- Compare time to objective progression in patients with prostate cancer and a rising prostate-specific antigen (PSA) after androgen suppression when treated with second-line hormonal therapy (ketoconazole and hydrocortisone) vs combination chemotherapy (docetaxel and estramustine).
- Compare time to PSA progression and correlate this with time to objective progression in patients treated with these regimens.
- Compare the quality of life in patients treated with these regimens.
- Compare overall survival of patients treated with these regimens.
- Compare the natural history of progression in patients treated with these regimens.
- Identify prognostic indicators of clinical outcome by immunohistochemical evaluation of apoptopic biomarkers in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior treatment with bisphosphonates (yes vs no). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral ketoconazole three times daily and oral hydrocortisone twice daily. Treatment continues in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive oral estramustine three times daily on days 1-5 and docetaxel IV over 1 hour on day 2. Treatment repeats every 3 weeks for up to 6 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed at baseline, on day 1 of week 9, at 6 months and 1 year, and then annually for up to 10 years or until beginning of first non-protocol therapy.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years.
PROJECTED ACCRUAL: A total of 590 patients (295 per treatment arm) will be accrued for this study within 4 years.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00027859
Show 98 Study Locations
|Study Chair:||Michael A. Carducci, MD||Sidney Kimmel Comprehensive Cancer Center|
|Study Chair:||Nirmala Bhoopalam, MD||Veterans Affairs Medical Center - Hines|
|Study Chair:||Gregory P. Swanson, MD||Deaconess Medical Center, Spokane, Washington|
|Study Chair:||William Dahut, MD||National Cancer Institute (NCI)|