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Hormone Therapy in Treating Patients With Prostate Cancer

A Phase II Trial of Potency-Sparing Hormonal Therapy in Patients With Elevated Serum PSA After Radiation Therapy or Radical Prostatectomy for Prostate Cancer

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00003323
Enrollment
101
Registered
2003-08-13
Start date
1998-05-31
Completion date
2010-03-31
Last updated
2016-07-04

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Prostate Cancer, Sexual Dysfunction and Infertility

Keywords

adenocarcinoma of the prostate, recurrent prostate cancer, sexual dysfunction and infertility

Brief summary

RATIONALE: Male hormones can stimulate the growth of prostate cancer cells. Hormone therapy using flutamide and finasteride may fight prostate cancer by reducing the production of male hormones. PURPOSE: Phase II trial to study the effectiveness of flutamide and finasteride in treating prostate cancer patients with high PSA levels who were previously treated with radiation therapy or radical prostatectomy.

Detailed description

OBJECTIVES: * Determine the efficacy of finasteride and flutamide in suppressing prostate specific antigen (PSA) levels in patients with elevated PSA after definitive radiation therapy or radical prostatectomy for prostate cancer. * Assess sexual function and other quality of life issues during this therapy. * Estimate the response to flutamide withdrawal in this group of patients who have not had a major reduction in circulating testosterone levels. * Measure the response rate to further hormonal manipulation with combined androgen blockade after the failure of this therapy. * Obtain data that may predict more aggressive disease. OUTLINE: This is a multicenter study. Patients receive finasteride and flutamide by mouth three times a day. Patients experiencing recurrence or a greater than 4 nu/mL (above 50%) increase in PSA level will discontinue flutamide treatments. Otherwise, patients continue therapy in the absence of unacceptable toxicity or disease progression. Quality of life is assessed prior to therapy and at 3 and 6 months. Patients are followed every 3 months for one year and every 6 months thereafter. PROJECTED ACCRUAL: This study will accrue 100 patients over 2 years.

Interventions

DRUGfinasteride

5 mg/d PO

DRUGflutamide

250 mg PO tid

OTHERquality-of-life assessment

Assessment survey administered at baseline, and 3 & 6 months post initiation of treatment

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Alliance for Clinical Trials in Oncology
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
MALE
Healthy volunteers
No

Inclusion criteria

1. Histologic Documentation: Previous histologic evidence of adenocarcinoma of the prostate. 2. Prior Treatment: 2.1 Definitive Local Therapy: Patients must have had a previous attempt at definitive therapy, which is defined as a previous radical prostatectomy or radiation therapy with at least 5500 cGy to the prostate. 1. Patients may have had both radiation therapy to the prostate and surgical resection, given as definitive therapy, provided they began the radiation therapy within 3 months of their prostatectomy. Also, brachytherapy alone and combinations of brachytherapy and external beam radiation therapy are also allowed, if given as a single therapy, and not given for a rising PSA after the previous therapy. 2. The previous treatment must have occurred at least 6 months, but no more than 10 years, prior to registration. 2.2 Previous Hormonal Therapy or Other Treatments: Patients may have had no more than 6 months of hormonal therapy with their other treatment, and must have been off all hormones used for the treatment of prostate cancer including Megace for at least 12 months. 1. No therapy within 2 years with finasteride or other 5 alpha-reductase inhibitors. 2. No previous chemotherapy for this malignancy. 3. No orchiectomy. 4. No corticosteroids in excess of standard replacement doses for adrenal failure. 3. Elevated PSA Criteria: 3.1 Patients must a PSA level between 1 ng/ml and 10 ng/ml, with a rise of at least 1 ng/ml above the nadir produced by definitive therapy. The PSA level must be repeated at least once, one month later to confirm the rise of 1 ng/ml above nadir. 3.2 After the second PSA has been drawn to confirm the rise, one additional PSA should be drawn as close to the start of therapy as possible. Therefore, a total of three PSAs must be drawn prior to the start of therapy. Only the last two need to be drawn at the same lab (ie, the second confirmatory PSA and the PSA drawn just prior to the start of the trial). The nadir PSA and the initial PSA suggesting a rise can be drawn at outside laboratories. The combination of the nadir PSA and the two PSAs showing a rise of 1.0 ng/ml are used for determining eligibility. The two elevated PSAs must be at least one month apart. 4. No clear evidence of local recurrence on the digital rectal exam. 5. No metastatic disease on the CT or bone scan. 6. Performance status 0-2 7. Required initial laboratory data 1. SGOT and/or SGPT ≤2 x upper limits of normal 2. Creatinine ≤2 x upper limits of normal 3. Bilirubin ≤2 x upper limits of normal

Design outcomes

Primary

MeasureTime frame
PSA levels1 year post treatment

Secondary

MeasureTime frame
QOL issues associated with treatment protocol3 & 6 months

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026