Prostate Cancer Clinical Trial
Official title:
Randomized Placebo-Controlled Trial of Mitoxantrone/Prednisone and Clodronate Versus Mitoxantrone/Prednisone Alone in Patients With Hormone Refractory Metastatic Prostate Cancer and Pain
RATIONALE: Some drugs used in chemotherapy can reduce the pain experienced by some people
with cancer. Combining more than one drug may be more effective at reducing cancer pain. It
is not known whether receiving combination chemotherapy with clodronate is more effective
than receiving combination chemotherapy without clodronate for hormone refractory metastatic
prostate cancer.
PURPOSE: Randomized double-blinded phase III trial to compare the effectiveness of
combination chemotherapy using mitoxantrone plus prednisone with or without clodronate in
treating pain in patients with hormone refractory metastatic prostate cancer.
OBJECTIVES: I. Compare the effect of mitoxantrone and prednisone with or without clodronate
on localized bone pain in patients with hormone refractory metastatic prostate cancer. II.
Compare the overall survival and quality of life of these patients after these treatments.
OUTLINE: This is a randomized, double blinded, placebo controlled, multicenter study.
Patients are stratified according to quality of pain (mild vs moderate) and previous
corticosteroids or one regimen of non-anthracycline-containing cytotoxic chemotherapy (e.g.,
estramustine) vs none. Patients are assigned to 1 of 2 treatment arms. Arm I consists of oral
prednisone twice a day and intravenous mitoxantrone followed by intravenous clodronate
administered over 3 hours every 3 weeks. Arm II consists of oral prednisone twice a day and
intravenous mitoxantrone followed by intravenous placebo administered over 3 hours every 3
weeks. Doses are adjusted for myelosuppression. Treatment continues until disease progression
(although patients initially on placebo can continue on open-label clodronate) or until the
maximum cumulative dose of mitoxantrone is reached. Patients with a palliative response may
continue on prednisone and the study drug (clodronate or placebo) until disease progression.
Quality of life is assessed before and every 3 weeks during study treatment. A daily pain
diary is also maintained. All patients are followed at 2 weeks and then every 3 months until
death.
PROJECTED ACCRUAL: This study will accrue 204 patients.
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