Prostatic Neoplasms Clinical Trial
Official title:
Intermittent Hormonal Therapy With Leuprorelin (3.75 mg SR) and Flutamide in the Treatment of Stage D2 or Tx Nx M1 ≠ M1a Metastatic Cancer of the Prostate
This study is aimed at evaluating the effects of intermittent hormonal treatment with complete androgen suppression (Leuprorelin 3.75 milligram [mg] sustained release [SR] and Flutamide) in patients presenting with stage D2 or Tx Nx M1 ≠ M1a metastatic prostrate cancer, with a prostate specific antigen (PSA) level 5-fold higher than normal (PSA greater than or equal to [≥] 20 nanogram per milliliter [ng/mL], as quantitated by the Hybritech radioimmunoassay) and with a subsequent decline to normal (PSA less than [<] 4 ng/mL) during the initial 6 months of induction treatment. The results will be compared with those obtained after continuous hormonal therapy with complete androgen suppression.
This is an open, comparative, randomized (1:1), multicenter, European (France, Germany,
Czech Republic, Slovakia and Bulgaria), Phase 2B study on parallel groups of patients
presenting with metastatic prostate cancer (stage D2 or Tx Nx M1 ≠ M1a), with a PSA level ≥
5-fold higher than normal (that is PSA ≥ 20 ng/mL, as quantitated by the Hybritech
radioimmunoassay) which return to normal within 6 months after the initiation of total
androgen blockade therapy with leuprorelin 3.75 mg SR and flutamide. It will involve 314
preselected patients.
A minimum of 180 eligible patients are required for this study. Selected patients will be
randomized centrally in two parallel groups at study entry. This phase 2B study will enable
evaluation of a high number of patients by direct comparison with conventional
administration. The study comprises of two therapeutic phases:
- A 6 month induction phase with complete androgen suppression by leuprorelin 3.75 mg SR
and flutamide. This phase involves patients meeting the preselection criteria.
- A data processing run per complete androgen suppression according to two methods,
continuous or intermittent, for the patients satisfying the criteria of selection of
the study and which will thus be randomized.
The selected patients will be randomized in two parallel groups at the time of inclusion:
- Group A patients will receive a continuous complete androgen suppression therapy by
leuprorelin 3.75mg SR and flutamide, until the appearance of signs of disease
progression or study end.
- Group B patients will receive an intermittent complete androgen suppression therapy by
leuprorelin 3.75 mg SR and flutamide, until the study end or the appearance of signs of
disease progression under treatment.
Group A patients will be routinely followed-up on a 3-month basis until there are signs of
disease progression. Group B patients (intermittent therapy) will be monitored every 3
months during on-treatment periods under the same conditions as described for group A.
The 3-month clinical follow-up will be same during off-treatment periods, but if PSA
increases to ≥10 ng/mL the patient must be contacted to schedule a prompt special visit in
order to reinstitute hormonal therapy. Subsequent visits will be scheduled on a 3-month
basis from the time of the special visit. Special visits will be the same as routine
consultations, except that the laboratory tests will not be redone.
When on-therapy tumor progression will be documented, every 6 months the investigators will
note all treatments administered to patients until death (while specifying the cause of
death).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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