A Phase 3 interventional study of bicalutamide and goserelin acetate in Prostate Cancer, sponsored by SWOG Cancer Research Network. Completed at 14 sites in Canada. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2017-04-17.
Sponsored by SWOG Cancer Research Network · Phase 3, Interventional, and Treatment
RATIONALE: Testosterone can stimulate the growth of prostate cancer cells. Hormone therapy may be effective treatment for prostate cancer. It is not yet known which regimen of hormone therapy is most effective for stage IV prostate cancer.
PURPOSE: This randomized phase III trial is studying two different regimens of hormone therapy and comparing how well they work in treating men with stage IV prostate cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to SWOG performance status (0-1 vs 2), severity of disease (minimal vs extensive), and prior hormonal therapy (neoadjuvant hormonal therapy vs finasteride vs neither).
Consolidation therapy: Patients are randomized to 1 of 2 consolidation regimens.
Quality of life is assessed before induction therapy, at 3 months (before consolidation therapy), and then at 9 and 15 months.
Patients are followed every 6-12 months for at least 10 years.
PROJECTED ACCRUAL: Approximately 1,500 patients will be accrued for this study.
6,484 studies on the registry are indexed under Prostatic Neoplasms; 1,415 are open to participants now.
This study's enrollment of 3,040 is above the median of 58 across 4,908 interventional studies indexed under Prostatic Neoplasms.
Browse Prostatic Neoplasms studies →SWOG Cancer Research Network is the lead sponsor of 339 studies on the registry; 37 are open to participants now.
Of its 17 completed or terminated interventional studies of FDA-regulated products, 17 (100%) have results posted.
Counted across the registry records on this site, refreshed daily.
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed adenocarcinoma of the prostate
Metastatic stage IV (stage D2)
For entry into late induction therapy:
PATIENT CHARACTERISTICS:
Age:
Performance status:
Hematopoietic:
Hepatic:
Renal:
Other:
No other malignancy within the past 5 years except:
PRIOR CONCURRENT THERAPY:
Biologic therapy:
Chemotherapy:
Endocrine therapy:
More than 1 year since any prior neoadjuvant or adjuvant hormonal therapy for a duration of no more than 4 months
Radiotherapy:
Surgery:
Patients continue CAD therapy comprising goserelin subcutaneously once a month and oral bicalutamide once daily. Treatment continues in the absence of disease progression.
Drug: bicalutamide · Drug: goserelin acetate
Patients undergo observation in the absence of rising prostate-specific antigen (PSA) or clinical symptoms of progressive disease. Patients with rising PSA or progressive disease begin CAD therapy as in consolidation arm I. Patients whose PSA normalizes after 8 courses return to observation. Patients whose PSA does not normalize after 8 courses continue CAD therapy.
Drug: bicalutamide · Drug: goserelin acetate · Other: clinical observation
Given orally
Given subcutaneously
Patients undergo observation in the absence of rising prostate-specific antigen (PSA) or clinical symptoms of progressive disease.
Overall Survival
Non-inferiority test to determine if intermittent combined androgen deprivation (CAD) overall survival is not substantially worse than continuous CAD overall survival. Specifically, the trial is designed for a one-sided test of the hypothesis that the hazard ratio of intermittent CAD to continuous CAD is 1.2. The assumptions used to compute the trial size are an overall type I error rate of 0.05 and a type II error of 0.10 (power = 0.9).
Time frame: Up to 15 years
Physical Functioning as Measured by the SF-36
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. Change from Baseline in SF-36 Score at 3 Months
Time frame: 3 months
Emotional Functioning as Measured by the SF-36 Mental Health Inventory
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. Change from Baseline in SF-36 Score at 3 Months
Time frame: 3 months
Erectile Dysfunction
This outcome was assessed by having patients report whether they had erectile dysfunction (a score of 1) or no erectile dysfunction (a score of 0). This analysis looks at change from Baseline to 3 Months.
Time frame: 3 months
High Libido
This outcome was assessed by having patients report whether their interest in sexual activities was very high, high, or moderate (a score of 1) or low or very low (a score of 0). This outcome measure is reporting a change from baseline in the percentage of participants with High Libido at 3 months. "High Libido" is defined as very high, high or moderate interest in sexual activities.
Time frame: 3 months
Vitality
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. This analysis looks at mean change from Baseline score to 3 Months.
Time frame: 3 months
Global Perception of Quality of Life
Time frame: 15 months
Social Functioning
Mean of the change in social functioning from randomization
Time frame: 15 months
Role Functioning
Mean of the change in role functioning from randomization
Time frame: 15 months
General Symptoms
Time frame: 15 months
| Milestone | Combined Androgen Deprivation (CAD) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|---|
| Started | 3040 | 0 | 0 |
| Eligible | 2950 | 0 | 0 |
| Eligible and began protocol therapy | 2950 | 0 | 0 |
| Completed | 1697 | 0 | 0 |
| Not completed | 1343 | 0 | 0 |
| Withdrew: Adverse event | 44 | 0 | 0 |
| Withdrew: Refusal unrelated to adverse event | 50 | 0 | 0 |
| Withdrew: Progression/relapse | 274 | 0 | 0 |
| Withdrew: Death | 62 | 0 | 0 |
| Withdrew: Other | 823 | 0 | 0 |
| Withdrew: Not eligible | 90 | 0 | 0 |
| Milestone | Combined Androgen Deprivation (CAD) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|---|
| Started | 0 | 867 | 882 |
| Eligible | 0 | 765 | 770 |
| Assessable for toxicity | 0 | 732 | 702 |
| Completed | 0 | 29 | 22 |
| Not completed | 0 | 838 | 860 |
| Withdrew: Adverse event | 0 | 36 | 14 |
| Withdrew: Refusal unrelated to adverse event | 0 | 53 | 75 |
| Withdrew: Progression/relapse | 0 | 295 | 298 |
| Withdrew: Death | 0 | 38 | 48 |
| Withdrew: Other | 0 | 314 | 313 |
| Withdrew: Not eligible | 0 | 102 | 112 |
Non-inferiority test to determine if intermittent combined androgen deprivation (CAD) overall survival is not substantially worse than continuous CAD overall survival. Specifically, the trial is designed for a one-sided test of the hypothesis that the hazard ratio of intermittent CAD to continuous CAD is 1.2. The assumptions used to compute the trial size are an overall type I error rate of 0.05 and a type II error of 0.10 (power = 0.9).
| years | Consolidation Arm I | Consolidation Arm II |
|---|---|---|
| Overall Survival | 5.8 (5.3 to 6.4) | 5.1 (4.8 to 5.5) |
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. Change from Baseline in SF-36 Score at 3 Months
| units on a scale | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Physical Functioning as Measured by the SF-36 | -1.74 ± 0.7366 | 0.09 ± 0.8084 |
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. Change from Baseline in SF-36 Score at 3 Months
| units on a scale | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Emotional Functioning as Measured by the SF-36 Mental Health Inventory | -0.95 ± 0.6804 | 1.92 ± 0.7241 |
This outcome was assessed by having patients report whether they had erectile dysfunction (a score of 1) or no erectile dysfunction (a score of 0). This analysis looks at change from Baseline to 3 Months.
| percentage of participants | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Erectile Dysfunction | 2 | -7 |
This outcome was assessed by having patients report whether their interest in sexual activities was very high, high, or moderate (a score of 1) or low or very low (a score of 0). This outcome measure is reporting a change from baseline in the percentage of participants with High Libido at 3 months. "High Libido" is defined as very high, high or moderate interest in sexual activities.
| percentage of participants | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| High Libido | -2 | 16 |
This outcome was scored on a scale of 0 to 100, with higher scores indicating better functioning. This analysis looks at mean change from Baseline score to 3 Months.
| units on a scale | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Vitality | -1.42 ± 0.7379 | -0.11 ± 0.8154 |
Results for this outcome have not been posted.
Mean of the change in social functioning from randomization
Results for this outcome have not been posted.
Mean of the change in role functioning from randomization
Results for this outcome have not been posted.
Results for this outcome have not been posted.
Collected over Up to 10 years after registration to Induction. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Continuous Hormonal Therapy | — | 19/732 (2.6%) | 665/732 (90.8%) |
| Intermittent Hormonal Therapy | — | 10/702 (1.4%) | 609/702 (86.8%) |
| Event | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Cardiac ischemia/infarctionCardiac disorders | 6/732 | 2/702 |
| Flu-like symptoms-otherGeneral disorders | 5/732 | 3/702 |
| Lung-otherRespiratory, thoracic and mediastinal disorders | 0/732 | 2/702 |
| Cardiovascular-otherCardiac disorders | 2/732 | 1/702 |
| LVEF decrease/CHFCardiac disorders | 1/732 | 1/702 |
| Cerebrovascular ischemiaNervous system disorders | 1/732 | 1/702 |
| Second primaryNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/732 | 0/702 |
| Pleural effusionsRespiratory, thoracic and mediastinal disorders | 1/732 | 0/702 |
| Hemorrhage-otherVascular disorders | 1/732 | 0/702 |
| Thrombosis/embolismVascular disorders | 1/732 | 0/702 |
| Event | Continuous Hormonal Therapy | Intermittent Hormonal Therapy |
|---|---|---|
| Hot flashesVascular disorders | 511/732 | 440/702 |
| Fatigue/malaise/lethargyGeneral disorders | 381/732 | 364/702 |
| Erectile impotenceReproductive system and breast disorders | 304/732 | 256/702 |
| Bone painMusculoskeletal and connective tissue disorders | 239/732 | 272/702 |
| Libido lossPsychiatric disorders | 262/732 | 226/702 |
| SweatingSkin and subcutaneous tissue disorders | 245/732 | 176/702 |
| GynecomastiaReproductive system and breast disorders | 181/732 | 158/702 |
| Urinary frequency/urgencyRenal and urinary disorders | 141/732 | 147/702 |
| InsomniaPsychiatric disorders | 141/732 | 123/702 |
| Pain-otherGeneral disorders | 140/732 | 131/702 |
Randomized and eligible patients (After induction, Patients with stable or declining PSA levels of 4.0 ng per milliliter or lower at months 6 and 7 were eligible for randomization).
| Age, Continuous(years) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy | Total |
|---|---|---|---|
| Median | 70 (39 to 92) | 70 (39 to 97) | 70 (39 to 97) |
| Sex: Female, Male(Participants) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy | Total |
|---|---|---|---|
| Female | 0 | 0 | 0 |
| Male | 765 | 770 | 1535 |
| Ethnicity (NIH/OMB)(Participants) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy | Total |
|---|---|---|---|
| Hispanic or Latino | 17 | 23 | 40 |
| Not Hispanic or Latino | 571 | 564 | 1135 |
| Unknown or Not Reported | 177 | 183 | 360 |
| Race (NIH/OMB)(Participants) | Continuous Hormonal Therapy | Intermittent Hormonal Therapy | Total |
|---|---|---|---|
| American Indian or Alaska Native | 2 | 4 | 6 |
| Asian | 5 | 8 | 13 |
| Native Hawaiian or Other Pacific Islander | 2 | 0 | 2 |
| Black or African American | 93 | 94 | 187 |
| White | 507 | 519 | 1026 |
| More than one race | 2 | 1 | 3 |
| Unknown or Not Reported | 154 | 144 | 298 |
The record gives a start of May 1995, a primary completion of Jun 2013 and a completion of Jun 2013. It does not say whether these dates are actual or estimated.
Results were first posted in Apr 2017, 3 years 10 months after primary completion.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Mar 2017. You cannot join it, but the record below documents what was studied.
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