Androgen-Deprivation + Radiation Therapy for Prostate Cancer

Not currently recruiting at 549 trial locations
Age: 18+
Sex: Male
Trial Phase: Phase 3
Sponsor: Radiation Therapy Oncology Group
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if combining androgen-deprivation therapy (a treatment to reduce male hormones) with radiation therapy effectively treats prostate cancer. Androgens, or male hormones, can promote the growth of prostate cancer cells. The trial will test whether reducing these hormones and using radiation together is more effective than radiation alone. Participants will receive either whole-pelvic radiation or high-dose radiation, possibly with brachytherapy (a type of internal radiation). Men with prostate cancer at moderate to high risk of recurrence, who have not yet undergone surgery or hormone treatments, may be suitable for this study. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants the opportunity to contribute to potentially groundbreaking treatment advancements.

Will I have to stop taking my current medications?

The trial requires that you stop taking certain medications like finasteride 30 days before joining and dutasteride 90 days before joining. If you are on hormonal therapy or certain other prostate cancer treatments, you may need to stop those as well. It's best to discuss your current medications with the trial team to see if any changes are needed.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that androgen-deprivation therapy (ADT) is generally well-tolerated by most patients. However, about 43% of prostate cancer patients on ADT experience significant sexual problems, compared to 20% of those not on ADT. Interestingly, patients over 75 years old seem to handle ADT better than younger patients.

Radiation therapy, such as intensity-modulated radiotherapy (IMRT), provides a safe and effective way to treat prostate cancer. This treatment uses precise energy beams to target cancer cells. Some patients might experience urinary or bowel issues, but these are usually manageable, and severe side effects are uncommon.

Overall, both treatments have been widely used and studied for their safety in treating prostate cancer. Patients should discuss any concerns with their healthcare team to understand how these treatments might affect them personally.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of androgen-deprivation therapy and radiation therapy for prostate cancer because it offers a potentially more comprehensive approach than standard treatments. Unlike traditional methods that often focus on either hormone therapy or radiation alone, this approach combines both, targeting the cancer on multiple fronts. The use of whole-pelvic radiotherapy and the option for brachytherapy in one arm allows for a more tailored and potentially more effective treatment, addressing both localized and more widespread cancer areas. This dual approach aims to increase the chances of controlling the cancer while minimizing side effects, which could lead to improved outcomes for patients.

What evidence suggests that androgen-deprivation therapy and radiation therapy could be effective for prostate cancer?

This trial will compare different radiation therapy approaches combined with hormone therapy for prostate cancer. Research has shown that combining hormone therapy, or androgen-deprivation therapy (ADT), with radiation effectively treats prostate cancer. Studies have found that treating the whole pelvic area with radiation, as in one arm of this trial, can improve survival rates, with 86.3% of patients surviving prostate cancer after 10 years. Another arm of this trial involves high-dose radiation treatments, such as brachytherapy, which also show strong results, with an 85% success rate in controlling the cancer. Both treatments aim to stop cancer growth and destroy cancer cells, offering promising outcomes for patients.678910

Who Is on the Research Team?

MR

Mack Roach, MD

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

Men with moderate to high-risk prostate cancer, confirmed by biopsy within the last 180 days. They should have a PSA level under 50 ng/mL and no bone metastases. Men previously on active surveillance for low risk prostate cancer who now have higher risk disease may also join if re-biopsied within 180 days. No prior pelvic radiation or radical prostate surgery is allowed, and they must be willing to use contraception.

Inclusion Criteria

I was diagnosed with prostate cancer at moderate to high risk of coming back within the last 6 months.
ANC ≥ 1,500/mm³
Baseline serum PSA value performed within 120 days prior to registration
See 9 more

Exclusion Criteria

I am not willing or able to use birth control.
I have had radiation to my pelvis, seed implants in my prostate, or both testicles removed.
I have had a condition where my lymphocytes grow abnormally.
See 18 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Neoadjuvant Androgen-Deprivation Therapy

Participants receive neoadjuvant androgen-deprivation therapy comprising bicalutamide or flutamide and LHRH agonist/antagonist therapy for 6 months

6 months

Radiotherapy

Participants undergo radiotherapy, either high-dose radiotherapy of the prostate and seminal vesicles or whole-pelvic radiotherapy, for approximately 9 weeks

9 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 year with decreasing frequency

What Are the Treatments Tested in This Trial?

Interventions

  • Androgen-Deprivation Therapy
  • Radiation Therapy
Trial Overview This phase III trial is testing whether combining androgen-deprivation therapy (which lowers male hormones) with whole-pelvic radiotherapy (a type of radiation that targets the entire pelvic area) is effective in treating patients with prostate cancer compared to other treatments.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm IIExperimental Treatment1 Intervention
Group II: Arm IActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Radiation Therapy Oncology Group

Lead Sponsor

Trials
191
Recruited
64,900+

NRG Oncology

Collaborator

Trials
242
Recruited
105,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

Androgen deprivation therapy, often used alongside radiotherapy for localized and advanced prostate cancer, can lead to various side effects affecting multiple body systems, including metabolism, muscles, heart health, brain function, and sexual health.
This review emphasizes the importance of monitoring and managing the toxic effects of androgen deprivation therapy to enhance patient care and reduce these adverse effects.
Androgen deprivation therapy toxicity and management for men receiving radiation therapy.Johnson, ME., Buyyounouski, MK.[2021]
Androgen deprivation therapy (ADT) is a key treatment for prostate cancer, enhancing the effectiveness of local therapies like radiation and providing significant relief for metastatic cases.
While ADT is effective, it can lead to adverse effects such as hot flashes, decreased bone density, metabolic changes, and gynecomastia, which require careful management and ongoing research to address.
Management of the side effects of androgen deprivation therapy in men with prostate cancer.Flaig, TW., Glodé, LM.[2019]
Androgen deprivation therapy (ADT) is commonly used alongside radiotherapy to treat prostate cancer, and understanding the biology of the androgen axis can enhance the effectiveness of these combined treatments.
Recent approvals of new drugs necessitate further pre-clinical and clinical studies to explore their potential benefits when used in conjunction with radiation therapy.
The androgen receptor for the radiation oncologist.Quero, L., Rozet, F., Beuzeboc, P., et al.[2015]

Citations

Long-Term Outcomes After High-Dose-Rate Brachytherapy ...These outcomes included lower biochemical recurrence-free survival at 5 and 8 years, lower OS, and lower prostate CSS compared to patients with ...
High-dose-rate brachytherapy boost for prostate cancer: A ...This study reports BPFS of 85.7%, local relapse-free survival of 97%, distant MFS of 97.6% and OS of 77.6%20.
Study confirms safety and efficacy of higher-dose-per-day ...Patients who received higher dose-escalated MHFRT did not improve cancer control when compared to those receiving standard doses, with five-year ...
Prostate high dose-rate brachytherapy as monotherapy for ...We report on the efficacy of a randomized Phase II trial comparing HDR monotherapy delivered as 27 Gy in 2 fractions vs. 19 Gy in 1 fraction with a median ...
ASTRO 2024: A Randomized Comparison of Low Dose ...HDR and LDR boost both appear to be highly effective for the treatment of unfavorable risk prostate cancer, with 85% biochemical cure (i.e., ...
a systematic review and network meta-analysis - PMCThis systematic review and network meta-analysis aimed to assess the comparative effectiveness and safety profiles of current combination ...
Adverse health outcomes for prostate cancer patients ...Overall, 43% (PCa patients) and 20% (controls) reported major sexual problems. In patients aged < 75 years, longer than short ADT duration ...
Clinical outcomes and safety of enzalutamide (ENZA) plus ...This post hoc analysis of ARCHES data demonstrated that ENZA + ADT provides clinical benefit and is generally well-tolerated in patients with mHSPC aged ≥75 ...
A 3-year Interim Analysis of the Observational J-ROCK StudyFirst interim results demonstrated that ADT plus docetaxel or ADT plus ARSIs improved clinical response compared with ADT alone or CAB at 18 mo after study ...
Comparison of Short-Term Outcomes and Safety Profiles ...This study aimed to compare the short-term outcomes and safety profiles of androgen-deprivation therapy (ADT)+abiraterone/prednisone with ...
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