A Study of Androgen Deprivation With Leuprolide, +/- Docetaxel for Clinically Asymptomatic Prostate Cancer Participants With a Rising Prostate Specific Antigen (PSA) (Rising PSA)

Sanofi

Status and phase: Terminated; Phase 3

Conditions: Prostatic Neoplasms

Treatments: Drug: Leuprolide; Drug: Docetaxel; Drug: Bicalutamide

Study type: Interventional

Funder types: Industry

Identifiers

NCT00514917

2007-000323-17 (EudraCT Number)

XRP6976J_3503

Details and patient eligibility

About

The primary objective was to evaluate and compare the efficacy of androgen deprivation with or without docetaxel as determined by the median progression free survival (PFS) over the period of 18-month therapy and at least 18-month follow-up.

The secondary objectives were:

• To assess cancer specific survival;
• To compare overall survival between the 2 treatment groups;
• To evaluate patient-reported outcomes including quality of life, fatigue, and sexual functioning as measured by 3 different assessments.

Full description

The duration of the study per participant was to be at least 36 months, of which the treatment period was 18 months for all participants, followed by at least 18 months follow-up period.

Participants received study treatment for up to 18 months from the time of study therapy initiation or less if one of the following occurred: disease progression, unacceptable toxicity, death, participant refusal or treatment delay beyond the time frame that is permitted for each treatment.

Enrollment: 413 patients

Sex: Male

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of prostate adenocarcinoma pathologically confirmed

• History of radical prostatectomy (pre-operative radiation therapy to the prostate or pelvis or salvage radiation after radical prostatectomy was allowed)

• Demonstration of biochemical progression of disease based on prostate specific antigen (PSA) doubling time. The minimum PSA value for eligibility was greater than or equal to (>=) 1. PSA doubling time over three values must be equal to (=) 9 months with a minimum of 3 weeks between assessments

• Serum testosterone >=100 nanogram per deciliter (ng/dL)

• Karnofsky performance status (KPS) >=70 percent (%)

• Adequate organ function as defined by the following laboratory criteria:

  • White blood cells >=3500 per cubic millimeter (mm^3)
  • Absolute neutrophil count (ANC) >=1500 per mm^3
  • Platelet count >=100,000 per mm^3
  • Hemoglobin >= 10.0 gram per deciliter (g/dL)
  • Total Bilirubin less than or equal to (<=) upper limit of normal (ULN) unless due to Gilbert's disease
  • Creatinine l <= 1.5 milligram per deciliter (mg/dL) or creatinine clearance >=60 cubic centimeters per minute
  • Aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase within pre-defined ranges

• Previous hormonal therapy was allowed provided that the total duration of therapy did not exceed 6 months

• Man of childbearing potential who was willing to consent to use effective contraception while on treatment and for at least 3 months thereafter

• Participant who was willing and was able to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures

Exclusion criteria

• Clinically significant cardiac disease (New York Heart Association Class III/IV), or severe debilitating pulmonary disease
• Uncontrolled serious active infection
• Anticipated duration of life < 2 years
• Less than 5-year history of successful treatment for other cancers or concurrent active nonprostate cancer other than nonmelanoma dermatologic tumor
• Peripheral neuropathy >=Grade 2
• History of hypersensitivity reaction to Docetaxel or other drugs formulated with polysorbate 80, leuprolide, or bicalutamide
• Prior chemotherapy within the past 10 years (except non-taxane based chemotherapy for treatment of other cancers); concurrent treatment on another clinical trial or with any other cancer therapy including chemotherapy, immunotherapy, radiotherapy (except salvage radiation therapy), chemoembolization therapy, cryotherapy
• Other severe acute or chronic medical conditions including psychiatric disease, or significant laboratory abnormality requiring further investigation that may cause undue risk for the participant's safety, delay or prohibit protocol participation, or interfere with the interpretation of study results, and in the judgment of the investigator would make the participant inappropriate for entry into this study
• Radiographic findings suspicious for metastatic disease in the treating physician's clinical judgment. Participant who had radiographically suspicious pelvic lymph nodes prior to radial prostatectomy, but who, at the time of enrollment did not have suspicious adenopathy was eligible. Participant was eligible even if he/she had tumor-containing pelvic adenopathy at the time of surgery as long as at the time of enrollment there was no radiographically evident nodal disease in the clinician's opinion
• Participant was the investigator or any sub-investigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol
• Participant unlikely to comply with protocol or research tests, for example, uncooperative attitude, inability to return for follow-up visits, and unlikelihood of completing the study
• Participant who participated in another clinical study/received investigational product within 30 days of screening

The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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413 participants in 2 patient groups

Docetaxel+Leuprolide+Bicalutamide

Experimental group

Description:

Participants received docetaxel 75 milligram per square meter (mg/m\^2) intravenous infusion over 1 hour every 3 weeks up to 10 cycles (3 week cycle) along with leuprolide 22.5 mg injection subcutaneously every 12 weeks up to 18 months and bicalutamide 50 mg tablet orally once daily for first 4 weeks of treatment.

Treatment:

Drug: Bicalutamide

Drug: Leuprolide

Drug: Docetaxel

Leuprolide+Bicalutamide

Active Comparator group

Description:

Participants received leuprolide 22.5 mg injection subcutaneously every 12 weeks up to 18 months and bicalutamide 50 mg tablet orally once daily for first 4 weeks of treatment.

Treatment:

Drug: Bicalutamide

Drug: Leuprolide