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A Randomized Comparison of Immediate Versus Deferred Androgen Deprivation Therapy Using Goserelin for Recurrent Prostate Cancer After Radical Radiotherapy.


Phase 3
18 Years
N/A
Open (Enrolling)
Male
Prostate Cancer

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Trial Information

A Randomized Comparison of Immediate Versus Deferred Androgen Deprivation Therapy Using Goserelin for Recurrent Prostate Cancer After Radical Radiotherapy.


Recurrent prostate cancer after radical radiation therapy is a common problem with often a
long interval from biochemical failure to the time of symptomatic relapse. Androgen
deprivation therapy (ADT) is the most commonly used intervention following radiation failure
and currently is often started immediately after the recognition of biochemical failure in
the absence of symptoms. ADT is associated with side effects that can impact on quality of
life. It is unclear whether ADT reduces prostate-specific mortality. There is currently
insufficient evidence on the timing of ADT with respect to prevention of prostate cancer
death and quality of life and cost particularly for men with fast and slow prostate specific
antigen (PSA) doubling times.

The general objective of the ELAAT trial is to determine the optimal timing of ADT in men
with recurrent prostate cancer after radical radiotherapy.

Consenting patients who have undergone prior radical radiotherapy for prostate cancer and
are now experiencing a recurrence will be screened for eligibility. If they are determined
to be eligible, patients will be stratified according to PSA doubling time, pre-radiation
Gleason Score, previous radical prostatectomy and clinical centre. After stratification,
patients will be randomized to immediate versus deferred ADT based on the 1:1 ratio between
the two arms.

Patients will be followed indefinitely and assessed formally at 6 month intervals after the
date or randomization. Patients will be assessed for recurrent disease (biochemical
failure), new primary cancer, complications of advanced malignancy, quality of life and
overall survival.


Inclusion Criteria:



1. Males over 18 years of age with histological confirmation of adenocarcinoma of the
prostate.

2. Biochemical progression after radical radiotherapy with a total prostate dose > 52
Gy.

- In patients without previous radical prostatectomy, biochemical progression is
defined as PSA in the range of nadir + 2 ng/mL (Phoenix definition) to ≤ 6 ng/mL
(this PSA must be within 30 days of randomization).

- In patients with previous radical prostatectomy, biochemical progression is
defined as a rising PSA (at least 2 values) in the range of 0.4 ng/mL to ≤ 3
ng/mL (most recent PSA must be within 30 days of randomization).

Exclusion Criteria:

1. Patients who are within 4 years of their brachytherapy implantation date.

2. Patients with medical conditions in which goserelin or bicalutamide is
contraindicated in the opinion of the supervising oncologist or urologist.

3. Patients with another active malignancy or malignancy treatment within 5 years (basal
or squamous cell skin cancers are not excluded from this trial).

4. Patients with geographic inaccessibility precluding them from necessary follow-up.

5. Failure to provide written informed consent.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Time to androgen independent disease (AID). AID is defined as the time from randomization to AID or last follow-up.

Outcome Time Frame:

Indefinitely

Safety Issue:

No

Principal Investigator

Andrew Loblaw, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Odette Cancer Centre - Sunnybrook Health Sciences Centre

Authority:

Canada: Health Canada

Study ID:

OCOG-P1

NCT ID:

NCT00439751

Start Date:

April 2007

Completion Date:

Related Keywords:

  • Prostate Cancer
  • Prostate Cancer
  • Androgen Deprivation Therapy
  • Recurrence
  • Biochemical Failure
  • Goserelin
  • Prostatic Neoplasms

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