Feasibility Trial in Men With Hormone Sensitive Oligometastatic Prostate Cancer (PRORAD)

November 26, 2020 updated by: Dr. Patrick Cheung

Randomized Feasibility Trial of Prostate Radiotherapy vs Prostatectomy in Men With Hormone Sensitive Oligometastatic Prostate Cancer

Patients with hormone sensitive oligometastatic prostate cancer (≤ 5 metastatic tumours outside of regional pelvic nodes with no more than 3 in any organ system) and no previous treatment to prostate will be treated with intermittent androgen deprivation therapy +/- chemotherapy, stereotactic radiotherapy to all metastases, and either radical prostatectomy or radiotherapy.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

Investigators propose to do a randomized feasibility trial comparing RP vs RT to the prostate in the setting of hormone sensitive oligometastatic prostate cancer. SBRT will be used to treat all of the metastases, and this will be combined with an intermittent ADT approach. Adding systemic chemotherapy will be allowed. Given the past difficulties of randomizing patients between RP and RT in localized prostate cancer studies (like SPIRIT), investigators feel a small feasibility project is the first step. In the setting of metastatic disease, where radical treatment is not routine standard of care, we hope that patients will be more inclined to accept randomization. If patients do not accept their assigned randomization (ie they prefer RP even though they are randomized to RT, or vice versa), they will still be treated with their prostate intervention of choice and followed for their outcomes.

Study Type

Interventional

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Ontario
      • Toronto, Ontario, Canada, M4N3M5
        • Sunnybrook Health Sciences Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  • Able to provide informed consent.
  • Histologic confirmation of prostate adenocarcinoma.
  • Stage IV disease with ≤ 5 metastases outside of the pelvis.
  • ≤ 3 metastases in any one organ system.
  • ECOG performance 0-1.
  • All metastatic tumours amenable to SBRT.
  • Patient eligible for either RP or RT to the prostate.

Exclusion Criteria:

  • Castration resistant prostate cancer.
  • Previous RP or RT to prostate.
  • Inability to treat all metastases with SBRT.
  • Prior malignancy within the past 5 years, excluding non-melanoma skin cancer, in-situ cancer, superficial bladder cancer, chronic lymphocytic leukemia or low grade lymphoma which is being observed.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm 1
Radical prostatectomy
Radical prostatectomy
Active Comparator: Arm 2
Radiotherapy
Patients will receive HDR unless judged to medically unfit to undergo HDR brachytherapy, in which case they will receive SBRT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patients willing to accept their randomization
Time Frame: 2 years
Patients willing to accept their randomization will be measured as a proportion.
2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Toxicity
Time Frame: 7 years
Acute and late toxicities will be measured using CTCAE v4.0 and will be reported as percentages.
7 years
Efficacy
Time Frame: 7 years
Time to CRPC will be calculated using Kaplan Meier methodology.
7 years
Efficacy
Time Frame: 7 years
Progression free survival will be calculated using Kaplan Meier methodology.
7 years
Efficacy
Time Frame: 7 years
Local control will be calculated using Kaplan Meier methodology.
7 years
Efficacy
Time Frame: 7 years
Distant control will be calculated using Kaplan Meier methodology.
7 years
Efficacy
Time Frame: 7 years
Overall survival will be calculated using Kaplan Meier methodology.
7 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Patrick Cheung, Sunnybrook Health Sciences Centre

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 22, 2017

Primary Completion (Actual)

May 30, 2019

Study Completion (Actual)

May 30, 2019

Study Registration Dates

First Submitted

January 11, 2017

First Submitted That Met QC Criteria

October 3, 2017

First Posted (Actual)

October 4, 2017

Study Record Updates

Last Update Posted (Actual)

December 1, 2020

Last Update Submitted That Met QC Criteria

November 26, 2020

Last Verified

November 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • ProRaD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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