Therapeutic Effect of Cytoreductive Radical Prostatectomy in Men With Newly Diagnosed Metastatic Prostate Cancer
SIMCAP (Surgery in Metastatic Carcinoma of Prostate): Phase 2.5 Multi-Institution Randomized Prospective Clinical Trial Evaluating the Impact of Cytoreductive Radical Prostatectomy Combined With Best Systemic Therapy on Oncologic and Quality of Life Outcomes in Men With Newly Diagnosed Metastatic Prostate Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To assess the clinical benefit of combining radical surgery cytoreductive radical prostatectomy (CRP) - with the best systemic therapy (BST) in men with newly diagnosed clinical metastatic prostate cancer (mPCa).
SECONDARY OBJECTIVES:
I. To determine the impact of CRP+BST on time to biochemical progression, cancer-specific survival, overall survival, complication rates, and quality of life (QOL) in patients with mPCa.
II. To determine the transcription levels of bone morphogenetic protein -6 (BMP-6) and transforming growth factor-beta (TGF-?).
OUTLINE: Participants are randomized to 1 of 2 arms.
ARM I: Participants receive antiandrogen therapy with or without docetaxel at the discretion of the treating physician.
ARM II: Participants receive antiandrogen therapy for at least 1 month, then undergo cytoreductive radical prostatectomy. Participants continue antiandrogen therapy and may receive docetaxel prior to surgery at the discretion of the treating physician.
After completion of study treatment, patients are followed up every 6 months from time of progression.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Laura Kane
- Phone Number: 7733696904
- Email: laura.kane@yale.edu
Study Contact Backup
- Name: Kristine DaCosta
- Phone Number: 508-345-8193
- Email: kristine.dacosta@yale.edu
Study Locations
-
-
Australia
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East Melbourne, Australia, Australia, 9084
- Epworth Healthcare
-
-
-
-
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Hong Kong, China
- Chinese University of Hong Kong
-
-
-
-
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Akita, Japan
- Akita University
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Tokyo, Japan
- Juntendo University
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Osaka
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Ōsaka-sayama, Osaka, Japan, 589-8511
- Kindai University
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-
-
-
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Goyang-si, South Korea
- National Cancer Center
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Gyeonggi-do, South Korea
- Seoul National University Bundang Hospital
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Seoul, South Korea
- Samsung Medical Center
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-
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-
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Taipei, Taiwan
- National Taiwan University Hospital
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-
-
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California
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Duarte, California, United States, 91010
- City of Hope
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Irvine, California, United States, 92697
- University of California, Irvine
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Los Angeles, California, United States, 90033
- University of Southern California
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Connecticut
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New Haven, Connecticut, United States, 06519
- Yale University
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New Jersey
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New Brunswick, New Jersey, United States, 08903
- Rutgers Cancer Institute of New Jersey
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania
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Washington
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Seattle, Washington, United States, 98104
- Swedish Medical Services
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically proven adenocarcinoma of the prostate
- Evidence of metastasis by magnetic resonance imaging (MRI)/computed tomography (CT) scan, bone scan, or histologic confirmation
- Clinical stage M1a (distant lymph node positive), M1b (bone metastasis), or M1c (solid organ metastasis.
- If solitary lesion, metastasis confirmed with either biopsy or two independent imaging modalities (i.e. CT and PET [positron emission tomography], bone scan and MRI, modality at the discretion of the treating physician)
- No previous local therapy for prostate cancer (i.e prostate radiation, cryotherapy, etc.)
- Give informed consent
- Prostate deemed resectable by surgeon
- Plans to start or has already started antiandrogen therapy (ADT) no longer than 6 months prior to consent
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Hemoglobin (HgB) >= 9 g/dL compatible for surgery
- Platelets > 80,000/mcL compatible for surgery
- Aspartate aminotransferase (AST) =< 2x upper limit of normal (ULN) compatible for surgery
- Alanine aminotransferase (ALT) =< 2x upper limit of normal (ULN) compatible for surgery
Exclusion Criteria:
- Refuses to give informed consent
- Deemed to have unresectable disease by surgeon
- Received ADT for more than 6 months prior to consent
- Life expectancy of less than 6 months prior to consent
- Active spinal cord compression
- Deep vein thrombosis (DVT) / pulmonary embolism (PE) in the past 6 months prior to consent
- Previous local therapy for prostate cancer
- Patients who have chemotherapy or radiotherapy for non-prostate cancer related treatment within 3 weeks prior to consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm I (ADT, docetaxel)
Participants receive antiandrogen therapy with or without docetaxel at the discretion of the treating physician.
|
Correlative studies
Ancillary studies
Ancillary studies
Other Names:
To demonstrate at least 30% improvement in FFS at 2 years after randomization with the power of 90% and error of 5% on a one-sided exponential MLE test.
Other Names:
To demonstrate at least 30% improvement in FFS at 2 years after randomization with the power of 90% and error of 5% on a one-sided exponential MLE test.
Other Names:
|
|
Experimental: Arm II (ADT, radical prostatectomy, docetaxel)
Participants receive antiandrogen therapy for at least 1 month, then undergo cytoreductive radical prostatectomy.
Participants continue antiandrogen therapy and may receive docetaxel prior to surgery at the discretion of the treating physician.
|
Correlative studies
Ancillary studies
Ancillary studies
Other Names:
To demonstrate at least 30% improvement in FFS at 2 years after randomization with the power of 90% and error of 5% on a one-sided exponential MLE test.
Other Names:
To demonstrate at least 30% improvement in FFS at 2 years after randomization with the power of 90% and error of 5% on a one-sided exponential MLE test.
Other Names:
Undergo cytoreductive radical prostatectomy
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Failure-free survival (FFS)
Time Frame: At 2 years
|
Failure is defined as any one of the following events: PSA progression, clinical progression, radiographic progression, or death from prostate cancer.
The % of men who fail within 2 years of randomization will be compare between the two groups using a one-sided log-rank test.
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At 2 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Cancer-specific survival
Time Frame: Up to 2 years
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Up to 2 years
|
|
Overall complication rate
Time Frame: Up to 2 years
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Up to 2 years
|
|
Time to biochemical progression
Time Frame: Up to 2 years
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Up to 2 years
|
|
Overall survival
Time Frame: Through study completion, a minimum of 4 years
|
Through study completion, a minimum of 4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Isaac Kim, MD, Yale University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Carcinoma
- Adenocarcinoma
- Physiological Effects of Drugs
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Hormone Antagonists
- Organic Chemicals
- Pharmacologic Actions
- Chemical Actions and Uses
- Hydrocarbons
- Cycloparaffins
- Hydrocarbons, Alicyclic
- Hydrocarbons, Cyclic
- Terpenes
- Taxoids
- Cyclodecanes
- Diterpenes
- Docetaxel
- Androgen Antagonists
Other Study ID Numbers
Other Study ID Numbers
- 2000031290
- P30CA072720 (U.S. NIH Grant/Contract)
- NCI-2018-00047 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- 081707 (Other Identifier: Rutgers Cancer Institute of New Jersey)
- Pro20170001506 (Other Identifier: WIRB)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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