Finasteride in Treating Patients With Stage II Prostate Cancer Who Are Undergoing Surgery
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Purpose
This randomized phase II trial studies how well finasteride works in treating patients with stage II prostate cancer who are undergoing surgery. Testosterone can cause the growth of prostate cancer cells. Hormone therapy using finasteride may fight prostate cancer by lowering the amount of testosterone the body makes. Giving finasteride before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed
| Condition | Intervention | Phase |
|---|---|---|
|
Adenocarcinoma of the Prostate Stage II Prostate Cancer |
Drug: finasteride Other: placebo Procedure: therapeutic conventional surgery Other: laboratory biomarker analysis |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | A Randomized Controlled Trial Evaluating the Tissue Effects of Preoperative Finasteride Versus Placebo for Patients With Clinically Organ-Confined Prostate Cancer |
- Molecular marker expression based on tissue microarray (TMA) derived from the dominant tumor focus [ Time Frame: At time of prostatectomy ] [ Designated as safety issue: No ]Data analysis will use a mixed-effects regression model, an approach appropriate for repeated measures (of continuous variables) from single participants.
- Molecular marker expression compared between tumor foci [ Time Frame: At time of prostatectomy ] [ Designated as safety issue: No ]The use of all data will be maximized by performing matched and unpaired or unmatched data analysis.
- Frequencies with which two GGs appear in tumor foci [ Time Frame: At time of prostatectomy ] [ Designated as safety issue: No ]The use of all data will be maximized by performing matched and unpaired or unmatched data analysis.
| Estimated Enrollment: | 200 |
| Study Start Date: | February 2007 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I (finasteride)
Patients receive finasteride PO QD for 4-6 weeks, and then undergo prostatectomy.
|
Drug: finasteride
Given PO
Other Names:
Procedure: therapeutic conventional surgery
Undergo prostatectomy
Other: laboratory biomarker analysis
Correlative studies
|
|
Placebo Comparator: Arm II (placebo)
Patients receive placebo PO QD for 4-6 weeks, and then undergo prostatectomy.
|
Other: placebo
Given PO
Other Name: PLCB
Procedure: therapeutic conventional surgery
Undergo prostatectomy
Other: laboratory biomarker analysis
Correlative studies
|
Detailed Description:
PRIMARY OBJECTIVES:
I. Compare the frequency of discriminating molecular marker expression in Gleason grade (GG) 3 cores, adjusted for Gleason score (GS) at prostatectomy, in patients with stage II prostate cancer treated with neoadjuvant finasteride vs placebo.
SECONDARY OBJECTIVES:
I. Compare the frequency with which grade 3 and grade 4 tumors occur in these patients.
II. Determine the frequency of discriminating molecular signature expression in tissue microarray cores segregated by GS at prostatectomy in these patients.
III. Compare GG 3-appearing areas (in tumors rated GS 6 at prostatectomy) in patients treated with finasteride vs placebo.
IV. Compare GG 3-appearing areas (in tumors rated GS 7 at prostatectomy) in patients treated with finasteride vs placebo.
V. Compare GG 4-appearing areas (in tumors rated GS 7 at prostatectomy) in patients treated with finasteride vs placebo.
OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study.
Patients are stratified according to study site, Gleason score (6 vs 7), and type of prostatectomy (open vs robotic/laparoscopic). Patients are randomized to 1 of 2 treatment arms.
Arm I: Patients receive finasteride orally (PO) once daily (QD) for 4-6 weeks, and then undergo prostatectomy.
Arm II: Patients receive placebo PO QD for 4-6 weeks, and then undergo prostatectomy.
Tumor tissue obtained at prostatectomy is used to make tissue microarrays and is analyzed by immunohistochemistry for molecular marker expression studies.
After completion of study treatment, patients are followed up for 30 days.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Criteria:
- Histologically confirmed adenocarcinoma of the prostate
- Clinical stage T1c or T2 (stage II)
- Gleason score of 6 or 7 on initial biopsy
- Prostate-specific antigen (PSA) level less than 10 ng/mL within the past 3 months
- Candidate for and scheduled to undergo prostatectomy
- ECOG performance status (PS) 0-2 OR Karnofsky PS 70-100%
- Fertile patients must use effective contraception
- No active malignancy at any other site
- No history of allergic reactions attributed to compounds of similar chemical or biological composition to finasteride
- No uncontrolled intercurrent illness including, but not limited to, any of the following: Ongoing or active infection; Symptomatic congestive heart failure; Unstable angina pectoris; Cardiac arrhythmia
- No psychiatric illness or social situation that would preclude study compliance
- More than 6 months since prior hormonal agents, including dutasteride or finasteride
- More than 6 months since prior chemotherapy
- More than 1 month since prior participation in another investigational study
- No prior radiotherapy for the primary tumor
- No concurrent dehydroepiandrosterone, phytoestrogen supplements, antiandrogen therapy, dutasteride, or other finasteride
- No concurrent anticoagulation, except for the use of daily acetylsalicylic acid (81 mg to 325 mg)
Contacts and Locations| United States, Ohio | |
| Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center | |
| Cleveland, Ohio, United States, 44195 | |
| United States, Texas | |
| M D Anderson Cancer Center | |
| Houston, Texas, United States, 77030 | |
| Principal Investigator: | Jeri Kim | M.D. Anderson Cancer Center |
More Information
No publications provided
| Responsible Party: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT00438464 History of Changes |
| Other Study ID Numbers: | NCI-2009-00856, 2006-0614, N01CN35159 |
| Study First Received: | February 20, 2007 |
| Last Updated: | January 16, 2013 |
| Health Authority: | United States: Institutional Review Board United States: Federal Government |
Additional relevant MeSH terms:
|
Adenocarcinoma Adenocarcinoma, Mucinous Prostatic Neoplasms Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Cystic, Mucinous, and Serous Genital Neoplasms, Male |
Urogenital Neoplasms Neoplasms by Site Genital Diseases, Male Prostatic Diseases Finasteride 5-alpha Reductase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013