Prostate Cancer Study In Men Who Have Failed First-Line Androgen Deprivation Therapy

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
GlaxoSmithKline
ClinicalTrials.gov Identifier:
NCT00470834
First received: May 7, 2007
Last updated: August 29, 2013
Last verified: July 2013
  Purpose

Dutasteride inhibits the conversion of testosterone to dihydrotestosterone (DHT) the male hormone that leads to benign prostate growth. By blocking the conversion of testosterone to DHT, dutasteride could allow bicalutamide to be a more effective anti-androgen thus prolonging bicalutamide's efficacy.


Condition Intervention Phase
Neoplasms, Prostate
Drug: dutasteride
Drug: placebo
Drug: bicalutamide
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized Double-Blind Parallel Group Study Comparing Casodex (or Generic Equivalent) 50mg Plus Placebo to Casodex (or Generic Equivalent) 50mg Plus Dutasteride 3.5mg Administered for 18 Months to Men With Prostate Cancer Who Have Failed First-Line Androgen Deprivation Therapy (Assessed by Rising PSA) Followed by a Two-Year Extension Phase

Resource links provided by NLM:


Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:
  • Time to Disease Progression [ Time Frame: Interval of time between the date of the start of treatment and the date of disease progression (up to Study Month 42) ] [ Designated as safety issue: No ]
    Time to disease progression (PD) is defined as the interval of time between the date of the start of treatment and the date of PD. PD is defined as prostate specific antigen (PSA) progression from Baseline (PSA value is 25% and at least 2 nanograms per milliliter [ng/mL] above Baseline, confirmed by a second PSA value); PSA progression from nadir, without a 50% decrease from Baseline (PSA value is 25% and at least 2 ng/mL above nadir, confirmed by a second PSA value); PSA progression from nadir, with a 50% or more decrease from Baseline (PSA value is 50% and at least 2 ng/mL above nadir, confirmed by a second PSA value); metastatic disease (radiographic evidence of metastatic disease); death due to prostate cancer; or the receipt of post-Baseline rescue medication. PSA confirmation was not required if no subsequent PSA values were available. Participants who did not experience an event were censored at the date of the latest follow-up information.


Secondary Outcome Measures:
  • Time to Treatment Failure [ Time Frame: Interval of time between the date of the start of treatment and the date of treatment failure (up to Study Month 42) ] [ Designated as safety issue: No ]
    Time to treatment failure is defined as the interval of time between the date of the start of treatment and the date of treatment failure. Treatment failure is defined as PSA progression from Baseline (PSA value is 25% and at least 2 ng/mL above Baseline, confirmed by a second PSA value); metastatic disease (radiographic evidence of metastatic disease); death due to prostate cancer; or receipt of post-baseline rescue medications. PSA confirmation was not required if no subsequent PSA values were available. Participants who did not experience an event were censored at the date of the latest follow-up information.

  • Number of Participants With PSA Response [ Time Frame: Time from Baseline PSA measurement until the first PSA measurement with a 50% or greater reduction in PSA values (up to Study Month 42) ] [ Designated as safety issue: No ]
    PSA response is defined as a 50% or greater decrease in PSA from Baseline, confirmed by a second PSA measurement. The time of this response was the date of the first PSA measurement that showed a 50% or greater decrease from the Baseline PSA measurement. PSA confirmation was not required if no subsequent PSA values were available.

  • Change From Baseline in Total PSA at Months 6, 12, 18, 21, and 42 [ Time Frame: Baseline and Months 6, 12, 18, 21, and 42 ] [ Designated as safety issue: No ]
    Change from Baseline in total PSA was measured at each scheduled post-baseline visit using a general linear model with effects for treatment and Baseline total PSA. Analysis was done using the last observation carried forward (LOCF) approach, in which missing post-Baseline values were imputed with earlier non-missing values. Change from Baseline was calculated as the post-Baseline value minus the Baseline value.

  • Number of Participants With Metastatic Disease [ Time Frame: Interval of time between the date of the start of treatment and the date of radiographic evidence of metastatic disease (up to Study Month 42) ] [ Designated as safety issue: No ]
    Metastatic disease is that evidenced by a radiographic assessment. The time of metastatic disease was the date of radiographic evidence.


Enrollment: 127
Study Start Date: May 2007
Study Completion Date: February 2013
Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1
50 mg bicalutamide and 3.5 mg Dutasteride (IP)
Drug: dutasteride
0.5mg dutasteride (Investigation Product)
Other Name: dutasteride
Drug: bicalutamide
50 mg Casodex or generic equivalent
Placebo Comparator: Arm 2
50 mg bicalutamide and placebo
Drug: placebo
making placebo
Other Name: placebo
Drug: bicalutamide
50 mg Casodex or generic equivalent

  Eligibility

Ages Eligible for Study:   40 Years to 90 Years
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • Men ≥40 and ≤90 years of age
  • Must have asymptomatic prostate cancer that has progressed during androgen deprivation therapy (rising PSA). PSA progression must have occurred after first-line treatment with GnRH analogues ( e.g. leuprolide, goserelin) or orchiectomy. PSA progression is defined by three rises in PSA each measured at least 4 weeks apart within the previous year.
  • Serum PSA ≥2 and ≤20ng/ml from central laboratory. One PSA retest from central laboratory is allowed if the value is <2 or >20ng/ml; or if the PSA value is not consistent with the previous rising PSA values that determined progression while on a GnRH analogue.
  • Serum Testosterone <50ng/ml from central laboratory.
  • Non-metastatic prostate cancer as confirmed on prior bone scan performed within 8 weeks of screening.
  • Expected survival ≥ 2 years
  • ECOG Performance status 0, 1, or 2

Exclusion criteria:

  • Additional hormonal therapy (excluding the current use of a GnRH analogue) within the past 6 months of:
  • Estrogens (e.g. megestrol, medroxyprogesterone, cyproterone, DES)
  • Drugs with antiandrogenic properties (e.g., spironolactone if >50mg/day, flutamide, bicalutamide*, ketoconazole**, progestational agents)

    *The use of an antiandrogen during GnRH analogue induction for <6 weeks is acceptable, but none within the 3 months prior to study entry.

    **The use of topical ketoconazole is permitted prior to and during the study. NOTE: Use of dietary and herbal supplements (e.g., selenium, Vitamin E, saw palmetto), excluding daily vitamins, during the study is discouraged, but not prohibited. All dietary and herbal supplement usage will be recorded in the eCRF.

  • Treatment with oral glucocorticoids during the 3 months prior to randomization or expectation of their use during the study.
  • Prior chemotherapy for prostate cancer. (prior prostatectomy or radiotherapy to the prostate are allowed)
  • Prostate surgery including TUNA, TURP, TUIP, laser treatment, thermotherapy, balloon dilatation, prosthesis, and cryosurgical ablation within 2 months prior to enrollment.
  • Current and/or previous use of the following medications:
  • Finasteride (Proscar, Propecia), or Dutasteride (GI198745, AVODART) exposure within 6 months prior to study entry
  • Anabolic steroids (within 6 months prior to study entry)
  • Participation in any investigational or marketed drug trial within the 30 days prior to the first dose of study drug or anytime during the study period.
  • Any unstable serious co-existing medical condition(s) including but not limited to myocardial infarction, coronary bypass surgery, unstable angina, cardiac arrhythmias, clinically evident congestive heart failure, or cerebrovascular accident within 6 months prior to Screening visit; uncontrolled diabetes; or peptic ulcer disease which is uncontrolled by medical management.
  • Abnormal liver function test greater than 1.5 times the upper limit of normal for alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP] or bilirubin.
  • Serum creatinine >2.0 times the upper limit of normal.
  • History of another malignancy within five years that could affect the treatment of prostate cancer or survival of the subject.
  • History or current evidence of drug or alcohol abuse within the last 12 months.
  • History of any illness (including psychiatric) that, in the opinion of the investigator, might confound the results of the study or pose additional risk to the subject.
  • Known hypersensitivity to any 5 alpha-reductase inhibitor or to any drug chemically related to dutasteride.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00470834

  Show 62 Study Locations
Sponsors and Collaborators
GlaxoSmithKline
Investigators
Study Director: GSK Clinical Trials GlaxoSmithKline
  More Information

No publications provided

Responsible Party: GlaxoSmithKline
ClinicalTrials.gov Identifier: NCT00470834     History of Changes
Other Study ID Numbers: AVO108943
Study First Received: May 7, 2007
Results First Received: August 29, 2013
Last Updated: August 29, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by GlaxoSmithKline:
prostate cancer
androgen deprivation therapy

Additional relevant MeSH terms:
Neoplasms
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Genital Diseases, Male
Prostatic Diseases
Androgens
Bicalutamide
Dutasteride
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Pharmacologic Actions
Androgen Antagonists
Hormone Antagonists
Antineoplastic Agents
Therapeutic Uses
5-alpha Reductase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on April 16, 2014