Phase II Study of Neoadjuvant Androgen Deprivation Therapy Plus Abiraterone With or Without Apalutamide for Patients With High-Risk Localized Prostate Cancer Prior to Radical Prostatectomy
Condition: Prostate Cancer
Intervention:
- Drug: Goserelin
- Drug: Prednisone
- Drug: Abiraterone
- Drug: Apalutamide
Purpose: This is a randomized study to evaluate the efficacy and safety neoadjuvant androgen deprivation therapy with goserelin and abiraterone with or without apalutamide prior to radical prostatectomy for patients diagnosed with localized high-risk prostate cancer.
Study Type: Interventional
Clinical Trials Identifier NCT 8-digits: NCT02789878
Sponsor: Instituto do Cancer do Estado de São Paulo
Primary Outcome Measures:
- Measure: Pathologic response
- Time Frame: 3 months
- Safety Issue:
Secondary Outcome Measures:
- Measure: Residual cellularity rate
- Time Frame: 3 months
- Safety Issue:
- Measure: Pathologic downgrading
- Time Frame: 3 months
- Safety Issue:
- Measure: PSA decline rate
- Time Frame: 3 months
- Safety Issue:
- Measure: Rate of positive surgical margins
- Time Frame: 3 months
- Safety Issue:
- Measure: Rate of undetectable PSA
- Time Frame: 12 months
- Safety Issue:
- Measure: Rate of Grade ≥ 3 CTCAE adverse events
- Time Frame: 3 months
- Safety Issue:
Estimated Enrollment: 64
Study Start Date: January 24, 2019
Phase: Phase 2
Eligibility:
- Age: minimum 18 Years maximum 80 Years
- Gender: Male
Inclusion Criteria:
- Histologic confirmed prostatic adenocarcinoma
- Non-castrate levels of testosterone (> 150 ng/dL)
- High-risk localized prostate cancer, defined by either:
- Tumor stage T3 by digital rectal examination, or
- Primary tumor Gleason score ≥ 8, or
- PSA ≥ 20 ng/mL
- Willing to undergo prostatectomy as primary treatment for localized prostate cancer
- Adequate hematologic, renal and hepatic function:
- WBC > 3000/uL
- Platelets > 150,000/uL
- Creatinine < 2 mg/dL
- Bilirubin < 1.5 x upper limit of normal (ULN)
- AST/ALT < 2 x ULN
- Karnofsky Performance Status (KPS) ≥ 80%
- Able to swallow the study drugs whole as tablets
Exclusion Criteria:
- Pathological finding consistent with small cell, ductal or neuroendocrine carcinoma of the prostate
- Current or prior hormonal therapy, radiation therapy or chemotherapy for prostate cancer
- Evidence of metastatic disease (M1) on imaging studies
- Other prior malignancy less than or equal to 5 years prior to randomization with the exception of squamous or basal cell skin carcinoma
- Abnormal cardiac function as manifested by NYHA (New York Heart Association) class III or IV heart failure
- History of prior cardiac arrhythmia.
- Evidence of serious and/or unstable pre-existing medical, psychiatric or other condition (including laboratory abnormalities) that could interfere with patient safety or provision of informed consent to participate in this study.
Contact:
- Diogo A Bastos, MD
- +55 11 38932691
Location:
- Instituto do Cancer do Estado de Sao Paulo
- Sao Paulo SP 01246-0000 Brazil
View trial on ClinicalTrials.gov