This Phase IV observational trial is intended to identify patients who are failing GnRH agonist therapy as evidenced by a rising PSA and who have yet to initiate secondary manoeuvres involving antiandrogens. This group may include both non-metastatic as well as metastatic patients. The trial will determine if these patients will benefit from switching to Degarelix. It will assess the effect of Degarelix's direct mode of action on androgen levels and whether continuous use of Degarelix improves disease progression. As per the CUA Guidelines for the Management of CRPC, because the androgen receptor remains active in most patients who have developed castration resistant disease, it is recommended that ADT should be continued (LEVEL 3, GRADE C). Therefore, it is logical to continue patients on Degarelix throughout the castrate resistant period. This will allow for the gathering of data that is currently unknown within this setting, such as the effect of combined treatment with antiandrogens as well as chemotherapy and other castrate resistant treatments.
This trial will include hormone sensitive prostate cancer patients switched to Degarelix therapy after failing on GnRH agonists but prior to use of secondary hormonal treatments such as antiandrogens. The purpose of this trial is to determine the effect of Degarelix's direct mode of action on androgen levels and whether continuous use of Degarelix improves disease progression. This is an open-label, multi-centre, Phase IV observational trial with s.c. injections of Degarelix one-month depot in patients with advanced prostate cancer. The visit frequency is once a month (28-day intervals), with eCRF data entry at every 4 months. All patients will be treated with a one-month starting dose followed by 23 monthly maintenance doses for a duration of 672 days. The primary endpoints will be evaluated after 24 treatment months. In total, 25 visits are scheduled for all patients.
Study Type
OBSERVATIONAL
Enrollment
125
Exdeo Clinical Research Inc.
Abbotsford, British Columbia, Canada
Southern Interior Medical Research Inc.
Kelowna, British Columbia, Canada
Andreou Research
Surrey, British Columbia, Canada
Dr. Steinhoff Clinical Research
Victoria, British Columbia, Canada
The Male/Female Health and Research Centre
Barrie, Ontario, Canada
Jonathan Giddens Medicine Professional Corporation
Brampton, Ontario, Canada
Brantford Urology Research
Brantford, Ontario, Canada
G. Kenneth Jansz Medicine Professional Corporation
Burlington, Ontario, Canada
Guelph Urology Associates
Guelph, Ontario, Canada
Mor Urology Inc.
Newmarket, Ontario, Canada
...and 7 more locations
Testosterone Suppression
To evaluate testosterone supression in hormone sensitive prostate cancer patients switched to Degarelix therapy after failing on GnRH agonists
Time frame: Two Years after first dose of degarelix.
Hormone Levels
To evaluate testosterone, bio available testosterone (calculated), prostate serum antigen (PSA), luteinizing hormone (LH) , follicle-stimulating hormone (FSH), dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEA) before and after switching to Degarelix and over time
Time frame: Two Years after first dose of degarelix.
PSA Response
To evaluate PSA response (ability of Degarelix to stabilise or reverse PSA progression)
Time frame: Two Years after first dose of degarelix.
PSA Failure
To evaluate how long patients are on degeralix prior to demonstrating biochemical disease progression (time to PSA failure)
Time frame: Two Years after first dose of degarelix.
PSA Doubling Time
To evaluate PSA doubling time.
Time frame: Two Years after first dose of degarelix.
Time to Metastases
To evaluate how long patients are on degeralix before they develop metastases (non-metastatic patients)
Time frame: Two Years after first dose of degarelix.
Time to Chemotherapy
Eevaluate how long patients have been on degeralix before initiating chemotherapy.
Time frame: Two Years after first dose of degarelix.
Time to Anti-Androgen use
Evaluate how long patients are on degeralix before initiating anti-androgen use as well as response to anti-androgen use
Time frame: Two Years after first dose of degarelix.
Patient Performance Status
To evaluate patient performance status as defined by the Eastern Cooperative Oncology Group (ECOG).
Time frame: Two Years after first dose of degarelix.
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