Cytoreductive Prostatectomy in Treating Patients With Newly Diagnosed, Metastatic Prostate Cancer

Rutgers, The State University of New Jersey26 enrolled

Overview

This phase I trial studies the side effects of cytoreductive prostatectomy in treating patients with newly diagnosed prostate cancer that has spread from the primary site to other places in the body. Cytoreductive prostatectomy is a type of surgery that removes the prostate and as much of the tumor as possible. When combined with hormone therapy, robotic assisted radical prostatectomy (RARP) or conventional open retropubic radical prostatectomy (RRP) may prolong survival in patients with prostate cancer that has spread.

PRIMARY OBJECTIVES: I. To determine the safety and feasibility of cytoreductive prostatectomy (to remove as much of the primary cancer as possible) in men with newly diagnosed clinical T1-3N1M0 or T1-3N0M1a-b prostate cancer (herein, collectively referred to as metastatic prostate cancer). SECONDARY OBJECTIVES: I. Time to prostate specific antigen (PSA) nadir and castration resistance following cytoreductive prostatectomy and subsequent standard systemic therapy, androgen deprivation. OUTLINE: Patients undergo RARP or conventional open RRP. Immediately following surgery, patients receive standard systemic androgen deprivation therapy. After completion of study treatment, patients are followed up every 90 days for 3 years.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Metastatic Prostate Carcinoma

Eligibility

Sex: MALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Histologically proven adenocarcinoma of the prostate * Evidence of lymph node or bone metastasis by magnetic resonance imaging (MRI)/computed tomography (CT), bone scan, or biopsy (N1Mx or NxM1) * Give informed consent * Clinical stage T3 or less (pelvic MRI shows no rectal and ureteral invasion) * Cleared by the primary medical doctor for surgery * No prior systemic therapy for metastatic prostate cancer * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Exclusion Criteria: * Refuses to give informed consent * Refuses or is unable to have pelvic MRI * Clinical stage T4 (pelvic MRI shows rectal and/or ureteral invasion) * Deemed a poor surgical risk per primary medical doctor * Received prior therapeutic intervention for metastatic prostate cancer * Known spinal cord compression or brain or liver metastasis * Deep vein thrombosis (DVT)/pulmonary embolism (PE) in the past 6 months

Locations (3)

City of Hope National Medical Center (COH)

Duarte, California, United States

University of California, Irvine (UCI)

Orange, California, United States

Rutgers Cancer Institute of New Jersey

New Brunswick, New Jersey, United States

Outcomes

Primary Outcomes

Rate of major peri-operative complications defined as Clavien-Dindo grade III or higher

Rate will be calculated for the primary end point, and one-sided Binomial test will be used to compare the rate to the hypothesized value. Descriptive statistics will be provided. Any further statistical analysis deemed necessary to calculate significant findings will be done with the assistance of the Rutgers Cancer Institute of New Jersey Biostatistics Section.

Time frame: Within 90 days after cytoreductive prostatectomy

Secondary Outcomes

Time to PSA nadir

Time to event data will be analyzed using the Kaplan-Meier product limit method. Descriptive statistics will be provided. Any further statistical analysis deemed necessary to calculate significant findings will be done with the assistance of the Rutgers Cancer Institute of New Jersey Biostatistics Section.

Time frame: Up to 3 years

Time to rising PSA while on the standard androgen deprivation therapy