This research study is comparing two different combinations of androgen deprivation therapy (ADT) used together with radiation as a treatment for rising PSA after radical prostatectomy (prostate cancer).
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational intervention to learn whether the intervention works in treating a specific disease. "Investigational" means that an intervention is being studied. In this study, the investigational agents are apalutamide and abiraterone acetate. Currently, the best standard treatment for men with this type of prostate cancer includes radiation therapy combined with androgen deprivation therapy (ADT). ADT blocks the function of hormones including testosterone which prostate cancer uses to grow and spread. All participants in this study will receive the main standard form of ADT called a luteinizing hormone-releasing hormone agonist (LHRHA). Physicians often also use another drug called bicalutamide to help the LHRHA block hormone function. The investigators are testing whether using two newer anti-hormonal drugs called abiraterone acetate and apalutamide with LHRHA can improve cure rates compared to using bicalutamide plus LHRHA. These two drugs work together to suppress both testosterone and the receptor where testosterone binds thereby providing more potent hormone suppression.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
345
-blocks the function of hormones including testosterone which prostate cancer uses to grow and spread
-blocks the function of hormones including testosterone which prostate cancer uses to grow and spread
Radiation
University of California, San Diego
San Diego, California, United States
University of California, San Francisco
San Francisco, California, United States
Yale Cancer Center
New Haven, Connecticut, United States
University of Chicago
Chicago, Illinois, United States
PSA Progression Free Survival
Time from randomization to PSA failure or death due to any cause
Time frame: Up to 5 years
Metastasis Free Survival on conventional imaging or pathologically (MFS)
Time from randomization to distant metastasis, identified on conventional imaging (CT, bone scan, or MRI) or pathologically, or death due to any cause or censored at date last known alive.
Time frame: Up to 5 years
Metastasis Free Survival only visible by PET Imaging (MFS-PET)
Time from randomization to distant metastasis, visible only by PET portion of a PET-CT, or death due to any cause or censored at date last known alive.
Time frame: Up to 5 years
Cause Specific Survival
The interval from randomization to the date of last known follow-up alive or date of death from each of the following causes: prostate cancer, cardiovascular disease, other causes.
Time frame: Up to 5 years
Overall Survival
Time from randomization to death due to any cause or censored at date last known alive
Time frame: Up to 5 years
Time to Testosterone Recovery
Time from randomization to date at which testosterone level returns to a normal level, or censored at the date of last disease evaluation for those whose testosterone has not reached a normal level
Time frame: Up to 5 years
Toxicity as measured by CTCAE v.4.0
Measure Grade 1-5 toxicities at study visits and follow-up using the CTCAE v.4.0 forms and determine attribution
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-blocks the function of hormones including testosterone which prostate cancer uses to grow and spread
Prednisone is a corticosteroid. It prevents the release of substances in the body that cause inflammation. It also suppresses the immune system.
-blocks the function of hormones including testosterone which prostate cancer uses to grow and spread
Dana-Farber Cancer Institute/Brigham and Women's Hospital
Boston, Massachusetts, United States
University of Michigan
Ann Arbor, Michigan, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
MD Anderson Cancer Center
Houston, Texas, United States
Time frame: Up to 5 years
Time to reinitiation of ADT
Time from randomization to date at which ADT is restarted for disease progression. Censoring occurs at date of last disease evaluation for those who are not restarted on ADT.
Time frame: Up to 5 years
Patient reported QOL
Patient-reported Quality of Life will be measured by a fatigue questionnaire
Time frame: Up to 5 years
Patient reported QOL
Patient-reported Quality of Life will be measured by a questionnaire assessing symptoms related to prostate cancer
Time frame: Up to 5 years
Patient reported QOL
Patient-reported Quality of Life will be measured by a memory survey
Time frame: Up to 5 years
Cardiovascular events consisting of myocardial infarction
Time from randomization to date at which first cardiovascular event (myocardial infarction, stroke, deep venous thrombosis, or pulmonary embolism) occurs. Censoring occurs at date of last disease evaluation for those who did not have a cardiovascular event.
Time frame: Up to 5 years