Informations générales (source: ClinicalTrials.gov)
Combination of Darolutamide and Stereotactic Body Radiation Therapy in Patients With Castration Resistant Prostate Cancer and Oligometastases on Functional Imaging
Interventional
Phase 3
UNICANCER (Voir sur ClinicalTrials)
octobre 2024
octobre 2032
13 septembre 2025
In earlier stages of prostate cancer, male sexual hormones (androgens) stimulate the
growth of cancer cells. Castration-resistant prostate cancer (CRPC) means that the
prostate cancer continued to grow despite patients are taking hormone therapy to control
the disease. One of the standard treatments for these patients is so-called 'new
generation' hormonal therapy. These hormone therapies include apalutamide, enzalutamide,
or darolutamide. They work by blocking androgen receptors that play an important role in
the growth of prostate cancer.
In the case of oligometastatic CRPC, the cancer has gone beyond the prostate and has
spread to other organs in the body (metastases), but these metastases remain limited in
number.
An early detection of the oligometastatic CRPC and appropriate treatment may prolong
survival in these patients.
The treatment proposed as part of this research is a combination of oral darolutamide,
approved in Europe to treat patients with CRPC who do not have metastasis visible on
CT-scan or bone scintigraphy (but visible with positron emission tomography-scan
(PET-Scan), a more precise imaging technique) with stereotactic body radiotherapy (SBRT),
a new radiotherapy technique guided by very high precision medical imaging. This method
makes it possible to better target cancer cells while preserving neighboring healthy
organs.
The principal objective of this trial is to evaluate the efficacy of the combination of
SBRT with darolutamide, compared to darolutamide.
Etablissements
| Les établissements d'Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| CLCC INSTITUT GUSTAVE ROUSSY | Ronan FLIPPOT, MD | Contact (sur clinicalTrials) | |||
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
| Centre Azuréen de Cancérologie - 06250 - Mougins - France | Philippe RONCHIN, MD | Contact (sur clinicalTrials) | |||
| CHU de Saint-Etienne - 42055 - Saint-Étienne - France | Thomas REYNAUD, MD | Contact (sur clinicalTrials) | |||
| Groupe Hospitalier Bretagne Sud - 56322 - Lorient - France | Guillaume BERA, MD | Contact (sur clinicalTrials) | |||
Critères
Homme
Inclusion Criteria:
1. Patient must have signed a written informed consent prior to any trial specific
procedures. When the patient is physically unable to give their written consent, a
trusted person of their choice, independent from the investigator or the sponsor,
can confirm in writing the patient's consent.
2. Patients aged ≥18 years.
3. Patient with histologically confirmed of adenocarcinoma prostate cancer without
small cell or pure endocrine features.
4. Patient with a history of local treatment with curative intent for localised
prostate cancer, including surgery or radiotherapy.
5. Patients with castration resistant prostate cancer, defined as either:
- An increasing PSA level, confirmed in 3 consecutive assessments performed at
least 1 week apart. This despite androgen deprivation therapy and castrate
levels of testosterone.
- Tumour progression of soft tissue according to the response criteria in solid
tumours (RECIST) version (v)1.1.
- Tumour progression on bone scan, according to PCWG3 criteria.
N.B. The two latter conditions only apply to the M1CRPC population.
6. Detection of 1 to 5 metastatic sites (pelvic lymph nodes included) on new generation
PET using either choline, fluciclovine, or PSMA as tracer.
7. All metastatic sites must be amenable to stereotactic radiation therapy.
8. Patient with normal haematological function: absolute neutrophil count (ANC) >1.0 x
10⁹/L, platelets count ≥100 x 10⁹/L, and haemoglobin ≥9.0 g/dL.
9. Patient with normal liver function with total bilirubin ≤1.5 upper limit of normal
(ULN) (unless documented Gilbert's syndrome), aspartate aminotransferase (ASAT) and
alanine aminotransferase (ALAT) ≤2.5 ULN (≤5 ULN in the presence of liver
metastases).
10. Adequate liver function with bilirubin <3 mg/dL and albumin >2.5 g/dL.
11. Systolic blood pressure <160 mmHg and diastolic blood pressure <100 mmHg, as
documented at baseline. Patients with hypertension are eligible if their
hypertension is controlled and they meet all other eligibility criteria.
12. Adequate kidney function with a creatinine clearance >30 mL/min (Cockcroft-Gault).
13. Patient with Eastern Cooperative Oncology group (ECOG) performance status (PS) ≤1.
14. Patient is willing to use contraceptive during and for at least 1 week after
discontinuing darolutamide.
15. Patient affiliated to the social security system (or equivalent according to local
regulations for participation in clinical trials).
16. Patient is willing and able to comply with the protocol for the duration of the
trial including undergoing treatment and scheduled visits, and examinations
including follow-up.
1. Patient must have signed a written informed consent prior to any trial specific
procedures. When the patient is physically unable to give their written consent, a
trusted person of their choice, independent from the investigator or the sponsor,
can confirm in writing the patient's consent.
2. Patients aged ≥18 years.
3. Patient with histologically confirmed of adenocarcinoma prostate cancer without
small cell or pure endocrine features.
4. Patient with a history of local treatment with curative intent for localised
prostate cancer, including surgery or radiotherapy.
5. Patients with castration resistant prostate cancer, defined as either:
- An increasing PSA level, confirmed in 3 consecutive assessments performed at
least 1 week apart. This despite androgen deprivation therapy and castrate
levels of testosterone.
- Tumour progression of soft tissue according to the response criteria in solid
tumours (RECIST) version (v)1.1.
- Tumour progression on bone scan, according to PCWG3 criteria.
N.B. The two latter conditions only apply to the M1CRPC population.
6. Detection of 1 to 5 metastatic sites (pelvic lymph nodes included) on new generation
PET using either choline, fluciclovine, or PSMA as tracer.
7. All metastatic sites must be amenable to stereotactic radiation therapy.
8. Patient with normal haematological function: absolute neutrophil count (ANC) >1.0 x
10⁹/L, platelets count ≥100 x 10⁹/L, and haemoglobin ≥9.0 g/dL.
9. Patient with normal liver function with total bilirubin ≤1.5 upper limit of normal
(ULN) (unless documented Gilbert's syndrome), aspartate aminotransferase (ASAT) and
alanine aminotransferase (ALAT) ≤2.5 ULN (≤5 ULN in the presence of liver
metastases).
10. Adequate liver function with bilirubin <3 mg/dL and albumin >2.5 g/dL.
11. Systolic blood pressure <160 mmHg and diastolic blood pressure <100 mmHg, as
documented at baseline. Patients with hypertension are eligible if their
hypertension is controlled and they meet all other eligibility criteria.
12. Adequate kidney function with a creatinine clearance >30 mL/min (Cockcroft-Gault).
13. Patient with Eastern Cooperative Oncology group (ECOG) performance status (PS) ≤1.
14. Patient is willing to use contraceptive during and for at least 1 week after
discontinuing darolutamide.
15. Patient affiliated to the social security system (or equivalent according to local
regulations for participation in clinical trials).
16. Patient is willing and able to comply with the protocol for the duration of the
trial including undergoing treatment and scheduled visits, and examinations
including follow-up.
1. Patient previously treated for metastatic prostate cancer with a novel hormonal
agent (NHA), a CYP17 inhibitor, ketoconazole, chemotherapy, or immunotherapy.
2. A history of cancer, other than the prostate cancer under study, within the 3 years
prior to study inclusion, excluding cured localised cancer such as non-melanomatous
skin cancer and non-muscle invasive bladder cancer.
3. Presence of an uncontrolled disease or affection that according to the investigator
will hinder compliance with the trial procedures or requires hospitalisation.
4. Known to have active viral hepatitis, active human immunodeficiency virus (HIV) A at
screening.
5. Patients with known allergy or severe hypersensitivity to the study treatment or any
of its excipients.
6. Inability to swallow oral medications.
7. Gastrointestinal disorder or procedure that can be expected to interfere
significantly with the absorption of study treatment.
8. Any of the following within 6 months before randomisation: stroke, myocardial
infarction, severe/unstable angina pectoris, coronary/peripheral artery bypass
graft; congestive heart failure New York Heart Association (NYHA) Class III or IV.
9. Patients participating in another therapeutic trial within the 30 days prior to
randomisation.
10. Patients unable to comply with trial obligations for geographic, social, or physical
reasons, or who are unable to understand the purpose and procedures of the trial.
11. Person deprived of their liberty or under protective custody or guardianship.