S9916, Combination Therapy in Treating Patients With Advanced Prostate Cancer That Has Not Responded to Hormone Therapy

• Status: Completed
• Trial end date: 2007-01-01
• Target enrollment: 0
• Participant gender: Male

Summary

RATIONALE: Drugs used in chemotherapy and hormone therapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug and giving drugs in different ways may kill more tumor cells. It is not yet known whether estramustine plus docetaxel is more effective than mitoxantrone plus prednisone for prostate cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of estramustine plus docetaxel with that of mitoxantrone plus prednisone in treating patients who have stage IV prostate cancer that has not responded to hormone therapy.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Southwest Oncology Group
• Collaborators: Cancer and Leukemia Group B; National Cancer Institute (NCI); North Central Cancer Treatment Group
• Treatments: Docetaxel; Estramustine; Hormones; Mitoxantrone; Prednisone

Criteria

DISEASE CHARACTERISTICS:

• Histologically confirmed metastatic adenocarcinoma of the prostate

• Unresponsive or refractory to hormonal therapy, as defined by at least 1 of the following criteria:

• Progression of bidimensionally measurable disease

• Progression of evaluable but not measurable disease (bone scan)

• At least 2 consecutive rises in PSA and a PSA level of at least 5 ng/mL

• No minimum PSA required for measurable disease or non-PSA evaluable disease

• Soft tissue disease that has been irradiated within the past 2 months is not considered measurable disease

• Prior orchiectomy OR

• Medical castration using leuprolide or goserelin

• Luteinizing hormone-releasing hormone (LHRH) agonist therapy must continue during study

• Prior nonsteroidal antiandrogens (flutamide, ketoconazole, bicalutamide, or nilutamide) allowed if disease progression occurred

• No third-space fluid accumulation such as ascites or symptomatic pleural effusion

• No brain metastases

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• SWOG 0-3

• Performance status 3 must be due to pain secondary to bone metastases

Life expectancy:

• Not specified

Hematopoietic:

• No hypercoagulability

Hepatic:

• Not specified

Renal:

• Creatinine no greater than 2.0 mg/dL

Cardiovascular:

• No history of myocardial infarction

• No history of congestive heart failure unless well controlled

• No history of cerebrovascular accident or atrial fibrillation

• No active thrombophlebitis

• Left ventricular ejection fraction (LVEF) at least 50% by Multi Gated Acquisition Scan (MUGA) scan or 2-D echocardiogram

Pulmonary:

• No history of pulmonary embolus

Other:

• Recovered from major infections

• No other significant active medical illness

• No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer currently in complete remission

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• At least 4 weeks since prior biologic therapy and recovered

• No more than 1 prior biologic therapy regimen

• No concurrent biological response modifiers

Chemotherapy:

• At least 4 weeks since prior chemotherapy and recovered

• No more than 1 prior chemotherapy regimen

• No prior estramustine, taxanes, anthracyclines, or mitoxantrone

• No other concurrent chemotherapy

Endocrine therapy:

• See Disease Characteristics

• At least 4 weeks since prior flutamide or ketoconazole (6 weeks for bicalutamide or nilutamide)

• No concurrent corticosteroids or hormonal therapy (except megestrol for hot flashes or continuing LHRH treatment)

Radiotherapy:

• See Disease Characteristics

• Prior samarium Sm 153 lexidronam pentasodium allowed

• At least 4 weeks since prior radiotherapy and recovered

• No prior radiotherapy to 30% or more of bone marrow

• No prior strontium chloride Sr 89

• No concurrent radiotherapy

Surgery:

• See Disease Characteristics

• At least 3 weeks since prior surgery and recovered

Other:

• At least 4 weeks since prior bisphosphonates

• No prior anticoagulation therapy (i.e., warfarin), except aspirin

• No concurrent bisphosphonates