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A Randomized Double-Blind, Placebo-Controlled Phase III Study of Early Versus Standard Zoledronic Acid to Prevent Skeletal Related Events in Men With Prostate Cancer Metastatic to Bone


Phase 3
18 Years
N/A
Open (Enrolling)
Male
Metastatic Cancer, Prostate Cancer

Thank you

Trial Information

A Randomized Double-Blind, Placebo-Controlled Phase III Study of Early Versus Standard Zoledronic Acid to Prevent Skeletal Related Events in Men With Prostate Cancer Metastatic to Bone


OBJECTIVES:

Primary

- Compare the time to first skeletal-related events in patients with prostate cancer and
bone metastases undergoing androgen deprivation therapy when treated with zoledronate
vs placebo.

Secondary

- Compare the overall and progression-free survival of patients treated with these
regimens.

- Compare the toxic effects in patients treated with these regimens.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study followed
by an open-label study. Patients are stratified according to ECOG performance status (0-1 vs
2), prior skeletal-related event (no vs yes), and serum alkaline phosphatase (< upper limit
of normal [ULN] vs ≥ ULN). Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive zoledronate IV over 15 minutes on day 1.

- Arm II: Patients receive placebo IV over 15 minutes on day 1. In both arms, courses
repeat every 4 weeks in the absence of disease progression or a skeletal-related event.
All patients receive concurrent androgen deprivation therapy. Patients also receive
oral calcium and cholecalciferol (vitamin D) supplements daily.

Patients progressing to androgen-independent prostate cancer proceed to open-label therapy
comprising zoledronate IV over 15 minutes on day 1. Courses repeat every 3 weeks in the
absence of disease progression or a skeletal-related event.

Patients are followed periodically for approximately 10 years after randomization.

PROJECTED ACCRUAL: A total of 680 patients (340 per treatment arm) will be accrued for this
study within 4 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Histologically confirmed adenocarcinoma of the prostate

- No small cell, neuroendocrine, or transitional cell carcinomas

- At least 1 bone metastasis by bone scan, MRI, CT scan, or plain radiographs

- Indeterminate lesions should be confirmed by a second imaging method

- At least 1 bone metastasis with no prior irradiation

- Concurrent androgen deprivation therapy required, defined as any of the following:

- Bilateral orchiectomy

- Gonadotropin-releasing hormone (GnRH) agonist with or without an antiandrogen

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- ECOG 0-2

Life expectancy

- Not specified

Hematopoietic

- Not specified

Hepatic

- Not specified

Renal

- Creatinine clearance ≥ 30 mL/min

- Corrected calcium ≥ 8.0 mg/dL and < 11.6 mg/dL

Other

- Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

- Concurrent standard biologic response modifiers allowed during open-label therapy
only

Chemotherapy

- Concurrent standard cytotoxic chemotherapy allowed during open-label therapy only

Endocrine therapy

- See Disease Characteristics

- Prior neoadjuvant and/or adjuvant hormonal therapy allowed provided duration of
therapy was no more than 6 months AND therapy was discontinued more than 6 months
before study entry

- No more than 6 months since initiation of any of the following hormonal therapies:

- Orchiectomy

- GnRH agonist (e.g., leuprolide, goserelin, or triptorelin)

- Estrogen therapy

- Antiandrogens (e.g., bicalutamide, flutamide, or nilutamide)

- Any other therapy known to lower testosterone levels or inhibit testosterone
effect

- No intermittent androgen deprivation therapy except for patients concurrently
enrolled on SWOG-9346

- Concurrent palliative corticosteroids allowed during open-label therapy only

- Concurrent standard hormonal agents allowed during open-label therapy only

Radiotherapy

- See Disease Characteristics

- No prior radiopharmaceuticals

- At least 4 weeks since prior radiotherapy

- Concurrent standard radiotherapy to extraskeletal tumor sites allowed during
open-label therapy only

Surgery

- See Disease Characteristics

Other

- No prior bisphosphonates

- No prior denosumab

- No other concurrent agents expected to alter osteoclast activity (e.g., denosumab,
calcitonin, mithramycin, gallium nitrate, or any other bisphosphonate)

- Concurrent daily supplemental elemental calcium (500 mg) and a multivitamin
containing cholecalciferol (Vitamin D) (400 IU) OR a combination tablet containing
both recommended

- Concurrent standard marketed antineoplastic therapies allowed during open-label
therapy only

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Time to first skeletal related event

Safety Issue:

No

Principal Investigator

Matthew R. Smith, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Massachusetts General Hospital

Authority:

United States: Food and Drug Administration

Study ID:

CDR0000353209

NCT ID:

NCT00079001

Start Date:

January 2004

Completion Date:

Related Keywords:

  • Metastatic Cancer
  • Prostate Cancer
  • adenocarcinoma of the prostate
  • recurrent prostate cancer
  • stage IV prostate cancer
  • bone metastases
  • Neoplasm Metastasis
  • Neoplasms
  • Neoplasms, Second Primary
  • Prostatic Neoplasms

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263
Cardinal Bernardin Cancer Center at Loyola University Medical Center Maywood, Illinois  60153-5500
University of Chicago Cancer Research Center Chicago, Illinois  60637
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Veterans Affairs Medical Center - East Orange East Orange, New Jersey  07018-1095
Rush-Copley Cancer Care Center Aurora, Illinois  60507
Carle Cancer Center at Carle Foundation Hospital Urbana, Illinois  61801
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
Bronson Methodist Hospital Kalamazoo, Michigan  49007
West Michigan Cancer Center Kalamazoo, Michigan  49007-3731
Borgess Medical Center Kalamazooaa, Michigan  49001
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
Duluth Clinic Cancer Center - Duluth Duluth, Minnesota  55805-1983
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
Minnesota Oncology Hematology, PA - Maplewood Maplewood, Minnesota  55109
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
Minnesota Oncology Hematology, PA - Woodbury Woodbury, Minnesota  55125
MetroHealth Cancer Care Center at MetroHealth Medical Center Cleveland, Ohio  44109
St. Rita's Medical Center Lima, Ohio  45801
Memorial Hospital of South Bend South Bend, Indiana  46601
CCOP - Montana Cancer Consortium Billings, Montana  59101
Mercy Hospital Cancer Center - Scranton Scranton, Pennsylvania  18501
CCOP - Greenville Greenville, South Carolina  29615
LDS Hospital Salt Lake City, Utah  84143
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
Holden Comprehensive Cancer Center at University of Iowa Iowa City, Iowa  52242-1002
Cancer Research Center of Hawaii Honolulu, Hawaii  96813
MBCCOP - LSU Health Sciences Center New Orleans, Louisiana  70112
Veterans Affairs Medical Center - Houston Houston, Texas  77030
Utah Valley Regional Medical Center - Provo Provo, Utah  84604
Veterans Affairs Medical Center - Buffalo Buffalo, New York  14215
Veterans Affairs Medical Center - Syracuse Syracuse, New York  13210
Louis A. Weiss Memorial Hospital Chicago, Illinois  60640
Veterans Affairs Medical Center - Baltimore Baltimore, Maryland  21201
Fletcher Allen Health Care - University Health Center Campus Burlington, Vermont  05401
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences Little Rock, Arkansas  72205
Josephine Ford Cancer Center at Henry Ford Hospital Detroit, Michigan  48202
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus Seattle, Washington  98104
SUNY Downstate Medical Center Brooklyn, New York  11203
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
Yale Cancer Center New Haven, Connecticut  06520-8028
SUNY Upstate Medical University Hospital Syracuse, New York  13210
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
Baylor University Medical Center - Houston Houston, Texas  77030-2399
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
CCOP - Hematology-Oncology Associates of Central New York East Syracuse, New York  13057
St. Mary's Hospital Medical Center - Green Bay Green Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
Big Sky Oncology Great Falls, Montana  59405
St. Peter's Hospital Helena, Montana  59601
Kalispell Regional Medical Center Kalispell, Montana  59901
Glacier Oncology, PLLC Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
American Fork Hospital American Fork, Utah  84003
Logan Regional Hospital Logan, Utah  84321
Utah Cancer Specialists at UCS Cancer Center Salt Lake City, Utah  84106
Olympic Hematology and Oncology Bremerton, Washington  98310
Skagit Valley Hospital Cancer Care Center Mt. Vernon, Washington  98273
University Cancer Center at University of Washington Medical Center Seattle, Washington  98195
Group Health Central Hospital Seattle, Washington  98104
North Puget Oncology at United General Hospital Sedro-Wooley, Washington  98284
Cancer Care Northwest - Spokane South Spokane, Washington  99202
Veterans Affairs Medical Center - Loma Linda (Pettis) Loma Linda, California  92357
Veterans Affairs Medical Center - Hines Hines, Illinois  60141
Greenebaum Cancer Center at University of Maryland Medical Center Baltimore, Maryland  21201
UNMC Eppley Cancer Center at the University of Nebraska Medical Center Omaha, Nebraska  68198-7680
New York Weill Cornell Cancer Center at Cornell University New York, New York  10021
UCSF Helen Diller Family Comprehensive Cancer Center San Francisco, California  94115
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center Washington, District of Columbia  20007
University of Illinois Cancer Center Chicago, Illinois  60612-7243
Indiana University Melvin and Bren Simon Cancer Center Indianapolis, Indiana  46202-5289
Dana-Farber/Harvard Cancer Center at Dana-Farber Cancer Institute Boston, Massachusetts  02115
Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis St. Louis, Missouri  63110
CCOP - Nevada Cancer Research Foundation Las Vegas, Nevada  89109-2306
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Oklahoma University Cancer Institute Oklahoma City, Oklahoma  73104
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Huntsman Cancer Institute at University of Utah Salt Lake City, Utah  84112
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Veterans Affairs Medical Center - Chicago Westside Hospital Chicago, Illinois  60612
University Medical Center of Southern Nevada Las Vegas, Nevada  89102
Salinas Valley Memorial Hospital Salinas, California  93901
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Mary Bird Perkins Cancer Center - Baton Rouge Baton Rouge, Louisiana  70809
Louisiana State University Health Sciences Center - Monroe Monroe, Louisiana  71210
Medical Center of Louisiana - New Orleans New Orleans, Louisiana  70112
Feist-Weiller Cancer Center at Louisiana State University Health Sciences Shreveport, Louisiana  71130-3932
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Community Cancer Center of Monroe Monroe, Michigan  48162
Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center Grand Island, Nebraska  68803
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Wood County Oncology Center Bowling Green, Ohio  43402
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
North Coast Cancer Care, Incorporated Sandusky, Ohio  44870
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
Fulton County Health Center Wauseon, Ohio  43567
Kaiser Permanente Health Care - Portland Portland, Oregon  97232
Dixie Regional Medical Center - East Campus Saint George, Utah  84770
Mountainview Medical Berlin, Vermont  05602
Minor and James Medical, PLLC Seattle, Washington  98104
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial Hospital Sheridan, Wyoming  82801
Massachusetts General Hospital Boston, Massachusetts  02114-2617
Hembree Mercy Cancer Center at St. Edward Mercy Medical Center Ft. Smith, Arkansas  72903
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler Savannah, Georgia  31405
Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
William N. Wishard Memorial Hospital Indianapolis, Indiana  46202
Michiana Hematology Oncology PC - La Porte La Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - Plymouth Plymouth, Indiana  46563
Covenant Cancer Treatment Center Waterloo, Iowa  50702
Cotton-O'Neil Cancer Center Topeka, Kansas  66606
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
Michiana Hematology Oncology PC - Niles Niles, Michigan  49120
Lakeside Cancer Specialists, PLLC Saint Joseph, Michigan  49085
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Great Falls Clinic - Main Facility Great Falls, Montana  59405
Sletten Cancer Institute at Benefis Healthcare Great Falls, Montana  59405
Kalispell Medical Oncology at KRMC Kalispell, Montana  59901
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at Ohio State University Comprehensive Cancer Center Columbus, Ohio  43210-1240
Fisher-Titus Medical Center Norwalk, Ohio  44857
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Susquehanna Cancer Center at Divine Providence Hospital Williamsport, Pennsylvania  17701
Sandra L. Maxwell Cancer Center Cedar City, Utah  84720
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center Murray, Utah  84157
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center Ogden, Utah  84403
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
St. Joseph Cancer Center Bellingham, Washington  98225
Columbia Basin Hematology Kennewick, Washington  99336
Evergreen Hematology and Oncology, PS Spokane, Washington  99218
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Ben Taub General Hospital Houston, Texas  77030
Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center Pomona, California  91767
Ruby L. Golleher Cancer Program at Presbyterian Intercommunity Hospital Whittier, California  90602
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Lowell General Hospital Lowell, Massachusetts  01854
Good Samaritan Cancer Center at Good Samaritan Hospital Kearney, Nebraska  68848-1990
Elliot Regional Cancer Center at Elliot Hospital Manchester, New Hampshire  03103
Dana-Farber/Brigham and Women's Cancer Center Boston, Massachusetts  02115
Duke Cancer Institute Durham, North Carolina  27710
Kinston Medical Specialists Kinston, North Carolina  28501
Greenville Hospital Cancer Center Greenville, South Carolina  29605
MBCCOP - Meharry Medical College - Nashville Nashville, Tennessee  37208-3599
La Grange Memorial Hospital La Grange, Illinois  60525
Rockwood Clinic Cancer Treatment Center Spokane, Washington  99204-2967
University of Wisconcin Cancer Center at Aspirus Wausau Hospital Wausau, Wisconsin  54401
Veterans Affairs Medical Center - Iowa City Iowa City, Iowa  52246-2208
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare Vineland, New Jersey  08360
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Union Memorial Hospital Baltimore, Maryland  21218
Good Samaritan Hospital of Maryland Baltimore, Maryland  21239
Lynchburg Hematology-Oncology Clinic Lynchburg, Virginia  24501
Providence Cancer Center at Providence Hospital Mobile, Alabama  36608
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Straub Clinic and Hospital, Incorporated Honolulu, Hawaii  96813
Hawaii Medical Center - East Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Kuakini Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Lusitana Honolulu, Hawaii  96813
Pacific Cancer Institute - Maui Wailuku, Hawaii  96793
Elmhurst Memorial Hospital Elmhurst, Illinois  60126
New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care Concord, New Hampshire  03301
Center for Cancer Care at Exeter Hospital Exeter, New Hampshire  03833
New Hampshire Oncology - Hematology, PA - Hooksett Hooksett, New Hampshire  03106
Bay Area Hospital Coos Bay, Oregon  97420
Fountain Valley, California  92708
Veterans Affairs Medical Center - West Haven West Haven, Connecticut  06516
Lovelace Medical Center - Downtown Albuquerque, New Mexico  87102
Callahan Cancer Center at Great Plains Regional Medical Center North Platte, Nebraska  69103
Provena St. Mary's Regional Cancer Center - Kankakee Kankakee, Illinois  60901
Heartland Oncology and Hematology Council Bluffs, Iowa  51503
Dana-Farber Cancer Institute at Londonderry Londonderry, New Hampshire  03053
Southeastern Regional Medical Center Lumberton, North Carolina  28359
Granville Medical Center Oxford, North Carolina  27565
Duke Health Raleigh Hospital Raleigh, North Carolina  27609
Person Memorial Hospital Roxboro, North Carolina  27573
St. Luke's Texas Cancer Institute at St. Luke's Episcopal Hospital Houston, Texas  77030
Self Regional Cancer Center at Self Regional Medical Center Greenwood, South Carolina  29646
Shore Regional Cancer Center at Memorial Hospital - Easton Easton, Maryland  21601
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Kings County Hospital Center Brooklyn, New York  11203
Kaiser Permanente Capital Area Medical Group - Shady Grove Facility Rockville, Maryland  20850
Nevada Cancer Institute Las Vegas, Nevada  89135
Kaiser Permanente Mid-Atlantic Medical Group-Largo Medical Facility Largo, Maryland  20774
Kaiser Permanente Medical Center - Fair Oaks Fairfax, Virginia  22033
Langlade Memorial Hospital Antigo, Wisconsin  54409
Lakeside Hospital Omaha, Nebraska  68130
Island Hospital Cancer Care Center at Island Hospital Anacortes, Washington  98221
Highline Medical Center Cancer Center Burien, Washington  98166
Riverview UW Cancer Center at Riverview Hospital Wisconsin Rapids, Wisconsin  54494
St. Nicholas Hospital Sheboygan, Wisconsin  53081
Saint Helena Hospital Saint Helena, California  94574
Leesburg Regional Medical Center Leesburg, Florida  34748
John R. Marsh Cancer Center at Washington County Hospital Hagerstown, Maryland  21740
Wheaton Franciscan Cancer Care - St. Joseph Milwaukee, Wisconsin  53210
Highland Clinic Shreveport, Louisiana  71105
Kaiser Permanente at Capitol Hill Medical Center Washington, District of Columbia  20002
Kaiser Permanente at Woodlawn Medical Center Baltimore, Maryland  21244
Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Medical Center Milford, Massachusetts  01757