Neoplasms

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Symptoms and General Pathology

Prostatic Neoplasms

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Urogenital Neoplasms

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Genital Diseases, Male

Urogenital Diseases

Prostatic Diseases

Male Urogenital Diseases

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Androgens

Exemestane

Bicalutamide

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Estrogens

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Hormones

Hormone Antagonists

Androgen Antagonists

Patients receive oral exemestane once daily

Patients receive exemestane as in arm I and oral bicalutamide once daily

Exemestane as in arm I and oral bicalutamide once daily

Exemestane+bicalutamide

Marco Bonomo, MD

RATIONALE: Androgens can stimulate the growth of prostate cancer cells. Hormone therapy using exemestane plus bicalutamide may fight prostate cancer by reducing the production of androgens. It is not yet known if exemestane is more effective with or without bicalutamide in treating prostate cancer.

PURPOSE: Randomized phase II trial to study the effectiveness of exemestane with or without bicalutamide in treating patients who have stage IV prostate cancer that has been previously treated with hormone therapy or surgery.

OBJECTIVES:

* Compare the efficacy and tolerability of exemestane with or without bicalutamide as second-line therapy after failure of androgen suppression (luteinizing hormone-releasing hormone agonist or orchiectomy) in patients with stage IV prostate cancer.
* Determine the potential antagonistic effect of the weak androgen action of exemestane when combined with bicalutamide in these patients.
* Compare the quality of life (QOL) in patients treated with these regimens.
* Correlate prostate-specific antigen response and data of QOL, including scores for pain intensity and analgesic consumption, in patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to performance status (0 vs 1-2), pain (none or mild vs moderate or severe), and participating center. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive oral exemestane once daily.
* Arm II: Patients receive exemestane as in arm I and oral bicalutamide once daily.

Treatment in both arms continues every 4 weeks for a minimum of 2 courses in the absence of disease progression or unacceptable toxicity.

Quality of life and pain are assessed at baseline, on day 1 of course 2 and any subsequent courses, and at disease progression or treatment failure (if applicable).

Patients are followed monthly until disease progression.

PROJECTED ACCRUAL: A total of 20-62 patients (10-31 per treatment arm) will be accrued for this study.

Exemestane With or Without Bicalutamide in Treating Patients With Stage IV Prostate Cancer

A Randomized Phase II Trial of Exemestane With and Without Bicalutamide as Second Line Therapy After Failure of Androgen Suppression in Advanced Prostate Cancer

Swiss Group for Clinical Cancer Research

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Exemestane With or Without Bicalutamide in Treating Patients With Stage IV Prostate Cancer	NCT00031889	Prostate Cancer	Exemestane Exemestane+bica...	18 Years -	Swiss Group for Clinical Cancer Research
Exemestane With or Without Bicalutamide in Treating Patients With Stage IV Prostate Cancer	NCT00031889	Prostate Cancer	Exemestane Exemestane+bica...	18 Years -	Swiss Group for Clinical Cancer Research

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