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Brief Title: Dexamethasone, Aspirin, and Diethylstilbestrol in Treating Patients With Locally Advanced or Metastatic Prostate Cancer
Official Title: A Randomized Phase III Trial of Dexamethasone and Aspirin (DA) Versus Dexamethasone, Diethylstilbestrol and Aspirin (DAS) in Locally Advanced or Metastatic Cancer of the Prostate - Immediate Versus Deferred Diethylstilbestrol
Study ID: NCT00316927
Brief Summary: RATIONALE: Giving dexamethasone together with aspirin and diethylstilbestrol may be effective in lowering prostate-specific antigen levels and may slow or stop the growth of prostate cancer. It is not yet known which schedule of dexamethasone, aspirin, and diethylstilbestrol is more effective in treating prostate cancer. PURPOSE: This randomized phase III trial is studying dexamethasone and aspirin when given together with two different schedules of diethylstilbestrol to compare how well they work in treating patients with locally advanced or metastatic prostate cancer.
Detailed Description: OBJECTIVES: Primary * Compare the prostate-specific antigen (PSA) response in patients with locally advanced or metastatic prostate cancer treated with dexamethasone and aspirin with delayed vs immediate diethylstilbestrol. Secondary * Compare the overall response rate in patients treated with these regimens. * Compare the quality of life of patients treated with these regimens. * Compare the progression-free and overall survival of patients treated with these regimens. OUTLINE: This is a randomized, controlled, multicenter study. Patients are stratified according to ECOG performance status (0 vs 1-3), prostate-specific antigen (PSA) response to prior therapy (PSA normalization vs inability to normalize), and bone scan (positive vs negative for bony metastases). Patients are randomized to 1 of 2 treatment arms. * Arm I (deferred diethylstilbestrol): Patients receive oral dexamethasone and oral acetylsalicyclic acid once daily (DA). Subsequent to treatment failure with DA, patients continue to receive DA as before in addition to oral diethylstilbestrol once daily (DAS). Treatment with DAS continues in the absence of disease progression or unacceptable toxicity. * Arm II (immediate diethylstilbestrol): Patients receive oral dexamethasone, oral acetylsalicyclic acid, and oral diethylstilbestrol once daily (DAS). Treatment continues in the absence of disease progression or unacceptable toxicity. Quality of life is evaluated monthly during study treatment. After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months thereafter. PROJECTED ACCRUAL: A total of 260 patients will be accrued for this study.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: MALE
Healthy Volunteers: No
Bristol Haematology and Oncology Centre, Bristol, England, United Kingdom
Burnley General Hospital, Burnley, England, United Kingdom
Kent and Canterbury Hospital, Canterbury, England, United Kingdom
Eastbourne District General Hospital, Eastbourne, England, United Kingdom
Whipps Cross Hospital, London, England, United Kingdom
Saint Bartholomew's Hospital, London, England, United Kingdom
Chelsea Westminster Hospital, London, England, United Kingdom
Maidstone Hospital, Maidstone, England, United Kingdom
Milton Keynes General Hospital, Milton Keynes, England, United Kingdom
Churchill Hospital, Oxford, England, United Kingdom
Oldchurch Hospital, Romford, England, United Kingdom
Torbay Hospital, Torquay Devon, England, United Kingdom
Weston General Hospital, Weston-super-Mare, England, United Kingdom
Worthing Hospital, Worthing, England, United Kingdom
Cancer Care Centre at York Hospital, York, England, United Kingdom
Name: Jonathan Shamash, MD, FRCP
Affiliation: St. Bartholomew's Hospital
Role: STUDY_CHAIR