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Brief Title: Tadalafil in Preventing Erectile Dysfunction in Patients With Prostate Cancer Treated With Radiation Therapy
Official Title: A Randomized, Double-blind, Placebo-controlled Phase III Trial to Evaluate the Effectiveness of a Phosphodiesterase 5 Inhibitor, Tadalafil, in Prevention of Erectile Dysfunction in Patients Treated With Radiotherapy for Prostate Cancer
Study ID: NCT00931528
Brief Summary: RATIONALE: Tadalafil may help prevent erectile dysfunction (ED) in patients with prostate cancer that has been treated with radiation therapy. It is not yet known whether tadalafil is more effective than a placebo in preventing erectile dysfunction. PURPOSE: This randomized phase III trial is studying tadalafil to see how well it works compared with a placebo in preventing erectile dysfunction in patients with prostate cancer treated with radiation therapy.
Detailed Description: OBJECTIVES: Primary * To determine whether tadalafil maintains spontaneous (off-drug) erectile function, as measured by the International Index of Erectile Function (IIEF) as compared to placebo at weeks 28-30 after initiation of radiotherapy in patients with prostate cancer. Secondary * Determine the difference in spontaneous (off-drug) erectile function between tadalafil and placebo at 1 and 2 years. * Determine the difference in overall sexual function as measured by the IIEF between tadalafil and placebo at weeks 28-30 and at 1 and 2 years. * Determine differences in patient and partner overall sexual satisfaction as measured by the Sexual Adjustment Questionnaire (SAQ) between tadalafil and placebo at weeks 28-30 and at 1 and 2 years. * Determine differences in patient and partner marital adjustment as measured by Locke's Marital Adjustment Test (LMAT) between tadalafil and placebo at weeks 28-30 and at 1 and 2 years. * Determine associations between patient and partner overall sexual satisfaction as measured by SAQ and patient and partner marital adjustment as measured by LMAT at weeks 28-30 and at 1 and 2 years. * Determine patient-related factors (i.e., age, pretreatment sexual response, tobacco use, and comorbidities) that may predict response to tadalafil therapy at weeks 28-30 and at 1 and 2 years. * Determine the difference in adverse events between tadalafil and placebo as assessed by Common Toxicity Criteria for Adverse Effects (CTCAE) v3.0 criteria. Tertiary * Characterization of preference and erectile function among patients who choose to stay on (or if on placebo, to start) tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor other than tadalafil, a non-PDE5-inhibitor erectile aide, or no PDE5 inhibitor or erectile aide at 28-30 weeks and at 1 and 2 years. * Identification of radiotherapy factors (i.e., modality, prescribed total dose, planning target volume margin, penile bulb dose-volume parameters) associated with erectile function. * Evaluation of the number of patients screened for eligibility, the number eligible that are presented the study, the number who refuse, and the number who are accrued. OUTLINE: This is a multicenter study. Patients are stratified according to age (≤ 65 years vs \> 65 years) and radiotherapy treatment (external beam radiation therapy vs brachytherapy\*). Patients are randomized to 1 of 2 treatment arms. Note: \* Radiotherapy start date for brachytherapy patients is the date of the procedure. All patients undergo either external beam radiotherapy alone to the prostate ± seminal vesicles only or low-dose rate permanent brachytherapy alone. * Arm I: Beginning ≤ 7 days after the start of radiotherapy, patients receive oral tadalafil once daily for 24 weeks in the absence of disease progression or unacceptable toxicity. * Arm II: Beginning ≤ 7 days after the start of radiotherapy, patients receive oral placebo once daily for 24 weeks in the absence of disease progression or unacceptable toxicity. Patients complete the International Index of Erectile Function (IIEF), the Sexual Adjustment Questionnaire (SAQ), the Locke's Marital Adjustment Test (LMAT) (if applicable), and the Expanded Prostate Cancer Index Composite Sexual Medications and Devices Evaluations Supplement questionnaires periodically. Partners or spouses complete the SAQ-Partner, LMAT (if applicable), and IIEF questionnaires periodically. After completion of study treatment, patients are followed at 28-30 weeks, and annually for up to 2 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: MALE
Healthy Volunteers: Yes
University of Alabama at Birmingham, Birmingham, Alabama, United States
Providence Hospital, Mobile, Alabama, United States
Arizona Center for Cancer Care-Peoria, Peoria, Arizona, United States
Mayo Clinic in Arizona, Scottsdale, Arizona, United States
Arizona Oncology Services Foundation, Scottsdale, Arizona, United States
Arizona Oncology Associates-West Orange Grove, Tucson, Arizona, United States
Sutter Cancer Centers Radiation Oncology Services-Auburn, Auburn, California, United States
Alta Bates Summit Medical Center-Herrick Campus, Berkeley, California, United States
Sutter Cancer Centers Radiation Oncology Services-Cameron Park, Cameron Park, California, United States
Mercy San Juan Medical Center, Carmichael, California, United States
Enloe Medical Center, Chico, California, United States
Saint Agnes Medical Center, Fresno, California, United States
Veterans Administration Long Beach Medical Center, Long Beach, California, United States
Northridge Hospital Medical Center, Northridge, California, United States
Kaiser Permanente Oakland-Broadway, Oakland, California, United States
Sutter Cancer Centers Radiation Oncology Services-Roseville, Roseville, California, United States
Radiological Associates of Sacramento, Sacramento, California, United States
Mercy General Hospital Radiation Oncology Center, Sacramento, California, United States
UCSF-Mount Zion, San Francisco, California, United States
California Pacific Medical Center, San Francisco, California, United States
Kaiser Permanente Cancer Treatment Center, South San Francisco, California, United States
Sutter Cancer Centers Radiation Oncology Services-Vacaville, Vacaville, California, United States
Sutter Solano Medical Center, Vallejo, California, United States
University of Colorado Cancer Center - Anschutz Cancer Pavilion, Aurora, Colorado, United States
Penrose-Saint Francis Healthcare, Colorado Springs, Colorado, United States
The Hospital of Central Connecticut, New Britain, Connecticut, United States
Christiana Care Health System-Christiana Hospital, Newark, Delaware, United States
Washington Hospital Center, Washington, District of Columbia, United States
Broward Health North, Deerfield Beach, Florida, United States
University of Florida, Gainesville, Florida, United States
Cancer Specialists of North Florida-Beaches, Jacksonville Beach, Florida, United States
Baptist Cancer Institute, Jacksonville, Florida, United States
Cancer Specialists of North Florida-Southside, Jacksonville, Florida, United States
University of Florida Health Science Center, Jacksonville, Florida, United States
Mayo Clinic in Florida, Jacksonville, Florida, United States
Cancer Specialists of North Florida-Baptist South, Jacksonville, Florida, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center, Miami, Florida, United States
21st Century Oncology-Orange Park, Orange Park, Florida, United States
21st Century Oncology-Palatka, Palatka, Florida, United States
Cancer Specialists of North Florida-Saint Augustine, Saint Augustine, Florida, United States
John B Amos Cancer Center, Columbus, Georgia, United States
Atlanta VA Medical Center, Decatur, Georgia, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler, Savannah, Georgia, United States
Queen's Medical Center, Honolulu, Hawaii, United States
University of Hawaii Cancer Center, Honolulu, Hawaii, United States
The Cancer Center of Hawaii-Liliha, Honolulu, Hawaii, United States
Saint Alphonsus Cancer Care Center-Boise, Boise, Idaho, United States
Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States
Advocate Lutheran General Hospital., Park Ridge, Illinois, United States
Saint John's Hospital, Springfield, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
Saint Vincent Anderson Regional Hospital/Cancer Center, Anderson, Indiana, United States
IU Health Bloomington, Bloomington, Indiana, United States
Radiation Oncology Associates PC, Fort Wayne, Indiana, United States
Parkview Hospital Randallia, Fort Wayne, Indiana, United States
IU Health Goshen Center for Cancer Care, Goshen, Indiana, United States
Memorial Hospital of South Bend, South Bend, Indiana, United States
Northern Indiana Cancer Research Consortium, South Bend, Indiana, United States
Baptist Health Lexington, Lexington, Kentucky, United States
Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana, United States
Ochsner Clinic CCOP, New Orleans, Louisiana, United States
Central Maine Medical Center, Lewiston, Maine, United States
Maine Medical Center- Scarborough Campus, Scarborough, Maine, United States
University of Maryland/Greenebaum Cancer Center, Baltimore, Maryland, United States
Saint Agnes Hospital, Baltimore, Maryland, United States
Johns Hopkins University/Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, United States
Central Maryland Radiation Oncology in Howard County, Columbia, Maryland, United States
Tate Cancer Center, Glen Burnie, Maryland, United States
Saint Anne's Hospital, Fall River, Massachusetts, United States
Cape Cod Hospital, Hyannis, Massachusetts, United States
Bronson Battle Creek, Battle Creek, Michigan, United States
Huron Valley-Sinai Hospital, Commerce, Michigan, United States
Wayne State University/Karmanos Cancer Institute, Detroit, Michigan, United States
Henry Ford Hospital, Detroit, Michigan, United States
Saint John Hospital and Medical Center, Detroit, Michigan, United States
McLaren-Flint, Flint, Michigan, United States
Mercy Health Saint Mary's, Grand Rapids, Michigan, United States
Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, United States
West Michigan Cancer Center, Kalamazoo, Michigan, United States
William Beaumont Hospital-Royal Oak, Royal Oak, Michigan, United States
Saint Mary's of Michigan, Saginaw, Michigan, United States
Saint Luke's Hospital of Duluth, Duluth, Minnesota, United States
Mayo Clinic, Rochester, Minnesota, United States
Coborn Cancer Center at Saint Cloud Hospital, Saint Cloud, Minnesota, United States
United Hospital, Saint Paul, Minnesota, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
Barnes-Jewish West County Hospital, Saint Louis, Missouri, United States
Siteman Cancer Center - Saint Peters, Saint Peters, Missouri, United States
Good Samaritan Hospital, Kearney, Nebraska, United States
Saint Elizabeth Regional Medical Center, Lincoln, Nebraska, United States
Nebraska Methodist Hospital, Omaha, Nebraska, United States
Concord Hospital, Concord, New Hampshire, United States
Wentworth-Douglass Hospital, Dover, New Hampshire, United States
Exeter Hospital, Exeter, New Hampshire, United States
Elliot Hospital, Manchester, New Hampshire, United States
Cooper Hospital University Medical Center, Camden, New Jersey, United States
MD Anderson Cancer Center at Cooper-Voorhees, Voorhees, New Jersey, United States
University of New Mexico Cancer Center, Albuquerque, New Mexico, United States
Memorial Medical Center - Las Cruces, Las Cruces, New Mexico, United States
New York Oncology Hematology PC - Albany, Albany, New York, United States
Southside Hospital, Bay Shore, New York, United States
Lourdes Hospital, Binghamton, New York, United States
Veteran Affairs New York Harbor Healthcare System-Brooklyn Campus, Brooklyn, New York, United States
Roswell Park Cancer Institute, Buffalo, New York, United States
Long Island Jewish Medical Center, New Hyde Park, New York, United States
Columbia University Medical Center, New York, New York, United States
Mission Hospital-Memorial Campus, Asheville, North Carolina, United States
Duke University Medical Center, Durham, North Carolina, United States
High Point Regional Hospital, High Point, North Carolina, United States
The Coleman Radiation Center-Carteret General Hospital, Morehead City, North Carolina, United States
CarolinaEast Health System-Medical Center, New Bern, North Carolina, United States
South Atlantic Radiation Oncology, Supply, North Carolina, United States
Coastal Carolina Radiation Oncology, Wilmington, North Carolina, United States
New Hanover Regional Medical Center, Wilmington, North Carolina, United States
Summa Akron City Hospital/Cooper Cancer Center, Akron, Ohio, United States
Summa Barberton Hospital, Barberton, Ohio, United States
University of Cincinnati, Cincinnati, Ohio, United States
Case Western Reserve University, Cleveland, Ohio, United States
Cleveland Clinic Cancer Center/Fairview Hospital, Cleveland, Ohio, United States
Cleveland Clinic Foundation, Cleveland, Ohio, United States
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center, Columbus, Ohio, United States
Ohio State University Medical Center, Columbus, Ohio, United States
Cleveland Clinic Cancer Center Independence, Independence, Ohio, United States
Toledo Clinic Cancer Centers-Maumee, Maumee, Ohio, United States
Hillcrest Hospital Cancer Center, Mayfield Heights, Ohio, United States
Lake University Ireland Cancer Center, Mentor, Ohio, United States
Southwest General Health Center Ireland Cancer Center, Middleburg Heights, Ohio, United States
UHHS-Chagrin Highlands Medical Center, Orange Village, Ohio, United States
Cancer Care Center, Incorporated, Salem, Ohio, United States
Flower Hospital, Sylvania, Ohio, United States
UHHS-Westlake Medical Center, Westlake, Ohio, United States
Cancer Treatment Center, Wooster, Ohio, United States
Cleveland Clinic Wooster Specialty Center, Wooster, Ohio, United States
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
Clackamas Radiation Oncology Center, Clackamas, Oregon, United States
Willamette Valley Cancer Center, Eugene, Oregon, United States
Three Rivers Community Hospital, Grants Pass, Oregon, United States
Providence Medford Medical Center, Medford, Oregon, United States
Rogue Valley Medical Center, Medford, Oregon, United States
Providence Portland Medical Center, Portland, Oregon, United States
Western Oncology Research Consortium, Portland, Oregon, United States
Providence Saint Vincent Medical Center, Portland, Oregon, United States
Abington Memorial Hospital, Abington, Pennsylvania, United States
Bryn Mawr Hospital, Bryn Mawr, Pennsylvania, United States
Delaware County Memorial Hospital, Drexel Hill, Pennsylvania, United States
Fox Chase Cancer Center Buckingham, Furlong, Pennsylvania, United States
Adams Cancer Center, Gettysburg, Pennsylvania, United States
Cherry Tree Cancer Center, Hanover, Pennsylvania, United States
Academic Urology Prostate Center, King Of Prussia, Pennsylvania, United States
Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States
Albert Einstein Medical Center, Philadelphia, Pennsylvania, United States
Lankenau Medical Center, Wynnewood, Pennsylvania, United States
WellSpan Health-York Hospital, York, Pennsylvania, United States
Spartanburg Regional Medical Center, Spartanburg, South Carolina, United States
Rapid City Regional Hospital, Rapid City, South Dakota, United States
Texas Oncology-Denton South, Denton, Texas, United States
The Klabzuba Cancer Center, Fort Worth, Texas, United States
University of Texas Medical Branch at Galveston, Galveston, Texas, United States
West Texas Cancer Center, Odessa, Texas, United States
University of Texas Health Science Center, San Antonio, Texas, United States
Texas Cancer Center-Sherman, Sherman, Texas, United States
Texas Oncology Cancer Center Sugar Land, Sugar Land, Texas, United States
Tyler Cancer Center, Tyler, Texas, United States
Intermountain Medical Center, Murray, Utah, United States
Utah Valley Regional Medical Center, Provo, Utah, United States
Dixie Medical Center Regional Cancer Center, Saint George, Utah, United States
Utah Cancer Specialists-Salt Lake City, Salt Lake City, Utah, United States
Huntsman Cancer Institute/University of Utah, Salt Lake City, Utah, United States
University of Virginia, Charlottesville, Virginia, United States
Danville Regional Medical Center, Danville, Virginia, United States
Virginia Mason CCOP, Seattle, Washington, United States
Compass Oncology Vancouver, Vancouver, Washington, United States
Appleton Medical Center, Appleton, Wisconsin, United States
Saint Vincent Hospital, Green Bay, Wisconsin, United States
Gundersen Lutheran, La Crosse, Wisconsin, United States
Mayo Clinic Health System-Franciscan Healthcare, La Crosse, Wisconsin, United States
Bay Area Medical Center, Marinette, Wisconsin, United States
Aurora Saint Luke's Medical Center, Milwaukee, Wisconsin, United States
Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin, United States
Oconomowoc Memorial Hospital-ProHealth Care Inc, Oconomowoc, Wisconsin, United States
Door County Cancer Center, Sturgeon Bay, Wisconsin, United States
Waukesha Memorial Hospital - ProHealth Care, Waukesha, Wisconsin, United States
Aurora West Allis Medical Center, West Allis, Wisconsin, United States
Tom Baker Cancer Centre, Calgary, Alberta, Canada
Cross Cancer Institute, Edmonton, Alberta, Canada
BCCA-Cancer Centre for the Southern Interior, Kelowna, British Columbia, Canada
BCCA-Fraser Valley Cancer Centre, Surrey, British Columbia, Canada
BCCA-Vancouver Cancer Centre, Vancouver, British Columbia, Canada
Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada
London Regional Cancer Program, London, Ontario, Canada
CHUQ - Pavilion Hotel-Dieu de Quebec, Quebec City, Quebec, Canada
Allan Blair Cancer Centre, Regina, Saskatchewan, Canada
Name: Deborah Watkins Bruner, RN, PhD
Affiliation: Abramson Cancer Center at Penn Medicine
Role: PRINCIPAL_INVESTIGATOR