E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with biochemical recurrence after primary treatment of prostate cancer presenting with ≤4 metastases |
Patiënten met biochemisch recidief na primaire behandeling van prostaatkanker met ≤4 metastasen |
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E.1.1.1 | Medical condition in easily understood language |
Metastatic prostate cancer |
Uitgezaaide prostaat kanker |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The overall aim of this project is to test the hypothesis that the addition of ADT to metastasis-directed radiotherapy (MDRT) in well-selected PCa patients with oligo-metastatic disease prolongs the metastases progression-free survival (MPFS) compared to MDRT alone |
Het algemene doel van dit project is de hypothese te testen dat de toevoeging van ADT aan metastase-gerichte radiotherapie (MDRT) bij goed geselecteerde PCa-patiënten met oligo-metastatische ziekte de metastasen-progressievrije overleving (MPFS) verlengt in vergelijking met alleen MDRT |
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E.2.2 | Secondary objectives of the trial |
Not applicable |
Niet van toepassing |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Histologically proven initial diagnosis of adenocarcinoma of the Prostate. 2. Biochemical recurrence of prostate cancer following primary local prostate treatment (radical prostatectomy, primary radiotherapy or radical prostatectomy +/- prostate bed adjuvant salvage radiotherapy) according to the EAU guidelines 2018. BCR after surgery: PSA > 0.1ng/ml. BCR after radiotherapy: PSA nadir +2 ng/ml (after exclusion of possible bounce effect). 3. Maximum 4 lesions (bone + lymph nodes) in total, without evidence of visceral metastases. a. Nodal relapse (N1) in the pelvis on PSMA-PET scan with a maximum of 4 positive lymph nodes. The upper limit of the pelvis is defined as the aortic bifurcation. b. Nodal relapse (M1) on PSMA-PET scan above the aortic bifurcation with a maximum of 3 positive lymph nodes. c. Bone relapse on PSMA-PET scan with a maximum of 3 lesions. 4. Age > 18 years. 5. PSMA-PET/CT scan or PSMA-PET/MRI within 60 days prior to randomization. 6. PSA < 10 ng/ml. 7. In case of chronic use of finasteride the PSA value should be < 5 ng/ml 8. WHO performance state 0-2. 9. Signed informed consent prior to registration/randomization.
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1. Histologisch bewezen initiële diagnose van adenocarcinoom van de prostaat. 2. Biochemische herhaling van prostaatkanker na primaire lokale prostaatbehandeling (radicale prostatectomie, primaire radiotherapie of radicale prostatectomie +/- adjuvante berging radiotherapie) volgens de EAU-richtlijnen 2018. BCR na chirurgie: PSA> 0,1 ng / ml. BCR na radiotherapie: PSA nadir +2 ng / ml (na uitsluiting van mogelijk bounce-effect). 3. Maximaal 4 laesies (bot + lymfeklieren) in totaal, zonder bewijs van viscerale metastasen. a. Nodal recidief (N1) in het bekken op PSMA-PET scan met maximaal 4 positieve lymfeklieren. De bovengrens van het bekken wordt gedefinieerd als de aortabifurcatie. b. Nodale recidief (M1) op PSMA-PET scan boven de aortabifurcatie met maximaal 3 positieve lymfeklieren. c. Terugval van het bot op PSMA-PET scan met maximaal 3 laesies. 4. Leeftijd> 18 jaar. 5. PSMA-PET/CT scan of PSMA-PET/MRI binnen 60 dagen voorafgaand aan randomisatie. 6. PSA <10 ng / ml. 7. In geval van chronisch gebruik van finasteride moet de PSA-waarde <5 ng / ml zijn 8. WHO-prestatiestatus 0-2. 9. Ondertekende geïnformeerde toestemming voorafgaand aan registratie / randomisatie. |
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E.4 | Principal exclusion criteria |
1. Visceral metastases. 2. PSA ≥ 10 ng/ml. 3. PSA-doubling time < 3 months. 4. ADT or chemotherapy for recurrent PCa. 5. Testosterone < 1.7 nmol/l 6. Painful metastases needed pain medication 7. Previous or concurrent invasive active cancers other than superficial non-melanoma skin cancers. 8. Inability to understand the information on trial-related topics, to give informed consent or to fill out QoL questionnaires.
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Tekst
Documenten
Taal herkennen
Engels
Nederlands Frans
Nederlands
Engels
Frans
1. Visceral metastases. 2. PSA ≥ 10 ng/ml. 3. PSA-doubling time < 3 months. 4. ADT or chemotherapy for recurrent PCa. 5. Testosterone < 1.7 nmol/l 6. Painful metastases needed pain medication 7. Previous or concurrent invasive active cancers other than superficial non-melanoma skin cancers. 8. Inability to understand the information on trial-related topics, to give informed consent or to fill out QoL questionnaires.
422/5000
1. Viscerale metastasen. 2. PSA ≥ 10 ng / ml. 3. PSA-verdubbelingstijd <3 maanden. 4. ADT of chemotherapie voor terugkerende PCa. 5. Testosteron <1,7 nmol / l 6. Pijnlijke metastasen hadden pijnmedicatie nodig 7. Eerdere of gelijktijdige invasieve actieve kankers anders dan oppervlakkige niet-melanoom huidkanker. 8. Onvermogen om de informatie over proefgerelateerde onderwerpen te begrijpen, geïnformeerde toestemming te geven of QoL-vragenlijsten in te vullen. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the 2-year metastases progression free survival |
Het primaire eindpunt is de 2-jarige metastasen progressievrije overleving |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Secondary endpoints are acute and late toxicity, quality of life (QoL), biochemical recurrence free survival and overall survival
- 3 years PSA progression - Start of 2nd line treatment - Start 2nd MDRT treatment for new (progressive) oligo-metastases - Acute and late toxicity (late toxicity up to 3 years) - Clinical progression-free survival - Quality of life - Relapse pattern - Time to start of palliative ADT - Time to castration-resistance - Disease-specific and overall survival - Sensitivity of the imaging modality (PSMA-PET/CT or PSMA-PET/MRI) for patients receiving MDRT |
Secundaire eindpunten zijn acute en late toxiciteit, kwaliteit van leven (QoL), biochemische recidiefvrije overleving en totale overleving
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
alleen radiotherapie |
only radiotherapy |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |