July 16, 2019
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July 18, 2019
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October 27, 2023
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June 1, 2020
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March 1, 2025 (Final data collection date for primary outcome measure)
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The percentage of patients with a PSA nadir <= 0.5 [ Time Frame: 6 months from end of treatment ] A response is defined as a PSA nadir <= 0.5 within 6 months from end of treatment
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Same as current
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- The percentage of patients with good erectile function at 3 months from end of treatment [ Time Frame: 3 months from end of treatment ]
Good erectile function is defined as firm enough for masturbation or foreplay' or 'firm enough for intercourse' responses to the question "How would you describe the usual quality of your erections during the past 4 weeks" on the EPIC-26 questionnaire.
- PSA progression free survival [ Time Frame: 3 years ]
PSA progression-free survival is defined as the time from randomization to PSA progression (PSA rise of 2 ng/mL above the nadir value).
- Metastasis free survival [ Time Frame: 3 years ]
Metastasis-free survival is defined as the time from randomization to distant metastasis (including bony or visceral) identified on imaging or pathologically, or death due to any cause, or censored at date last known alive.
- Cause specific survival [ Time Frame: 3 years ]
Cause specific survival is defined as the interval from the date of randomization to the date of last known follow-up alive, or the date of death from each of the following causes: prostate cancer, cardiovascular disease, other causes
- To evaluate differences in long-term maintenance of erectile function [ Time Frame: 3 years ]
The answers to EPIC-26 question "How would you describe the usual quality of your erections during the past 4 weeks" from treatment start to the end of follow up at three years show how erectile function has been affected over time.
- Rate of Toxicity [ Time Frame: 3 years ]
Toxicity as measured by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
- Quality of Life impact as measured by Expanded Prostate Cancer Index (EPIC)-26 [ Time Frame: 3 years ]
EPIC-26 is a shortened version of the EPIC questionnaire that evaluates subject's urinary incontinence, urinary irritation/obstruction, bowel, sexual, and hormonal domains. EPIC is a robust prostate-cancer health-related QOL instrument that measures a broad spectrum of symptoms and has been widely validated. For each domain, scales range between 0 (worse) and 100 (better).
- Global health impact as measured by Patient-Reported Outcome Measurement Information System (PROMIS) Global Health Score [ Time Frame: 3 years ]
PROMIS is a standardized method for measuring an individual's global health in terms of physical and mental functioning. Scores range from 23.4 (worse) to 63.3 (better).
- Memory as measured by the St. Louis University Mental Status Examination (SLUMS) [ Time Frame: 3 years ]
SLUMS is a single-page exam that measures mild cognitive changes. Scores can be divided as 0-20 (mild dementia), 21-26 (mild cognitive disorder), and 27-30 (normal).
- Quality of Life impact as measured by Patient-Reported Outcome Measurement Information System (PROMIS) Sexual Function and Satisfaction Measures (SexFS) Brief Profile Version 2.0. [ Time Frame: 3 years ]
The PROMIS SexFS Brief Profile v2.0 measures a range of sexual activities, symptoms, functioning, and evaluation of experiences over the past 30 days. Scores range from 31.6 (worse) to 62.7 (better).
- Testosterone kinetics [ Time Frame: 3 years ]
For arm 1, time to Testosterone Recovery is defined as the time from randomization to the date at which the testosterone level returns to a normal level on the assay used, or censored at date of last disease evaluation for those whose testosterone has not reached a normal level. Furthermore, testosterone levels will be compared between arms 1 and 2 at EOT and yearly intervals after EOT.
- Cardiovascular events [ Time Frame: 3 years ]
Time to cardiovascular event is defined as the time from randomization to the date at which the first cardiovascular event occurs. Censoring occurs at date of last disease evaluation for those who did not have a cardiovascular event. Cardiovascular events consisting of myocardial infarction, stroke, deep venous thrombosis, or pulmonary embolism will be collected during study visits and follow-ups.
- Time to re-initiation of ADT [ Time Frame: 3 years ]
Time to re-initiation of ADT is defined as the time from randomization to the date at which ADT is reinitiated. Censoring occurs at date of last disease evaluation for those who are not restarted on ADT.
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- The percentage of patients with good erectile function [ Time Frame: 3 months from end of treatment ]
Good erectile function is defined as firm enough for masturbation or foreplay' or 'firm enough for intercourse' responses to the question "How would you describe the usual quality of your erections during the past 4 weeks" on the EPIC-26 questionnaire.
- PSA progression free survival [ Time Frame: 3 years ]
PSA progression-free survival is defined as the time from randomization to PSA progression (PSA rise of 2 ng/mL above the nadir value).
- Metastasis free survival [ Time Frame: 3 years ]
Metastasis-free survival is defined as the time from randomization to distant metastasis (including bony or visceral) identified on imaging or pathologically, or death due to any cause, or censored at date last known alive.
- Cause specific survival [ Time Frame: 3 years ]
Cause specific survival is defined as the interval from the date of randomization to the date of last known follow-up alive, or the date of death from each of the following causes: prostate cancer, cardiovascular disease, other causes
- Rate of Toxicity [ Time Frame: 3 years ]
Toxicity as measured by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
- Quality of Life impact as measured by Expanded Prostate Cancer Index (EPIC)-26 [ Time Frame: 3 years ]
EPIC-26 is a shortened version of the EPIC questionnaire that evaluates subject's urinary incontinence, urinary irritation/obstruction, bowel, sexual, and hormonal domains. EPIC is a robust prostate-cancer health-related QOL instrument that measures a broad spectrum of symptoms and has been widely validated. For each domain, scales range between 0 (worse) and 100 (better).
- Global health impact as measured by Patient-Reported Outcome Measurement Information System (PROMIS) Global Health Score [ Time Frame: 3 years ]
PROMIS is a standardized method for measuring an individual's global health in terms of physical and mental functioning. Scores range from 23.4 (worse) to 63.3 (better).
- Memory as measured by the St. Louis University Mental Status Examination (SLUMS) [ Time Frame: 3 years ]
SLUMS is a single-page exam that measures mild cognitive changes. Scores can be divided as 0-20 (mild dementia), 21-26 (mild cognitive disorder), and 27-30 (normal).
- Quality of Life impact as measured by Patient-Reported Outcome Measurement Information System (PROMIS) Sexual Function and Satisfaction Measures (SexFS) Brief Profile Version 2.0. [ Time Frame: 3 years ]
The PROMIS SexFS Brief Profile v2.0 measures a range of sexual activities, symptoms, functioning, and evaluation of experiences over the past 30 days. Scores range from 31.6 (worse) to 62.7 (better).
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Not Provided
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Not Provided
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INTREPId (INTermediate Risk Erection PreservatIon Trial)
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INTREPId (INTermediate Risk Erection PreservatIon Trial): A Randomized Trial of Radiation Therapy and Darolutamide for Prostate Cancer
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This research study is comparing the use of a new form of hormonal therapy used with radiation as a possible treatment for intermediate risk prostate cancer. More specifically, this research would help determine whether this new form of hormonal therapy is as effective as the standard hormone therapy while also preserving erectile function.
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This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific disease. "Investigational" means that the drug is being studied.
In this research study, the investigators are looking at whether the novel form of hormonal therapy, called Darolutamide, when paired with radiation therapy will provide the same quality of care as the current standard treatments available for men with this type of cancer. Darolutamide prevents testosterone from signaling throughout the body. Although studies have shown that Darolutamide has activity in more advanced forms of prostate cancer, the activity of Darolutamide is unknown in intermediate risk prostate cancer treated with radiation therapy. The U.S. Food and Drug Administration (FDA) has not approved Darolutamide as a treatment for any disease.
The current standard of care treatments available to men with this type of cancer are radiation therapy with or without androgen deprivation therapy (ADT) involving a gonadotropin releasing hormone agonist plus bicalutamide (both FDA-approved) or surgery. ADT works by depriving the body of testosterone which "feeds" prostate cancer cells and weakens prostate cancer cells from repairing damage caused by radiation therapy.
In addition, the investigator will be assessing erectile function at baseline, during and after treatment to determine if short-term erectile function can be preserved without sacrificing long-term disease control.
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Interventional
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Phase 2
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Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment
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Prostate Cancer
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- Drug: Bicalutamide
Bicalutamide is categorized as an antiandrogen. Antiandrogens are substances that block the effects of testosterone. Cancer of the prostate depends on the male hormone testosterone for its growth. If the amount of testosterone is reduced it is possible to slow down or shrink the cancer.
- Drug: GnRH Agonist
In men, GnRH agonists cause the testicles to stop making testosterone. Some GnRH agonists are used to treat prostate cancer.
- Radiation: Radiation Therapy
Radiation Therapy is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors.
- Drug: Darolutamide
Darolutamide belongs to a class of drugs called androgen receptor inhibitors. In the body, these agents compete with androgens for binding to the androgen receptor, which reduces the ability of androgens to promote the growth of prostate cancer cells
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- Experimental: Bicalutamide+GnRH Agonist+Radiation Therapy
- Bicalutamide is administered orally on a daily basis
- GnRH Agonist as prescribed
- Radiation therapy is administered starting 4-16 weeks after ADT
Interventions:
- Drug: Bicalutamide
- Drug: GnRH Agonist
- Radiation: Radiation Therapy
- Experimental: Darolutamide+Radiation Therapy
- Darolutamide is administered orally twice daily
- Radiation therapy is administered starting 4-16 weeks after Darolutamide
Interventions:
- Radiation: Radiation Therapy
- Drug: Darolutamide
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Roy A, Green O, Brenneman R, Bosch W, Gay HA, Michalski JM, Baumann BC. Assessing Inter-Fraction Changes in The Size and Position of The Penile Bulb During Daily MR-Guided Radiation Therapy to The Prostate Bed: Do We Need to Adjust How We Plan Radiation in The Post-Radical Prostatectomy Setting to Reduce Risk of Erectile Dysfunction? Clin Genitourin Cancer. 2022 Jun;20(3):e227-e232. doi: 10.1016/j.clgc.2022.01.006. Epub 2022 Jan 11.
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Recruiting
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220
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Same as current
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March 1, 2028
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March 1, 2025 (Final data collection date for primary outcome measure)
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Inclusion Criteria:
Exclusion Criteria:
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Sexes Eligible for Study: |
Male |
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18 Years and older (Adult, Older Adult)
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No
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United States
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|
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NCT04025372
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19-202
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Yes
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Studies a U.S. FDA-regulated Drug Product: |
Yes |
Studies a U.S. FDA-regulated Device Product: |
No |
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Plan to Share IPD: |
Yes |
Plan Description: |
The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research |
Supporting Materials: |
Study Protocol |
Supporting Materials: |
Statistical Analysis Plan (SAP) |
Supporting Materials: |
Informed Consent Form (ICF) |
Time Frame: |
Data can be shared no earlier than 1 year following the date of publication |
Access Criteria: |
Boston Children's Hospital (BCH) - Contact the Technology & Innovation Development Office at www.childrensinnovations.org or email tido@childrens.harvard.edu Beth Israel Deaconess Medical Center (BIDMC) - Contact the Beth Israel Deaconess Medical Center Technology Ventures Office at tvo@bidmc.harvard.edu Brigham and Women's Hospital (BWH) - Contact the Partners Innovations team at http://www.partners.org/innovation Dana-Farber Cancer Institute (DFCI) - Contact the Belfer Office for Dana-Farber Innovations (BODFI) at innovation@dfci.harvard.edu Massachusetts General Hospital (MGH) - Contact the Partners Innovations team at http://www.partners.org/innovation |
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Martin King, MD, PhD, Dana-Farber Cancer Institute
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Martin T. King, MD, PhD, Dana-Farber Cancer Institute, Principal Investigator
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Dana-Farber Cancer Institute
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Same as current
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- Bayer
- Decipher Biosciences
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Principal Investigator: |
Martin T. King, MD, PhD |
Brigham and Women's Hospital |
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Dana-Farber Cancer Institute
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October 2023
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