NCT04641078

Brief Summary

The current trial will test the combination of darolutamide with SBRT, in oligometastatic recurrent hormone sensitive prostate cancer. We hypothesize that the addition of short-term darolutamide improves metastasis-free survival when added to SBRT without a detrimental impact on the QoL. Considering the large reluctance of both patients and physicians to be randomized to observation, we propose to use the historical data from previous reported randomized trials (STOMP and ORIOLE) as a comparator to explore as a secondary endpoint.

Trial Health

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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
124

participants targeted

Target at P75+ for phase_2 prostate-cancer

Timeline
Completed

Started Feb 2021

Typical duration for phase_2 prostate-cancer

Geographic Reach
1 country

8 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 17, 2020

Completed
6 days until next milestone

First Posted

Study publicly available on registry

November 23, 2020

Completed
3 months until next milestone

Study Start

First participant enrolled

February 12, 2021

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 12, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 12, 2026

Completed
Last Updated

February 28, 2024

Status Verified

February 1, 2024

Enrollment Period

5 years

First QC Date

November 17, 2020

Last Update Submit

February 26, 2024

Conditions

Keywords

RadiotherapyMetastasis-directed therapyOligometastatic recurrent hormone sensitive prostate cancer

Outcome Measures

Primary Outcomes (1)

  • Metastasis-free survival

    Metastasis-free survival is defined as time between randomization and the appearance of a new metastatic recurrence (any M1) as suggested by PET-CT or death due to any cause.

    2 year

Secondary Outcomes (10)

  • Clinical progression-free survival

    2 year

  • Biochemical relapse-free survival

    2 year

  • Time to next systemic therapy

    4 year

  • Castrate resistant-free survival

    4 year

  • Prostate cancer-specific survival

    4 year

  • +5 more secondary outcomes

Study Arms (2)

Arm A

EXPERIMENTAL

SBRT + 6 months of darolutamide (600 mg b.i.d.)

Drug: DarolutamideRadiation: metastasis-directed treatment

Arm B

OTHER

SBRT only

Radiation: metastasis-directed treatment

Interventions

600 mg BID

Arm A

stereotactic body radiotherapy

Arm AArm B

Eligibility Criteria

Age18 Years+
Sexmale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Histologically proven initial diagnosis of adenocarcinoma of the prostate
  • Biochemical relapse of PCa following radical local prostate treatment (radical prostatectomy (RP), primary radiotherapy or the combination of RP and prostate bed adjuvant/ salvage radiotherapy) according to the EAU guidelines 2018.
  • Following RP, patients with a biochemical relapse are eligible in case a metastatic relapse is detected even in the absence of prior postoperative prostate bed radiotherapy (adjuvant or salvage). In the absence of prior prostate bed radiotherapy, prostate bed radiotherapy is mandatory for all pT3a or higher or patients with a positive margin at time of RP.
  • For patients without prior RP that have a suspected local recurrence following primary radiotherapy, a biopsy should confirm local recurrence. Patients with a confirmed local recurrence and metastases are eligible in case they also undergo a local salvage therapy.
  • Metastatic relapse on PSMA PET-CT with a maximum of 5 metastases (any M1a, M1b or M1c). Concomitant diagnosis of N1 disease is allowed as long as all lesions are treated with SBRT and the total number of lesions does not exceed 5. PSMA positive lesions will be scored using the MI-RADS scoring system with lesions scored 4 or 5 considered positive19.
  • Asymptomatic for metastatic PCa
  • Age \>= 18 years
  • WHO class 0-1
  • Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
  • Before patient registration/randomization, written informed consent must be given in accordance with to ICH/GCP, and national/local regulations.

You may not qualify if:

  • Local relapse in the prostate gland or prostate bed not suitable for a local salvage treatment
  • Small cell carcinoma of the prostate
  • PSA doubling time \>12 months
  • Serum testosterone level \<50ng/dl or 1.7 nmol/L at time of randomization
  • Currently receiving ADT or PSA rise while on active treatment with ADT (LHRH-agonist, LHRH-antagonist, anti-androgen or estrogen) within the past 6 weeks
  • Spinal cord compression or impending spinal cord compression
  • Metastases in previously irradiated areas precluding safe delivery of SBRT
  • Contraindications to darolutamide
  • Previous treatment with cytotoxic agent for PCa
  • Treatment during the past month with products known to influence PSA levels (e.g. fluconazole, finasteride, corticosteroids,…)
  • Other active malignancy, except non-melanoma skin cancer or other malignancies with a documented disease-free survival for a minimum of 3 years.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (8)

OLVZ Aalst

Aalst, Belgium

RECRUITING

GZA

Antwerp, Belgium

RECRUITING

AZ St-Jan Brugge

Bruges, Belgium

RECRUITING

Institut Jules Bordet

Brussels, Belgium

RECRUITING

AZ St-Lucas Gent

Ghent, Belgium

RECRUITING

Ghent University Hospital

Ghent, Belgium

RECRUITING

Jessa Ziekenhuis

Hasselt, Belgium

RECRUITING

AZ Groeninge

Kortrijk, Belgium

RECRUITING

MeSH Terms

Conditions

Prostatic NeoplasmsNeoplasm Metastasis

Interventions

darolutamide

Condition Hierarchy (Ancestors)

Genital Neoplasms, MaleUrogenital NeoplasmsNeoplasms by SiteNeoplasmsGenital Diseases, MaleGenital DiseasesUrogenital DiseasesProstatic DiseasesMale Urogenital DiseasesNeoplastic ProcessesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Piet Ost, MD, PhD

    University Hospital, Ghent

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Piet Ost, MD, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 17, 2020

First Posted

November 23, 2020

Study Start

February 12, 2021

Primary Completion

February 12, 2026

Study Completion

February 12, 2026

Last Updated

February 28, 2024

Record last verified: 2024-02

Locations