The acute toxicity results of the GETUG-AFU 22 study: A multicenter randomized phase II trial comparing the efficacy of a short hormone therapy in combination with radiotherapy to radiotherapy alone as a salvage treatment for patients with detectable PSA after radical prostatectomy.

Authors

null

Stephane Gilles Guerif

Centre Hospitalier Universitaire de Poitiers, Poitiers, France

Stephane Gilles Guerif , Igor Latorzeff , Lise Roca , Djelila Allouache , Stephane Supiot , Edouard Lagneau , Pierre Richaud , Deniaud-Alexandre Elisabeth , Philippe Ronchin , Benyoucef Ahmed , Lysian Cartier , Hadji Hamidou , Ali Hasbini , Gilles Crehange , Pascal Pommier , Guy De Laroche , Muriel Habibian , Emmanuel Gross , Philippe Fourneret , Laurent Salomon

Organizations

Centre Hospitalier Universitaire de Poitiers, Poitiers, France, Clinique Pasteur Groupe Oncorad Garonne, Toulouse, France, Institut Regional du Cancer Montpellier Val d'Aurelle, Montpellier, France, Centre Francois Baclesse, Caen, France, ICO, Nantes, France, Centre d'Oncologie et de Radiotherapie du Parc, Dijon, France, Institut Bergonier, Bordeaux, France, CH Vendee, La Roche Sur Yon, France, Centre Azureen de Cancerologie, Mougins, France, CH Rouen, Rouen, France, Clinique Sainte Catherine, Avignon, France, ICO Angers, Angers, France, Clinique Pasteur, Brest, France, Georges-Francois Leclerc Cancer Center, Dijon, France, CRLCC Leon Berard, Lyon, France, Institut de Cancerologie de La Loire, St Priest En Jarez, France, UNICANCER, Paris, France, Ramsay Generale de Sante, Hopital Prive Clairval, Institut Cancerologie Marseille Provence, Marseille, France, Centre Hospitalier Metropole Savoie, Chambery, France, Urology Department, APHP, Henri-Mondor Hospital, Creteil, France

Research Funding

Pharmaceutical/Biotech Company

Background: Radical prostatectomy (RP) is recommended as a standard treatment for localized prostate cancer. However no recommendations exist for pts with detectable PSA after RP. Methods: Pts with localized prostate cancer, treated by RP (R0 or R1), with a PSA level post-RP ≥ 0.2 ng/mL and ≤ 2 ng/mL at randomization and N0 M0 on imaging were included. Pts were randomized (1:1) to radiotherapy (RT) alone (RT arm) or 6 months degarelix hormone therapy (HT) with RT (RT+HT arm). RT consisted of pelvic irradiation (46 Gy in 23 Fr) with a boost on the prostate bed (66 Gy in 33 Fr). The primary endpoint is the event-free survival (EFS). Secondary endpoints are: 5-yr EFS and metastases-free survival, 5 and 10-yr OS, acute and late toxicity (CTCAE V4.0), and QOL. With 122 patients, the probability of selecting the most effective arm is over 80% for a 20% reduction in the HR = 0.80. Results: From Dec-2012 to Sept-2015, 125 pts were included (RT arm: 64 pts; RT+HT arm: 61). Median follow up is 14.7 months (6.2; 33.5). The baseline characteristics are well-balanced: median age was 66 yrs (50-77), all men having an ECOG ≤ 1 (ECOG 0 in 92%), a median Gleason score of 7 (3-9), a median PSA of 0.3 ng/mL (0.09-1.82) post-RP and 0.6 ng/mL (0.12-3.65) at randomization. All pts received 33 Fr of RT. In the RT+HT arm 98.4% of pts received the 6 months of HT planned. All pts were eligible for safety analysis. No grade 4 toxicity or toxic death was reported. Grade 3 acute toxicity, occurring within 6 months of RT, were reported for 11/125 pts (9%): 3/64 pts (5%) in the RT arm and 8/61 pts (13%) in RT+HT arm (NS). Regarding grade 3 toxicities, the following occurred only in the RT+HT arm: erectile dysfunction (3 pts) and urinary incontinence (2 pts); in contrast, dysuria/pollakiuria (2 pts) occurred only in the RT arm. In the RT+HT arm, grade 2 toxicities included hot flushes (8 pts) and decreased libido (7 pts). Conclusions: In terms of acute toxicities the RT+HT arm is well tolerated with the observed toxicities usually expected with concomitant HT. The primary endpoint analysis is expected for 2018. Clinical trial information: NCT01994239

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Abstract Details

Meeting

2017 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Localized Disease

Clinical Trial Registration Number

NCT01994239

Citation

J Clin Oncol 35, 2017 (suppl 6S; abstract 16)

DOI

10.1200/JCO.2017.35.6_suppl.16

Abstract #

16

Poster Bd #

B3

Abstract Disclosures