Protocol of a randomised, controlled trial comparing immediate curative therapy with conservative treatment in men aged ≥75 years with non-metastatic high-risk prostate cancer (SPCG 19/GRand-P).

clinical trial curative treatment elderly patients geriatric oncology prostate cancer

Journal

BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721

Informations de publication

Date de publication:
12 Mar 2024
Historique:
medline: 12 3 2024
pubmed: 12 3 2024
entrez: 12 3 2024
Statut: aheadofprint

Résumé

Older men (aged ≥75 years) with high risk, non-metastatic prostate cancer (PCa) are increasingly treated with curative therapy (surgery or radiotherapy). However, it is unclear if curative therapy prolongs life and improves health-related quality of life (HRQoL) in this age group compared to conservative therapy, which has evolved considerably during the last decade. The Scandinavian Prostate Cancer Group (SPCG) 19/Norwegian Get-Randomized Research Group-Prostate (GRand-P) is a randomised, two-armed, controlled, multicentre, phase III trial carried out at study centres in Norway, Denmark, Finland, and Sweden. The primary endpoints are overall survival and HRQoL (burden of disease scale, European Organisation for the Research and Treatment of Cancer [EORTC] Elderly Cancer patients). Secondary endpoints are PCa-specific survival, metastasis-free survival, role-functioning scale (EORTC quality of life questionnaire 30-item core), urinary irritative/obstructive scale (26-item Expanded Prostate Cancer Index Composite [EPIC-26]), bowel scale (EPIC-26), intervention-free survival, PCa morbidity, use of secondary and tertiary systemic therapies, mean quality-adjusted life-years (QALYs), and mean total healthcare costs. A total of 980 men (aged ≥75 years) with non-metastatic, high-risk PCa will initially be screened with Geriatric 8 (G8) health status screening tool and Mini-COG© brief cognitive test. Participants identified by G8 as 'fit' or 'frail' will be randomised (ratio 1:1) to either immediate curative therapy (radiotherapy or prostatectomy) or conservative therapy (endocrine therapy or observation). Participants who are unable or unwilling to participate in randomisation will be enrolled in a separate observation group. Randomised patients will be followed for 10 years. Ethics approval has been granted in Norway (457593), Denmark (H-22051998), Finland (R23043) and Sweden (Dnr 2023-05296-01). The trial is registered on Clinicaltrials.org (NCT05448547).

Sections du résumé

BACKGROUND BACKGROUND
Older men (aged ≥75 years) with high risk, non-metastatic prostate cancer (PCa) are increasingly treated with curative therapy (surgery or radiotherapy). However, it is unclear if curative therapy prolongs life and improves health-related quality of life (HRQoL) in this age group compared to conservative therapy, which has evolved considerably during the last decade.
STUDY DESIGN METHODS
The Scandinavian Prostate Cancer Group (SPCG) 19/Norwegian Get-Randomized Research Group-Prostate (GRand-P) is a randomised, two-armed, controlled, multicentre, phase III trial carried out at study centres in Norway, Denmark, Finland, and Sweden.
ENDPOINTS METHODS
The primary endpoints are overall survival and HRQoL (burden of disease scale, European Organisation for the Research and Treatment of Cancer [EORTC] Elderly Cancer patients). Secondary endpoints are PCa-specific survival, metastasis-free survival, role-functioning scale (EORTC quality of life questionnaire 30-item core), urinary irritative/obstructive scale (26-item Expanded Prostate Cancer Index Composite [EPIC-26]), bowel scale (EPIC-26), intervention-free survival, PCa morbidity, use of secondary and tertiary systemic therapies, mean quality-adjusted life-years (QALYs), and mean total healthcare costs.
PATIENTS AND METHODS METHODS
A total of 980 men (aged ≥75 years) with non-metastatic, high-risk PCa will initially be screened with Geriatric 8 (G8) health status screening tool and Mini-COG© brief cognitive test. Participants identified by G8 as 'fit' or 'frail' will be randomised (ratio 1:1) to either immediate curative therapy (radiotherapy or prostatectomy) or conservative therapy (endocrine therapy or observation). Participants who are unable or unwilling to participate in randomisation will be enrolled in a separate observation group. Randomised patients will be followed for 10 years.
TRIAL REGISTRATION BACKGROUND
Ethics approval has been granted in Norway (457593), Denmark (H-22051998), Finland (R23043) and Sweden (Dnr 2023-05296-01). The trial is registered on Clinicaltrials.org (NCT05448547).

Identifiants

pubmed: 38469686
doi: 10.1111/bju.16314
doi:

Banques de données

ClinicalTrials.gov
['NCT05448547']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Nordic Cancer Union
Organisme : KLINBEFORSK
Organisme : Helse Sør-Øst RHF
Organisme : Kreftforeningen

Informations de copyright

© 2024 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

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Auteurs

Sven Löffeler (S)

Department of Urology, Vestfold Hospital Trust, Tønsberg, Norway.

Helena Bertilsson (H)

Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Urology, St. Olav's University Hospital, Trondheim, Norway.

Christoph Müller (C)

Department of Oncology, Sørlandet Hospital Trust, Kristiansand, Norway.

Kirsti Aas (K)

Department of Urology, Akershus University Hospital, Lørenskog, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Hege Sagstuen Haugnes (HS)

Department of Oncology, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, The Arctic University of Norway (UIT), Tromsø, Norway.

Bjørg Aksnessaether (B)

Department of Oncology, Møre og Romsdal Hospital Trust, Ålesund, Norway.

Maiju Pesonen (M)

Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.

Kristian Thon (K)

Department of Oncology, Oslo University Hospital, Oslo, Norway.

Torgrim Tandstad (T)

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Department of Oncology, The Cancer Clinic, St Olav's University Hospital, Trondheim, Norway.

Teemu Murtola (T)

Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Department of Urology, Tampere University Hospital, Tampere, Finland.

Mads Hvid Poulsen (MH)

Department of Urology, Odense University Hospital, Odense, Denmark.
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.

Tobias Nordstrøm (T)

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

Maria Nyre Vigmostad (MN)

Department of Oncology, Stavanger University Hospital, Stavanger, Norway.

Fredrik Ottosson (F)

Department of Urology, Oslo University Hospital, Oslo, Norway.

Karin Holmsten (K)

Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology, Capio St. Göran Hospital, Stockholm, Sweden.

Ola Christiansen (O)

Department of Urology, Innlandet Hospital Trust, Hamar, Norway.

Marit Slaaen (M)

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.

Erik Skaaheim Haug (ES)

Department of Urology, Vestfold Hospital Trust, Tønsberg, Norway.

Anne Holck Storås (AH)

Department of Oncology, Oslo University Hospital, Oslo, Norway.

Lars Asphaug (L)

Institute of Health and Society, University of Oslo, Oslo, Norway.
Clinical Trials Unit, Oslo University Hospital, Oslo, Norway.

Antti Rannikko (A)

Department of Urology and Research Program in Systems Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Klaus Brasso (K)

Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Classifications MeSH