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The purpose of this study is to look at the efficacy and safety of leuprolide acetate in patients with prostate cancer.
Other assessments include evaluation of main leuprolide PK parameters in 12 subjects after administration of 3 doses.
Study Design:
This will be a multi-center, open-label, fixed investigation of six monthly dosages of leuprolide acetate 3.75 mg administered to patients with histologically proven carcinoma of prostate, who might benefit from medical androgen deprivation therapy.
A total of 120 male patients will receive a single, i.m. injection of leuprolide acetate 3.75 mg initially on study day 0 (after baseline assessment) and then monthly (i.e. every 28 days) for five months.
12 of the patients will also have plasma leuprolide levels measured for PK analysis during the first 3 injection periods (PK group). These patients will belong to pre-defined study sites.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| leuprolide acetate | Drug |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy: to determine the proportion of patients achieving castration levels of plasma testosterone (defined as <0.5 ng/mL) 4 weeks after the first administration | ||
| to determine the proportion of patients maintaining castration levels of plasma testosterone from week 4 to study end | ||
| to determine the proportion of patients showing acute rises in plasma testosterone levels upon repeated dosing from week 4 to study end | ||
| Safety: evaluation of the safety of the new formulation based on adverse events (AEs), local tolerability, vital signs, electrocardiograms (ECGs), and clinical parameters |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy: determination of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prostate-specific antigen (PSA) concentrations | ||
| World Health Organization/Eastern Cooperative Oncology Group (WHO/ECOG) performance status, bone pain, urinary symptoms and urinary pain after administration |
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Inclusion Criteria:
Exclusion Criteria:
Evidence of brain metastases, in the opinion of the Investigator, taking into account medical history, clinical observations and symptoms
Evidence of spinal cord compression, in the opinion of the Investigator, taking into account medical history, clinical observations and symptoms
Evidence of severe urinary tract obstruction with threatening urinary retention, in the opinion of the Investigator, taking into account medical history, clinical observations and symptoms
Excruciating, severe pain from extensive osseous deposits, in the opinion of the Investigator, taking into account medical history, clinical observations and symptoms
Testosterone levels < 1.5 ng/mL at screening, locally determined at the laboratory of each clinical site
Previous cancer systemic therapy such as chemotherapy, immunotherapy (e.g. antibody therapies, tumor-vaccines), biological response modifiers (e.g. cytokines) within 3 months of baseline
Previous hormonal therapy for treatment of prostate cancer, such as luteinising hormone-releasing hormone (LHRH) analogues (e.g. Lupron®, Zoladex®, etc.) [no wash-out allowed]
Previous treatment with androgen receptor (AR) blockers, such as Casodex®, Fugerel®, Megace®, Androcur® (no wash-out allowed)
Previous orchiectomy, adrenalectomy or hypophysectomy
Previous prostatic surgery (e.g. radical prostatectomy, transurethral resection of the prostate [TUR-P]) within 2 weeks of baseline
Previous local therapy to the primary tumor with a curative attempt other than surgery (external beam radiotherapy, brachytherapy, thermotherapy, cryotherapy) within 2 weeks of baseline
Any investigational drug within 5 half-lives of its physiological action or 3 months (whichever is longer) before baseline
Administration of 5-alpha-reductase inhibitors (Proscar®, Avodart®, Propecia®) within 3 months before baseline
Over-the-counter (OTC) or alternative medical therapies which have an estrogenic or anti-androgenic effect (i.e., PC-SPES, saw palmetto, Glycyrrhiza®, Urinozinc®, dehydroepiandrosterone [DHEA]) within the 3 months before baseline
Hematological parameters (RBC, total and differential WBC count, platelet count, hemoglobin, hematocrit) outside 20% of the upper or lower limits of normal (ULN, LLN) for the clinical laboratory at screening
Co-existent malignancy, according to the Investigator's opinion
Uncontrolled congestive heart failure, myocardial infarction or a coronary vascular procedure (e.g. balloon angioplasty, coronary artery bypass graft) or significant symptomatic cardiovascular disease(s) within 6 months before baseline; resting uncontrolled hypertension: (>/= 160/100 mmHg) or symptomatic hypotension within 3 months before baseline
Venous thrombosis within 6 months of baseline
Insulin-dependent diabetes mellitus
History of drug and/or alcohol abuse within 6 months of baseline
Serious concomitant illness(es) or disease(s) [e.g., hematological, renal, hepatic, respiratory, endocrine, psychiatric] that may interfere with, or put patients at additional risk for, their ability to receive the treatment outlined in the protocol
Patients receiving anticoagulants who have prothrombin and partial thromboplastin times outside of the normal range for the laboratory assays; patients who are on anticoagulation or antiplatelet medications (e.g. dipyridamole, ticlopidine, warfarin derivatives) who are not receiving a stable dose for 3 months before baseline; patients who are receiving warfarin-derivative anticoagulants who do not have an International Normalized Ratio (INR) in the therapeutic range for the clinical indication for which the anticoagulant has been prescribed.
Blood donations/losses within 2 months of baseline, apart from previous prostatic surgery patients (see earlier exclusion [9]; please note that these patients should not be included in the pharmacokinetic [PK] group)
Known hypersensitivity to GnRH, GnRH agonist, including any LHRH analogues, or any excipients of the study formulation
History of the following prior to the study:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Urology Centers of Alabama | Homewood | Alabama | 35209 | United States | ||
| Desert Oasis Cancer Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20435244 | Derived | Marberger M, Kaisary AV, Shore ND, Karlin GS, Savulsky C, Mis R, Leuratti C, Germa JR. Effectiveness, pharmacokinetics, and safety of a new sustained-release leuprolide acetate 3.75-mg depot formulation for testosterone suppression in patients with prostate cancer: a Phase III, open-label, international multicenter study. Clin Ther. 2010 Apr;32(4):744-57. doi: 10.1016/j.clinthera.2010.04.013. |
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| Casa Granda |
| Arizona |
| 85222 |
| United States |
| Southwest Florida Urologic Associates | Fort Myers | Florida | 33907 | United States |
| Advanced Research Institute, Inc. | New Port Richey | Florida | 34652 | United States |
| Florida Urology Specialists | Sarasota | Florida | 34237 | United States |
| Regional Urology | Shreveport | Louisiana | 71106 | United States |
| Lakeside Urology | Saint Joseph | Michigan | 49085 | United States |
| Hamilton Urology, P.A. | Hamilton | New Jersey | 08690 | United States |
| Lawrenceville Urology | Lawrenceville | New Jersey | 08648 | United States |
| AccuMed Research Associates | Garden City | New York | 11530 | United States |
| Urological Surgeons of Long Island | Garden City | New York | 11530 | United States |
| Hudson Valley Urology | Kingston | New York | 12401 | United States |
| Hudson Valley Urology | Poughkeepsie | New York | 12601 | United States |
| Carolina Urologic Research Center | Myrtle Beach | South Carolina | 29572 | United States |
| Urology Associates, PC | Nashville | Tennessee | 37209 | United States |
| Department of Urology, Vienna University Medical School | Vienna | A-1090 | Austria |
| Urocentrum Praha | Prague | 120 00 | Czechia |
| Charles University, Clinic of Urology | Prague | Czechia |
| Urology Department, Hviezdoslavova | Prague | Czechia |
| Masaryk Hospital, Urology Dept. | Ústí nad Labem | 401 13 | Czechia |
| Department of Urology, Technical University of Dresden | Dresden | 01307 | Germany |
| Department of Urology, Semmelweis University | Budapest | H-1082 | Hungary |
| Department of Urology, Medical School, University of Pécs | Pécs | H-7621 | Hungary |
| Department of Urology, General Hospital of Bolzano | Bolzano | 39100 | Italy |
| Sexual Medicine Unit and Urology, Università Vita Salute San Raffaele Fondazione Centro San Raffaele del Monte Tabor | Milan | 20132 | Italy |
| Department of Urology, Jessenius Faculty of Medicine, Comenius University | Martin | Slovakia |
| Institut Català d'Oncologia, Hospital Duran I Reynals, Servicio de Oncologia Medica | Barcelona | 08907 | Spain |
| Royal Free Hospital and School of Medicine | London | NW3 2QG | United Kingdom |
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D016729 | Leuprolide |
| ID | Term |
|---|---|
| D007987 | Gonadotropin-Releasing Hormone |
| D010906 | Pituitary Hormone-Releasing Hormones |
| D007028 | Hypothalamic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D009479 | Neuropeptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D009842 | Oligopeptides |
| D009419 | Nerve Tissue Proteins |
| D011506 | Proteins |
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