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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2009-01214 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| MC0253 | Other Identifier | Mayo Clinic | |
| P30CA015083 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as leuprolide acetate, goserelin, flutamide, or bicalutamide may lessen the amount of androgens made by the body. Monoclonal antibodies, such as ipilimumab, can block cancer growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry cancer-killing substances to them. Giving antihormone therapy together with ipilimumab may kill more tumor cells.
PURPOSE: This randomized phase II trial is study how well giving hormone therapy and ipilimumab together works in treating patients with advanced prostate cancer.
OBJECTIVES:
I. To generally test whether the addition of CTLA-4 blockade can enhance clinical treatment response in advance prostate cancer patients compared with treatment with AA therapy alone.
II. To specifically examine whether concomitant AA therapy + MDX-010 can be used to prolong the progression-free interval in advanced prostate cancer patients compared with inductive short-term AA therapy alone.
III. To specifically examine whether concomitant AA therapy + MDX-010 can be used to enhance initial PSA responses in advanced prostate cancer patients compared with inductive short-term AA therapy alone.
IV. To specifically examine whether delayed MDX-010 can be used to induce PSA response in patients experiencing disease progression following cessation of short-term AA therapy.
V. To generally examine whether MDX-010 enhances host immune response that might be involved in conferring treatment advantages to patients receiving AA therapy.
VI. To specifically examine whether MDX-010 potentiates T-cell responses in advanced prostate cancer patients initiating inductive short-term AA therapy.
VII. To further examine whether treatment induced T-cell responses correlate with clinical response to treatment.
VIII. To examine whether short-term AA there (+/- MDX-010) induces the appearance of newly emigrated T or immature and/or B cells.
OUTLINE:
Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive either leuprolide acetate intramuscularly (IM) or goserelin subcutaneously (SC) on days 0, 28, and 56. Patients also receive oral flutamide three times daily or oral bicalutamide once daily. Treatment with antiandrogen (AA) therapy continues for 3 months (3-4 months for patients who initiated AA therapy <= 21 days prior to enrollment) in the absence of disease progression or unacceptable toxicity. Patients receive ipilimumab IV over 90 minutes on day 7 (within 7-28 days post-initiation of AA therapy for patients who initiated AA therapy <= 21 days prior to enrollment) of AA therapy.
Arm II: Patients receive AA therapy as in arm I. Patients may crossover to arm II in the case of disease progression.
After completion of study treatment, patients are followed periodically.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I | Experimental | Patients receive either leuprolide acetate intramuscularly (IM) or goserelin subcutaneously (SC) on days 0, 28, and 56. Patients also receive oral flutamide three times daily or oral bicalutamide once daily. Treatment with antiandrogen (AA) therapy continues for 3 months (3-4 months for patients who initiated AA therapy <= 21 days prior to enrollment) in the absence of disease progression or unacceptable toxicity. Patients receive ipilimumab IV over 90 minutes on day 7 (within 7-28 days post-initiation of AA therapy for patients who initiated AA therapy <= 21 days prior to enrollment) of AA therapy. |
|
| Arm II | Active Comparator | Patients receive AA therapy as in arm I. Patients may crossover to arm II in the case of disease progression. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bicalutamide | Drug | Given orally |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Progression-free at 18 Months | PSA progression is defined as a rise in PSA to >4.0 ng/mL demonstrated twice in measurements taken two weeks apart. | 18 months from the start of AA therapy |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Participants With Undetectable Prostate-specific Antigen (PSA) Response | Percent of participants who had undetectable PSA at 3 months on the initially assigned treatment arm (prior to crossing over). | 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Eugene Kwon | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
All participants were initially randomized to either arm.
112 participants were recruited between June 2004 and June 2009 at Mayo Clinic.
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| ID | Title | Description |
|---|---|---|
| FG000 | Androgen Ablative (AA) Therapy + MDX-010 | 3 months of concurrent androgen ablative (AA) therapy + MDX-010 Androgen ablative (AA) therapy is received a combined regimen of GnRH agonist and androgen receptor blocker. GnRH agonists must be in the form of a 1 month depot of either leuprolide acetate (Lupron) 7.5 mg intramuscular (IM), or goserelin acetate (Zoladex) 3.6 mg subcutaneous (SC) and will be administered on Day 0 (baseline), Day 28 and Day 56. Androgen receptor blockade may be provided by oral administration of either flutamide (Eulexin) 250 mg orally 3 times daily, or bicalutamide (Casodex) 50 mg orally once daily. MDX-010 is received as an infusion at a dose of 3.0 mg/kg on day 7. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Treatment Period 1 Initial Randomization |
|
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| Flutamide | Drug | Given orally |
|
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| Goserelin Acetate | Drug | Given SC |
|
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| Ipilimumab | Drug | Given IV |
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| Leuprolide Acetate | Drug | Given IM |
|
|
| Pharmacological Study | Other | Correlative study |
|
| FG001 | Androgen Ablative (AA) Then AA Therapy + MDX-010 | 3 months of initial AA therapy alone Androgen ablative (AA) therapy is received a combined regimen of GnRH agonist and androgen receptor blocker. GnRH agonists must be in the form of a 1 month depot of either leuprolide acetate (Lupron) 7.5 mg intramuscular (IM), or goserelin acetate (Zoladex) 3.6 mg subcutaneous (SC) and will be administered on Day 0 (baseline), Day 28 and Day 56. Androgen receptor blockade may be provided by oral administration of either flutamide (Eulexin) 250 mg orally 3 times daily, or bicalutamide (Casodex) 50 mg orally once daily. |
| COMPLETED |
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| NOT COMPLETED |
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| Washout Period of 14 Days |
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| Treatment Period 2 Crossover |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Entire Study Population | All participants initially randomized. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Number | participants |
| ||||||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||||||||||
| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants Progression-free at 18 Months | PSA progression is defined as a rise in PSA to >4.0 ng/mL demonstrated twice in measurements taken two weeks apart. | Posted | Number | participants | 18 months from the start of AA therapy |
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| |||||||||||||||||||||||||||
| Secondary | Percent of Participants With Undetectable Prostate-specific Antigen (PSA) Response | Percent of participants who had undetectable PSA at 3 months on the initially assigned treatment arm (prior to crossing over). | 105 participants had follow-up PSA information; those without a follow-up PSA were excluded from this analysis. | Posted | Number | percentage of participants | 3 months |
|
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Two participants cancelled prior to beginning study treatment, thus did not experience any adverse events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Entire Study Population | All participants (Androgen ablative (AA) therapy + MDX-010 and Androgen ablative (AA) therapy alone the AA Therapy + MDX-010) were grouped together for this outcome. | 10 | 110 | 107 | 110 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Ischemia/Infarction | Cardiac disorders | MedDRA 6 | Systematic Assessment |
| |
| Vision-Blurred | Eye disorders | MedDRA 6 | Systematic Assessment |
| |
| Diarrhea-No Colostom | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Ileus | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Pain-Abdominal | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Hepatic | Hepatobiliary disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypersensitivity | Immune system disorders | MedDRA 6 | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
| |
| Alanine aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Alkaline phosphatase | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Amylase | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Aspartate aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Creatinine | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Lipase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Hypercalcemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hyperuricemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Peripheral motor neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
| |
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Rash/Desquamation | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA 6 | Systematic Assessment |
| |
| Thrombosis | Vascular disorders | MedDRA 6 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | MedDRA 6 | Systematic Assessment |
| |
| Lymph node pain | Blood and lymphatic system disorders | MedDRA 6 | Systematic Assessment |
| |
| Cardiovascular | Cardiac disorders | MedDRA 6 | Systematic Assessment |
| |
| Ventricular tachycardia | Cardiac disorders | MedDRA 6 | Systematic Assessment |
| |
| Endocrine | Endocrine disorders | MedDRA 6 | Systematic Assessment |
| |
| Vision | Eye disorders | MedDRA 6 | Systematic Assessment |
| |
| Vision-Blurred | Eye disorders | MedDRA 6 | Systematic Assessment |
| |
| Anal hemorrhage | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Colitis | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Colonic hemorrhage | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Diarrhea-No Colostom | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Duodenal ulcer | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Dyspepsia | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Pain-Abdominal | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Constitutional Symptoms | General disorders | MedDRA 6 | Systematic Assessment |
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| Edema: Limb | General disorders | MedDRA 6 | Systematic Assessment |
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| Facial pain | General disorders | MedDRA 6 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA 6 | Systematic Assessment |
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| Pain-Chest | General disorders | MedDRA 6 | Systematic Assessment |
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| Rigors | General disorders | MedDRA 6 | Systematic Assessment |
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| Hepatic | Hepatobiliary disorders | MedDRA 6 | Systematic Assessment |
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| Hypersensitivity | Immune system disorders | MedDRA 6 | Systematic Assessment |
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| Abdominal infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Colon infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Lung (pneumonia) infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Penis infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Pneumonia | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Skin (cellulites) infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
| |
| Wound infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
| |
| Bruising (in absence of grade 3 or 4 thrombocytopenia) | Injury, poisoning and procedural complications | MedDRA 6 | Systematic Assessment |
| |
| Alanine aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Alkaline phosphatase | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Amylase | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Aspartate aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Blood bilirubin increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Coagulation | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Creatinine | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Lipase increased | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Metabolic/Lab | Investigations | MedDRA 6 | Systematic Assessment |
| |
| Platelet count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Weight loss | Investigations | MedDRA 6 | Systematic Assessment |
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| Bicarbonate | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypercalcemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hyperglycemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hyperkalemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hyperuricemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypoalbuminemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypocalcemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Hyponatremia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Hypophosphatemia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Arthritis | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Extremity-lower necrosis | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Musculoskeletal | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Cognitive disorder | Nervous system disorders | MedDRA 6 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 6 | Systematic Assessment |
| |
| Ischemia-Cerebral | Nervous system disorders | MedDRA 6 | Systematic Assessment |
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| Neuro | Nervous system disorders | MedDRA 6 | Systematic Assessment |
| |
| Peripheral motor neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
| |
| Peripheral sensory neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
| |
| Depression | Psychiatric disorders | MedDRA 6 | Systematic Assessment |
| |
| Insomnia | Psychiatric disorders | MedDRA 6 | Systematic Assessment |
| |
| Pollakiuria | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
| |
| Ureteral Obstruction | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
| |
| Urinary bladder hemorrhage | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
| |
| Urinary retention | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
| |
| Breast pain | Reproductive system and breast disorders | MedDRA 6 | Systematic Assessment |
| |
| Prostatic pain | Reproductive system and breast disorders | MedDRA 6 | Systematic Assessment |
| |
| Atelectasis | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Pharyngolaryngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Pulmonary | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Sinus Reactions | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
| |
| Acne | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Alopecia | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Decubitus Ulcer | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Dry skin | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Nail Changes | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Rash/Desquamation | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Urticaria | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
| |
| Flushing | Vascular disorders | MedDRA 6 | Systematic Assessment |
| |
| Hot flashes | Vascular disorders | MedDRA 6 | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA 6 | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Eugene D. Kwon | Mayo Clinic | kwon.eugene@mayo.edu |
| 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 |
|---|---|
| C053541 | bicalutamide |
| D005485 | Flutamide |
| D017273 | Goserelin |
| D000074324 | Ipilimumab |
| D060908 | CTLA-4 Antigen |
| D016729 | Leuprolide |
| C493311 | luprolide acetate gel depot |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| 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 |
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D000082102 | Immune Checkpoint Proteins |
| D061025 | Costimulatory and Inhibitory T-Cell Receptors |
| D011971 | Receptors, Immunologic |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
| D000945 | Antigens, Differentiation, T-Lymphocyte |
| D000943 | Antigens, Differentiation |
| D000954 | Antigens, Surface |
| D000941 | Antigens |
| D001685 | Biological Factors |
| D015415 | Biomarkers |
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| Title | Measurements |
|---|
|
| 60-69 |
|
| >= 70 |
|
|
|