TREATMENT OPTIONS


 Nerve sparing radical prostatectomy


State-of-the-art external beam radiotherapy


Seed Brachytherapy


Patient Information For High Dose Rate Hdr Prostate Brachytherapy


Hormonal therapy


 Prostatic cryotherapy


Systemic chemotherapy


Radioactive intravenous Strontium


Access to state-of-the-art clinical trial


Patient Information for Radiotherapy


  1. Pain relief for metastatic bone disease


  1. Clinical Trials


MEDICAL ONCOLOGY TRIALS

A randomised Phase 3 study comparing Cabazitaxel/Prednisone in combination with Custirsen (OGX-011) to Cabazitaxel /Prednisone for second-line chemotherapy in men with metastatic castrate resistant prostate cancer (Pending – to be open in the next few months)

PRINCIPAL INVESTIGATOR: Dr Patricia Bastick      phone: (02) 9113 3910

CLINICAL TRIALS COORDINATOR: Mary Margaret Gozar   phone: (02) 9113 3830


This will be a randomized, open-label, multicenter, international trial. Treatment will consist of cabazitaxel/prednisone/custirsen vs cabazitaxel/prednisone. To be eligible for randomization onto the study, patients must have documented progression of prostate cancer after prior first-line docetaxel treatment and meet other inclusion criteria. Patients are not eligible if they have received chemotherapy for prostate cancer beyond the first-line docetaxel-containing regimen, or if they have history of or current brain metastases, current symptomatic cord compression requiring therapy, active second malignancy, or uncontrolled medical conditions/illnesses that would preclude protocol therapy. A total of approximately 630 patients will be randomized. Patients will be randomly assigned with equal probability to the two arms.


RADIATION ONCOLOGY TRIALS

A Phase 3 multi-centre randomised trial comparing adjuvant radiotherapy (RT) with early salvage RT in patients with positive margins or extraprostatic disease following radical prostatectomy (TROG 08.03 – RAVES)

PRINCIPAL INVESTIGATOR: Dr Joseph Bucci      phone: (02) 9113 1675

CLINICAL TRIALS COORDINATOR: Xiaolu Wang phone: (02) 9113 2844


To test the hypothesis that active surveillance with early salvage radiotherapy can be considered non-inferior to standard treatment with adjuvant (immediate) radiotherapy with respect to risk of biochemical failure (bF) in patients with extraprostatic (pT3) disease and/or positive margins following RP.


The 2 treatment groups to be compared are:

Arm 1 – Standard arm

Adjuvant RT commenced within 4 months of RP.

64Gy in 32 fractions to the prostate bed

Arm 2 – Experimental arm

Active surveillance with early salvage RT.

64 Gy in 32 fractions to the prostate bed.

Trigger for SRT – a PSA level ≥ 0.2ng/ml. RT should commence as soon as possible (no later than 4 months) following the first PSA measurement ≥ 0.2ng/mL

Feasibility of using Polyethylene Glycol Hydrogel to increase prostate-rectum separation and its impact on rectal dose during radiation therapy (PEG Hydrogel Study)

PRINCIPAL INVESTIGATOR: Dr Nadine Beydoun      phone: (02) 9113 1212

CO-INVESTIGATOR: Dr Joseph Bucci      phone: (02) 9113 1675


This study is assessing the feasibility of using a tranperineal injection of polyethylene glycol based tissue spacer to increase separation between the prostate gland and rectum prior to radiotherapy. The study will be recruiting external beam and high dose rate brachytherapy patients (10 patients in each arm), as well as seed brachytherapy patients with suboptimal rectal dosimetry (20 patients; 10 pre-implant and 10 post-implant). Total patients 40.

Outcomes we will be assessing include feasibility (prostate-rectum separation and rectal dose before and after spacer injection), stability of the spacer (as assessed by repeat CT/MRI 4-6 weeks after spacer injection), toxicity (NCI CTCAE v4.0 day 0-1 post-spacer and 4-6 weeks post-spacer), and quality of life (EORTC QLQC-30 and PR25, EPIC, and IPSS at baseline, 4-6 weeks, 6 and 12 months). 

OTHER PROJECTS 

Brachynet Database – a tool for monitoring quality outcomes for patients undergoing brachytherapy

CLINICAL TRIALS COORDINATOR: Kylie Melki    phone: (02) 9113 2844


There are two types of brachytherapy treatments- seeds and HDR (high dose rate brachytherapy). Data is being collected for both types and includes demographic, diagnosis, pathology, clinical evaluation, lifestyle, PSA & testosterone results, clinical surveys, treatment and progression information.


Retrospective assessment of outcomes in seed brachytherapy patients from 2002 to date including dositometric outcomes, urinary and rectal toxicity and quality of life

PRINCIPAL INVESTIGATOR: Dr Nadine Beydoun      phone: (02) 9113 1212


This study is looking at a specific cohort of 18 patients, which recently had a special type of I-125 "thinseed", and will be comparing outcomes with standard I-125 seeds in these patients (acute urinary toxicity, operative time, prostate swelling post-implant, dosimetric comparison).

“The Cereal and Prostate Pilot”. An un-randomised study investigating a 6-week phytochemical-rich cereal intervention for men with various stages of prostate cancer.

PRINCIPAL INVESTIGATORS: Prof Paul de Souza and Dr Joseph Bucci

phone: (02) 9113 1675

CLINICAL TRIALS COORDINATOR: Carol Gano phone: (02) 9113 2518


The 3 treatment groups to be compared are:

Arm 1 – men diagnosed with early prostate cancer (post biopsy confirmation)

Arm 2 – men who have had PSA elevated for the second time, who are still androgen-sensitive

Arm 3 – men who have had a third rise in PSA, who are now castration resistant or androgen-insensitive through prostatectomy or by chemical castration

Investigations include: three visits to St George Hospital for blood and urine samples as well as collection of prostate tissue post-prostatectomy. Data related to nutrition and exercise is also collected.

Proteomic analysis of human body fluids and tissues to discover novel biomarkers for prostate cancer diagnosis and prognosis

PRINCIPAL INVESTIGATORS: Associate Professor Yong Li, Professor John Kearsley, A/Professor Peter Graham, Dr Paul Cozzi and Dr Joe Bucci (Prostate Cancer Institute, St George Hospital and UNSW

The purpose of this study is to identify novel markers in the human body fluids (tears, saliva, urine and blood) and tissues of patients with prostate cancer using modern proteomic approaches for early detection and monitoring progression. The success in identifying proteins of interest in prostate cancer patients may be used to early diagnose and stage the disease, monitor prostate cancer progression and recurrence, and to guide clinicians in choosing the best treatment methods for an individual patient. This could have a major impact on the prognosis of many of the 3000 Australian men who succumb to these cancers each year.


For more information about clinical trials click here