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Trial registered on ANZCTR
Registration number
ACTRN12606000301561
Ethics application status
Approved
Date submitted
28/07/2004
Date registered
28/07/2004
Date last updated
12/11/2018
Date data sharing statement initially provided
12/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
TOAD - Timing of androgen deprivation intervention in prostate cancer patients with a rising PSA
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Scientific title
A collaborative randomised phase III trial: The timing Of intervention with Androgen Deprivation in prostate cancer patients with a rising Prostate Specific Antigen (PSA)
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Secondary ID [1]
79
0
VCOG PR 1-03
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Secondary ID [2]
80
0
TROG 03.06
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Secondary ID [3]
81
0
National Clinical Trials Registry: NCTR580
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Secondary ID [4]
279
0
Trans-Tasman Radiation Oncology Group Inc (TROG): TROG 03.06
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Universal Trial Number (UTN)
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Trial acronym
TOAD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prostate cancer
52
0
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Condition category
Condition code
Cancer
58
58
0
0
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will be randomised to receive androgen deprivation therapy either immediately (experimental arm)
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Intervention code [1]
1195
0
Treatment: Other
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Comparator / control treatment
Patients will be randomised to receive androgen deprivation therapy delayed for at least 2 years or until evidence of significant disease progression (control arm).
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Control group
Active
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Outcomes
Primary outcome [1]
1855
0
The primary endpoint of the trial is death from any cause
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Assessment method [1]
1855
0
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Timepoint [1]
1855
0
Measured at 6 monthly assessments
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Secondary outcome [1]
3267
0
Cancer specific survival
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Assessment method [1]
3267
0
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Timepoint [1]
3267
0
6 monthly for 5 years
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Secondary outcome [2]
3268
0
Clinical progression
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Assessment method [2]
3268
0
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Timepoint [2]
3268
0
6 monthly for 5 years
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Secondary outcome [3]
3269
0
Time to first androgen independence
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Assessment method [3]
3269
0
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Timepoint [3]
3269
0
6 monthly for 5 years
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Secondary outcome [4]
3270
0
Complication rate incidence and timing (eg cord compression, pathological fracture)
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Assessment method [4]
3270
0
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Timepoint [4]
3270
0
6 monthly for 5 years
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Secondary outcome [5]
3271
0
Treatment related morbidity (including cognitive, osteoporosis)
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Assessment method [5]
3271
0
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Timepoint [5]
3271
0
6 monthly for 5 years
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Secondary outcome [6]
3272
0
Quality of life
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Assessment method [6]
3272
0
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Timepoint [6]
3272
0
6 monthly for 5 years
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Secondary outcome [7]
3273
0
Prognostic factors for progression (delayed group)
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Assessment method [7]
3273
0
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Timepoint [7]
3273
0
6 monthly for 5 years
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Eligibility
Key inclusion criteria
STUDIES 1 AND 2- Histologically confirmed adenocarcinoma of the prostate- Accessible for follow-up- Informed consent to be randomised to immediate or delayed androgen deprivation- Males aged 18 years and overINCLUSION CRITERIA STUDY 1 PSA relapse after definitive radical treatment- No evidence of metastatic disease on staging investigations (bone scan, abdomino-pelvic CT scan)- Prior androgen deprivation limited to a maximum of seven months neo-adjuvant/concurrent treatment, completed at least 12 months prior to study entryINCLUSION CRITERIA STUDY 2- Not suitable for radical treatment at primary diagnosis.- Decision not to treat curatively- No symptoms due to local or metastatic disease requiring radiation or immediate hormone therapy- No prior androgen deprivation therapy
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Significant co-morbidity limiting life expectancy to less than 5 years- Patients with symptomatic disease requiring therapy- Previous androgen deprivation for longer than 7 months (Study 1)- Diagnosis of PSA relapse or incurable disease more than six months prior to randomisation- Patients entered into TROG studies 96.01 or RADAR- Patients with a PSA doubling time of less than 3 months (Study 1)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Randomisation is performed centrally using computer software.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Treatment is allocated using a database embedded dynamically balanced randomisation method.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2004
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Actual
3/09/2004
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Date of last participant enrolment
Anticipated
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Actual
13/07/2012
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Date of last data collection
Anticipated
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Actual
31/12/2013
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Sample size
Target
750
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Accrual to date
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Final
293
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
87
0
Government body
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Name [1]
87
0
National Health & Medical Research Council
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Address [1]
87
0
National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
87
0
Australia
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Funding source category [2]
88
0
Commercial sector/Industry
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Name [2]
88
0
untied pharmaceutical company grants
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Address [2]
88
0
Hospira
Level 6, 390 St Kilda Road
Melbourne, VIC, 3004
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Country [2]
88
0
Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
The Cancer Council Victoria
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Address
1 Rathdowne St, Carlton South, 3053, VIC
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Country
Australia
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Secondary sponsor category [1]
68
0
Other Collaborative groups
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Name [1]
68
0
Trans Tasman Radiation Oncology Group (TROG)
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Address [1]
68
0
Dept of Radiation Oncology
Newcastle Mater Misericordiae Hospital
Locked Bag7, NHMRC NSW 2310
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Country [1]
68
0
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
769
0
Alfred Hospital
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Ethics committee address [1]
769
0
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Ethics committee country [1]
769
0
Australia
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Date submitted for ethics approval [1]
769
0
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Approval date [1]
769
0
25/10/2004
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Ethics approval number [1]
769
0
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Ethics committee name [2]
770
0
Campbelltown Hospital
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Ethics committee address [2]
770
0
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Ethics committee country [2]
770
0
Australia
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Date submitted for ethics approval [2]
770
0
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Approval date [2]
770
0
06/12/2005
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Ethics approval number [2]
770
0
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Ethics committee name [3]
771
0
Cham, Mr Chee Wee
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Ethics committee address [3]
771
0
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Ethics committee country [3]
771
0
Australia
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Date submitted for ethics approval [3]
771
0
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Approval date [3]
771
0
19/08/2005
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Ethics approval number [3]
771
0
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Ethics committee name [4]
772
0
Christchurch Hospital
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Ethics committee address [4]
772
0
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Ethics committee country [4]
772
0
New Zealand
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Date submitted for ethics approval [4]
772
0
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Approval date [4]
772
0
19/04/2005
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Ethics approval number [4]
772
0
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Ethics committee name [5]
773
0
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Ethics committee address [5]
773
0
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Ethics committee country [5]
773
0
Australia
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Date submitted for ethics approval [5]
773
0
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Approval date [5]
773
0
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Ethics approval number [5]
773
0
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Ethics committee name [6]
774
0
Concord Repatriation Hosp
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Ethics committee address [6]
774
0
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Ethics committee country [6]
774
0
Australia
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Date submitted for ethics approval [6]
774
0
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Approval date [6]
774
0
05/10/2004
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Ethics approval number [6]
774
0
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Ethics committee name [7]
775
0
Dunedin Hospital
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Ethics committee address [7]
775
0
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Ethics committee country [7]
775
0
New Zealand
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Date submitted for ethics approval [7]
775
0
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Approval date [7]
775
0
24/06/2005
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Ethics approval number [7]
775
0
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Ethics committee name [8]
776
0
East Coast Cancer Centre
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Ethics committee address [8]
776
0
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Ethics committee country [8]
776
0
Australia
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Date submitted for ethics approval [8]
776
0
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Approval date [8]
776
0
30/11/2004
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Ethics approval number [8]
776
0
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Ethics committee name [9]
777
0
Geelong Hospital
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Ethics committee address [9]
777
0
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Ethics committee country [9]
777
0
Australia
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Date submitted for ethics approval [9]
777
0
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Approval date [9]
777
0
04/11/2004
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Ethics approval number [9]
777
0
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Ethics committee name [10]
778
0
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Ethics committee address [10]
778
0
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Ethics committee country [10]
778
0
Australia
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Date submitted for ethics approval [10]
778
0
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Approval date [10]
778
0
28/04/2006
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Ethics approval number [10]
778
0
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Ethics committee name [11]
779
0
Liverpool Hospital
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Ethics committee address [11]
779
0
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Ethics committee country [11]
779
0
Australia
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Date submitted for ethics approval [11]
779
0
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Approval date [11]
779
0
06/11/2004
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Ethics approval number [11]
779
0
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Ethics committee name [12]
780
0
Mander, Mr Julian
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Ethics committee address [12]
780
0
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Ethics committee country [12]
780
0
Australia
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Date submitted for ethics approval [12]
780
0
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Approval date [12]
780
0
19/05/2006
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Ethics approval number [12]
780
0
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Ethics committee name [13]
781
0
Mater QRI
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Ethics committee address [13]
781
0
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Ethics committee country [13]
781
0
Australia
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Date submitted for ethics approval [13]
781
0
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Approval date [13]
781
0
09/09/2004
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Ethics approval number [13]
781
0
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Ethics committee name [14]
782
0
Monash Medical Centre
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Ethics committee address [14]
782
0
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Ethics committee country [14]
782
0
Australia
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Date submitted for ethics approval [14]
782
0
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Approval date [14]
782
0
19/04/2006
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Ethics approval number [14]
782
0
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Ethics committee name [15]
783
0
Nepean Cancer Care Centre
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Ethics committee address [15]
783
0
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Ethics committee country [15]
783
0
Australia
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Date submitted for ethics approval [15]
783
0
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Approval date [15]
783
0
29/03/2005
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Ethics approval number [15]
783
0
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Ethics committee name [16]
784
0
Newcastle Mater
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Ethics committee address [16]
784
0
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Ethics committee country [16]
784
0
Australia
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Date submitted for ethics approval [16]
784
0
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Approval date [16]
784
0
18/03/2005
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Ethics approval number [16]
784
0
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Ethics committee name [17]
785
0
Peter MacCallum Cancer Centre
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Ethics committee address [17]
785
0
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Ethics committee country [17]
785
0
Australia
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Date submitted for ethics approval [17]
785
0
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Approval date [17]
785
0
24/08/2004
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Ethics approval number [17]
785
0
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Ethics committee name [18]
786
0
Princess Alexandra Hospital
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Ethics committee address [18]
786
0
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Ethics committee country [18]
786
0
Australia
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Date submitted for ethics approval [18]
786
0
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Approval date [18]
786
0
30/08/2004
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Ethics approval number [18]
786
0
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Ethics committee name [19]
787
0
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Ethics committee address [19]
787
0
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Ethics committee country [19]
787
0
Australia
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Date submitted for ethics approval [19]
787
0
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Approval date [19]
787
0
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Ethics approval number [19]
787
0
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Ethics committee name [20]
788
0
Repatriation General Hospital
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Ethics committee address [20]
788
0
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Ethics committee country [20]
788
0
Australia
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Date submitted for ethics approval [20]
788
0
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Approval date [20]
788
0
04/08/2004
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Ethics approval number [20]
788
0
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Ethics committee name [21]
789
0
Royal Brisbane Hospital
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Ethics committee address [21]
789
0
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Ethics committee country [21]
789
0
Australia
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Date submitted for ethics approval [21]
789
0
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Approval date [21]
789
0
03/08/2004
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Ethics approval number [21]
789
0
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Ethics committee name [22]
790
0
Royal Prince Alfred
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Ethics committee address [22]
790
0
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Ethics committee country [22]
790
0
Australia
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Date submitted for ethics approval [22]
790
0
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Approval date [22]
790
0
23/08/2004
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Ethics approval number [22]
790
0
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Ethics committee name [23]
791
0
Sinclair, Mr Graham
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Ethics committee address [23]
791
0
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Ethics committee country [23]
791
0
Australia
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Date submitted for ethics approval [23]
791
0
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Approval date [23]
791
0
28/06/2005
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Ethics approval number [23]
791
0
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Ethics committee name [24]
792
0
Sir Charles Gairdner Hospital
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Ethics committee address [24]
792
0
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Ethics committee country [24]
792
0
Australia
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Date submitted for ethics approval [24]
792
0
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Approval date [24]
792
0
19/12/2005
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Ethics approval number [24]
792
0
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Ethics committee name [25]
793
0
Syme, Mr Rodney
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Ethics committee address [25]
793
0
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Ethics committee country [25]
793
0
Australia
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Date submitted for ethics approval [25]
793
0
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Approval date [25]
793
0
01/03/2005
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Ethics approval number [25]
793
0
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Ethics committee name [26]
794
0
St George Hospital
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Ethics committee address [26]
794
0
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Ethics committee country [26]
794
0
Australia
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Date submitted for ethics approval [26]
794
0
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Approval date [26]
794
0
16/03/2005
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Ethics approval number [26]
794
0
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Ethics committee name [27]
795
0
Vivian, Mr Justin
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Ethics committee address [27]
795
0
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Ethics committee country [27]
795
0
Australia
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Date submitted for ethics approval [27]
795
0
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Approval date [27]
795
0
19/05/2006
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Ethics approval number [27]
795
0
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Ethics committee name [28]
796
0
Waikato Hospital
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Ethics committee address [28]
796
0
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Ethics committee country [28]
796
0
New Zealand
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Date submitted for ethics approval [28]
796
0
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Approval date [28]
796
0
23/11/2004
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Ethics approval number [28]
796
0
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Ethics committee name [29]
797
0
Wellington Hospital
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Ethics committee address [29]
797
0
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Ethics committee country [29]
797
0
New Zealand
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Date submitted for ethics approval [29]
797
0
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Approval date [29]
797
0
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Ethics approval number [29]
797
0
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Ethics committee name [30]
798
0
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Ethics committee address [30]
798
0
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Ethics committee country [30]
798
0
Australia
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Date submitted for ethics approval [30]
798
0
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Approval date [30]
798
0
06/08/2004
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Ethics approval number [30]
798
0
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Ethics committee name [31]
799
0
Westmead Hospital
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Ethics committee address [31]
799
0
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Ethics committee country [31]
799
0
Australia
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Date submitted for ethics approval [31]
799
0
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Approval date [31]
799
0
26/10/2004
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Ethics approval number [31]
799
0
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Ethics committee name [32]
6163
0
Auckland City Hospital
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Ethics committee address [32]
6163
0
Waikato DHB, Regional Cancer Centre, Private Bag, 3200 Hamilton, NZ
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Ethics committee country [32]
6163
0
New Zealand
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Date submitted for ethics approval [32]
6163
0
26/10/2006
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Approval date [32]
6163
0
26/10/2006
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Ethics approval number [32]
6163
0
WAI/04/07/058
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Ethics committee name [33]
6164
0
Royal North Shore Hospital
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Ethics committee address [33]
6164
0
Research Office, Level 4, Vindin House, RNSH, Pacific Hwy, St Leonards, NSW 2065
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Ethics committee country [33]
6164
0
Australia
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Date submitted for ethics approval [33]
6164
0
16/09/2006
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Approval date [33]
6164
0
16/09/2006
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Ethics approval number [33]
6164
0
0608-144M
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Ethics committee name [34]
6165
0
Dr Henry Woo
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Ethics committee address [34]
6165
0
New South Wales Cancer Council
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Ethics committee country [34]
6165
0
Australia
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Date submitted for ethics approval [34]
6165
0
10/01/2005
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Approval date [34]
6165
0
10/01/2005
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Ethics approval number [34]
6165
0
123
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Ethics committee name [35]
6166
0
Illawarra Cancer Care Centre
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Ethics committee address [35]
6166
0
SE Sydney and Illawarra Area Health Service Health and Medical HREC
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Ethics committee country [35]
6166
0
Australia
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Date submitted for ethics approval [35]
6166
0
14/05/2008
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Approval date [35]
6166
0
14/05/2008
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Ethics approval number [35]
6166
0
CT08/001
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Summary
Brief summary
This is a clinical trial for patients with prostate cancer. The aim of the project is to provide information about the best timing to start treatment in men who have a rising PSA (prostate specific antigen) blood test, after having had treatment with the aim of curing their prostate cancer. In some men, the surgery or radiotherapy given initially in the attempt to cure the cancer is not successful. One of the earliest ways of detecting recurrence of the cancer in these men is with the PSA blood test, which can detect activity of the cancer months or years before other tests, and usually long before any symptoms appear. We know that treatment with hormone therapy – removing the male hormone testosterone – is helpful in controlling advanced disease causing symptoms, although it is not a cure. This is called ‘androgen deprivation’, testosterone being an androgen hormone. The cancer cells are deprived of a source of energy, keeping them under control for a while, but eventually they tend to start growing again in spite of the treatment. We know that using androgen deprivation usually causes the PSA level in men to fall, including men in your situation who have no other signs of active cancer. What we do not know is whether using androgen deprivation immediately the PSA starts to rise will prolong life more than waiting to start treatment until there are other signs that the disease is progressing. It would be simple to start everyone on treatment with androgen deprivation if there were no side effects with the treatment. However, there are a number of side effects that may interfere with day-to-day living. These include (but are not limited to): hot flushes, tiredness, anaemia, and loss of muscle mass and bone density. There may be weight gain, and nipple tenderness or swelling. Some men notice changes in mental function, or shortness of breath. Most also find that sex drive and erectile function, if normal before starting treatment, cease. Quality of life may be affected. If androgen deprivation therapy is ceased, some of the side effects (such as loss of sex drive, loss of muscle bulk or bone mineral density) may be halted or reversed. Generally the standard approach would be to delay introducing treatment until the disease progresses. So the purpose of the study is to see whether immediate treatment is better or worse than delayed treatment in terms of prolonging lifespan, balanced against the effects on the quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
35547
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Address
35547
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Country
35547
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Phone
35547
0
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Fax
35547
0
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Email
35547
0
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Contact person for public queries
Name
10384
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Deborah Howell
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Address
10384
0
The Cancer Council Victoria
1 Rathdowne Street
Carlton VIC 3053
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Country
10384
0
Australia
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Phone
10384
0
+61(0)3 9635 5179
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Fax
10384
0
+61(0)3 9635 5410
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Email
10384
0
[email protected]
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Contact person for scientific queries
Name
1312
0
Prof Gillian Duchesne
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Address
1312
0
Director Radiation Oncology
Peter MacCallum Cancer Centre
Locked Bag 1
A'Beckett Street
Melbourne Victoria 8001
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Country
1312
0
Australia
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Phone
1312
0
+61(0)3 9656 1004
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Fax
1312
0
+61(0)3 9656 1424
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Email
1312
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Timing of androgen-deprivation therapy in patients with prostate cancer with a rising PSA (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial.
2016
https://dx.doi.org/10.1016/S1470-2045%2816%2900107-8
Embase
Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial.
2017
https://dx.doi.org/10.1016/S1470-2045%2817%2930426-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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