Can gene risk based on the Decipher risk score inform hormonal therapy treatment with radiation for unfavorable intermediate risk prostate cancer?

If you over the age of 18 with localized prostate cancer that is “unfavorable intermediate risk” based on your physician’s evaluation and risk factors such as PSA, Gleason score, and tumor stage, you may be able to participate.

This study will be testing to see if radiation alone is as effective as radiation plus hormone therapy at controlling cancer for men with a low gene risk score. Additionally, this study will be testing if adding another new hormone therapy drug to the usual combination of radiation and hormone therapy increases the length of time without prostate cancer spreading for men with a higher gene risk score. 

The usual hormone drugs for up to 6 months plus the usual radiation therapy for 2-11 weeks depending on the type of radiation therapy given by your doctor, or

The usual approach for patients who are not in a study is treatment with radiation therapy alone or in combination with hormonal drugs, approved by the Food and Drug Administration (FDA), and radiation therapy.  For patients who get the usual approach for this cancer, about 80 out of 100 are free of cancer after 5 years.  

• You may lose time at work or home and spend more time in the hospital or doctor’s office than usual.
• You may be asked sensitive or private questions which you normally do not discuss.
• The study treatments may not be as good as the usual approach for your cancer at shrinking or stabilizing your cancer and preventing your cancer from spreading.
• The study drugs used on this trial may cause side effects. Your doctor will review all of the potential side effects with you. It is important to tell your doctor about any side effects during the study so that they may be treated and so that potential adjustments to the study drugs may be made. 

There is evidence that the study approach is effective in stabilizing your type of cancer. It is not possible to know now if the study approach will be similar to (if you have low Decipher score) or extend (if you have a high Decipher score) your time without disease spreading compared to the usual approach.  This study will help the study doctors learn things that will help people in the future.

If you are in the group receiving radiation therapy alone your treatment can last up to 11 weeks depending on the type of radiation therapy you receive. The other three groups receiving radiation plus hormone therapy will receive treatment for six months.

After you finish your study treatment, your doctor will continue to follow your condition and watch for side effects and cancer control.

No. Taking part in this study is voluntary. You are free to choose to participate or not to participate. If you choose to participate in this study, you are able to leave the study at any time. If you decide not to take part in this study, your doctor will discuss other treatment options with you.

• the costs of tests, exams, procedures, and drugs that you get during the study to monitor your safety and prevent and treat side effects.  
• the costs of the hormone therapy.
• the radiation therapy.
• your insurance co-pays and deductibles.

Your privacy is very important to us and the researchers will make every effort to protect it. Your information may be given out if required by law. For example, certain states require doctors to report to health boards if they find a disease like tuberculosis. However, the researchers will do their best to make sure that any information that is released will not identify you. Some of your health information and/or information about your specimens from this study will be kept in a central database for research. Your name or contact information will not be put in the database.

• NRG Oncology and Bayer, the company supporting the study now or in the future. This would include any organization helping the company with the study. 
• The National Cancer Institute (NCI) Central Institutional Review Board (CIRB), which is a group of people who review the research with the goal of protecting the people who take part in the study. 
• The Food and Drug Administration and the groups it works with to review research.  
• The NCI and the groups it works with to review research, including the Cancer Trials Support Unit (CTSU).
• The NCI’s National Clinical Trials Network and the groups it works with to conduct research including the Imaging and Radiation Oncology Core (IROC).

Doctors and researchers conduct a clinical study, also called a “clinical trial,” to find better ways to prevent, diagnose, or treat an illness. NRG Oncology is supported by the National Cancer Institute (NCI) and runs clinical studies specifically for patients with cancer or to prevent cancer. Most clinical studies test something we know against something we don’t know. In all situations, these studies are strictly evaluated before they are allowed to be offered to any patient. The study is designed to answer the question that we do not know the answer to, so that current and future patients may have better treatments or information than what we currently have. There are different types of clinical studies that might be available for patients. For more information see “Types of Clinical Trials” and “Phases of Clinical Trials”.

Patients who volunteer to take part in a clinical study are followed closely by their health care professionals and members of the research team. For more information see “Research Team Members”.

Yes. They are exactly the same thing.

The care cancer doctors provide to cancer patients today is the direct result of clinical studies (also known as clinical trials) that were done in the past. Clinical studies give doctors and the treatment team information about what types of treatments work and what treatments do not work, in a number of different situations. Some studies focus on treating the cancer, others on preventing the cancer, and others on helping patients feel better or healthier during or after treatments. When you take part in a clinical study, you add to our knowledge about cancer and it may help improve cancer care for future patients. Clinical studies are available to patients with many types of cancer and at all stages of treatment. In some situations, the only way to get these new treatments is by joining a clinical study.

A clinical study may take place in many locations, such as:

physician offices

hospitals

clinics

A study is typically led by a principal investigator who is a doctor or other advanced health care professional. A clinical study is carried out by following a very specific plan known as the “protocol”. The protocol is designed so all patients in the study are treated as well as possible and in the same way. The protocol also provides rules for the doctors and clinical study staff to follow to keep patients safe and make sure the study is run in an ethical manner.

No, not at all. Participation in a clinical study is completely voluntary. For more information see “Deciding to Take Part in a Clinical Trial”. You are free to choose to participate or not to participate. If you choose to participate in a study, you may still decide to leave the study at any time. If you decide not to participate in a study, your doctor will discuss other treatment options with you. For more information see “Questions to Ask Your Doctor about Treatment Clinical Trials".

• You may choose to have the usual treatment approach (known as “standard of care”)
• You may choose to take part or learn more about a different study, if one is available
• You may choose not to be treated for cancer