Clinical trial · Interventional
S0421, Docetaxel and Prednisone With or Without Atrasentan in Treating Patients With Stage IV Prostate Cancer and Bone Metastases That Did Not Respond to Previous Hormone Therapy
Phase III Study of Docetaxel and Atrasentan Versus Docetaxel and Placebo for Patients With Advanced Hormone Refractory Prostate Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
RATIONALE: Drugs used in chemotherapy, such as docetaxel, prednisone, and atrasentan work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. It is not yet known whether docetaxel, prednisone, and atrasentan are more effective than docetaxel and prednisone in treating prostate cancer. PURPOSE: This randomized phase III trial is studying docetaxel, prednisone, and atrasentan to see how well they work compared to docetaxel and prednisone in treating patients with stage IV prostate cancer and bone metastases that did not respond to previous hormone therapy.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Metastatic Cancer | Malignant Neoplasm | CURATED_BROADER | 0.78 |
| Prostate Cancer | Malignant Prostate Neoplasm | CURATED_EXACT | 0.92 |
Interventions
Interventions (4)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| atrasentan hydrochloride | Drug | — | UNRESOLVED |
| docetaxel | Drug | Docetaxel | ALIAS |
| placebo | Other | — | UNRESOLVED |
| prednisone | Drug | Prednisone | ALIAS |
Design
Arms and outcomes
Arms (2)
- type
- ACTIVE_COMPARATOR
- label
- Arm I: placebo
- description
- Patients receive docetaxel and prednisone as in arm I. Patients also receive oral placebo once daily on days 1-21. Treatment repeat every 21 days for up to 12 courses. Patients with stable or responding disease after course 12 may register for continued oral placebo treatment for up to 52 weeks.
- interventionNames
- Drug: docetaxel
- Drug: prednisone
- Other: placebo
- type
- EXPERIMENTAL
- label
- Arm II: atrasentan hydrochloride
- description
- Patients receive docetaxel IV over 1 hour on day 1. Patients also receive oral atrasentan and oral prednisone once daily on days 1-21. Treatment repeats every 21 days for up to 12 courses. Patients with stable or responding disease after course 12 may register for continued oral atrasentan treatment for up to 52 weeks.
- interventionNames
- Drug: atrasentan hydrochloride
- Drug: docetaxel
Eligibility
Eligibility (as posted)
- Sex
- Male
- Minimum age
- 18 Years
Show eligibility criteria text
DISEASE CHARACTERISTICS:
* Histologically confirmed adenocarcinoma of the prostate
* Stage IV disease (any T, any N, M1b)
* Evidence of bone metastases by bone scan or MRI
* Measurable or nonmeasurable disease
* Soft tissue disease that has been irradiated within the past 2 months is not assessable as measurable disease
* Hormone-refractory disease despite androgen deprivation and antiandrogen withdrawal, as defined by 1 of the following criteria:
* Prostate-specific antigen (PSA) progression, defined as 3 consecutive rising PSA levels\* taken ≥ 1 week apart
* PSA ≥ 5 ng/mL NOTE: \*If the third confirmatory PSA level is \< the second level, the patient is considered eligible provided a fourth PSA level is \> the second level
* Progression of measurable disease
* Progression of nonmeasurable disease by bone scan
* Must have undergone surgical or medical (e.g., luteinizing hormone-releasing hormone \[LHRH\] agonist \[e.g., leuprolide or goserelin\] or LHRH antagonist therapy) castration
* Patients who have undergone medical castration must continue LHRH agonist or antagonist therapy during study treatment
* Must have completed 12 courses of blinding protocol treatment (atrasentan/placebo) AND stopped docetaxel for any reason (including completion of 12 courses) other than progressive disease
* No symptomatic pleural effusion
* No third space fluid accumulation (e.g., ascites)
* No prior or concurrent brain metastases
* Patients with clinical evidence of brain metastases must have a negative brain CT scan or MRI within the past 8 weeks
PATIENT CHARACTERISTICS:
Age
* 18 and over
Performance status
* Zubrod 0-3\* NOTE: For a performance status of 3, the cause must be due to pain secondary to bone metastases
Life expectancy
* Not specified
Hematopoietic
* Not specified
Hepatic
* Not specified
Renal
* Not specified
Other
* Fertile patients must use effective contraception
* Able to take oral medication without crushing, dissolving, or chewing tablets
* No major infection
* No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or stage I or II cancer in complete remission
* No symptomatic sensory neuropathy ≥ grade 2
* No history of hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80
* No other significant, active medical illness that would preclude study treatment or survival
PRIOR CONCURRENT THERAPY:
Biologic therapy
* No more than 1 prior systemic vaccine or biologic therapy
* At least 4 weeks since prior vaccine or biologic therapy and recovered
* No concurrent biological response modifiers
* No concurrent prophylactic colony-stimulating factors
Chemotherapy
* More than 2 years since prior adjuvant therapy with a single non-taxane-containing cytotoxic regimen
* No prior cytotoxic chemotherapy for metastatic prostate cancer
* No other concurrent chemotherapy
Endocrine therapy
* See Disease Characteristics
* At least 6 weeks since prior bicalutamide or nilutamide AND has subsequent disease progression
* At least 4 weeks since prior flutamide or ketoconazole AND has subsequent disease progression
* Prior or concurrent megestrol for treatment of hot flashes allowed
* No other concurrent corticosteroid or hormonal therapy unless continuing luteinizing hormone-releasing hormone treatment and/or bisphosphonate therapy
Radiotherapy
* See Disease Characteristics
* Prior samarium allowed
* At least 3 weeks since prior radiotherapy and recovered
* No prior radiotherapy to ≥ 30% of the bone marrow
* No prior strontium
* No concurrent radiotherapy
Surgery
* See Disease Characteristics
* At least 3 weeks since prior surgery and recovered
Other
* More than 4 weeks since prior investigational drugs
* Concurrent bisphosphonates allowed provided therapy is started prior to study entry, dose is maintained during the first 12 weeks of study treatment, and patient meets criteria for disease progression
* No initiation of bisphosphonates during the first 12 weeks of study treatment
* No concurrent herbal medications or food supplements (e.g., PC-SPES, saw palmetto, Hypericum perforatum \[St. John's wort\])
* Concurrent daily vitamins and calcium supplements allowed
* At least 14 days since prior and no concurrent administration of any of the following:
* Antibiotics (e.g., clarithromycin, erythromycin, troleandomycin, rifampin, rifabutin, and rifapentine)
* Antifungals (e.g., itraconazole, ketoconazole, fluconazole \[doses \> 200 mg/day\], and voriconazole)
* Antidepressants (e.g., nefazodone and fluvoxamine)
* Calcium channel blockers (e.g., verapamil, diltiazem)
* Miscellaneous (e.g., amiodarone \[no use within 6 months prior to study entry\], grapefruit juice, bitter orange, or modafinil)
* Anticonvulsants (e.g., phenytoin, carbamazepine, phenobarbital, and oxcarbazepine)
* Antibiotics (e.g., rifampin, rifabutin, and rifapentine)References
Publications (7)
- RESULTGoldkorn A, Ely B, Quinn DI, et al.: Results of telomerase activity measurements from live circulating tumor cells captured on a slot microfilter in a phase III SWOG-coordinated prostate cancer trial (S0421). [Abstract] J Clin Oncol 30 (Suppl 15): A-4663, 2012.
- RESULTLara P, Ely B, Quinn DI, et al.: SWOG 0421: prognostic and predictive value of bone metabolism biomarkers (BMB) in castration resistant prostate cancer (CRPC) patients (pts) with skeletal metastases treated with docetaxel (DOC) with or without atrasentan (ATR). [Abstract] J Clin Oncol 30 (Suppl 15): A-4547, 2012.
- RESULTQuinn DI, Tangen CM, Hussain M, et al.: SWOG S0421: phase III study of docetaxel (D) and atrasentan (A) versus docetaxel and placebo (P) for men with advanced castrate resistant prostate cancer (CRPC). [Abstract] J Clin Oncol 30 (Suppl 15): A-4511, 2012.
- RESULTGoldkorn A, Ely B, Quinn DI, Tangen CM, Fink LM, Xu T, Twardowski P, Van Veldhuizen PJ, Agarwal N, Carducci MA, Monk JP 3rd, Datar RH, Garzotto M, Mack PC, Lara P Jr, Higano CS, Hussain M, Thompson IM Jr, Cote RJ, Vogelzang NJ. Circulating tumor cell counts are prognostic of overall survival in SWOG S0421: a phase III trial of docetaxel with or without atrasentan for metastatic castration-resistant prostate cancer. J Clin Oncol. 2014 Apr 10;32(11):1136-42. doi: 10.1200/JCO.2013.51.7417. Epub 2014 Mar 10. PMID 24616308
- RESULTGoldkorn A, Xu T, Lu B, et al.: Circulating tumor cell capture and analysis in a multicenter SWOG-coordinated prostate cancer trial. [Abstract] J Clin Oncol 28 (Suppl 15): A-TPS342, 2010.
- DERIVEDLara PN Jr, Ely B, Quinn DI, Mack PC, Tangen C, Gertz E, Twardowski PW, Goldkorn A, Hussain M, Vogelzang NJ, Thompson IM, Van Loan MD. Serum biomarkers of bone metabolism in castration-resistant prostate cancer patients with skeletal metastases: results from SWOG 0421. J Natl Cancer Inst. 2014 Apr;106(4):dju013. doi: 10.1093/jnci/dju013. Epub 2014 Feb 24. PMID 24565955
- DERIVEDQuinn DI, Tangen CM, Hussain M, Lara PN Jr, Goldkorn A, Moinpour CM, Garzotto MG, Mack PC, Carducci MA, Monk JP, Twardowski PW, Van Veldhuizen PJ, Agarwal N, Higano CS, Vogelzang NJ, Thompson IM Jr. Docetaxel and atrasentan versus docetaxel and placebo for men with advanced castration-resistant prostate cancer (SWOG S0421): a randomised phase 3 trial. Lancet Oncol. 2013 Aug;14(9):893-900. doi: 10.1016/S1470-2045(13)70294-8. Epub 2013 Jul 17.