Ongoing Trials: Only a few more patients needed to help advance research in prostate cancer and upper urinary tract cancer

Two ECOG-ACRIN Cancer Research Group treatment trials are close to meeting their enrollment goals. One is testing treatment that could help improve outcomes for patients with recurrent prostate cancer. The other aims to improve treatment for aggressive upper urinary tract cancer. The prostate cancer trial needs 38 more participants, and the upper urinary tract cancer trial needs 20.

If you have one of these cancers, ask your doctor whether the trial may be an option. If you know someone who might be eligible, please share this update.

Prostate cancer that returns after surgery

For prostate cancer that returns after surgery, standard treatment is radiation to the area where the prostate was removed and to the pelvic lymph nodes. It also includes 6 months of androgen deprivation therapy (ADT), a type of hormone therapy. The EA8191/INDICATE trial is testing whether PET scans can help doctors identify patients who may benefit from more treatment. The goal is to give extra treatment to those who may benefit and spare others the added side effects if they are unlikely to benefit. Enrollment is complete for patients whose PET scans show no cancer outside the pelvis. The trial needs 38 more patients whose PET scans show signs that cancer has spread beyond the pelvis.

Participants are randomly assigned by a computer to one of two treatment groups. Both groups receive standard treatment with radiation and ADT. Both groups also receive apalutamide, another hormone treatment. In one group, the treatment plan also includes radiation to the areas outside the pelvis where the PET scan shows cancer. In the other group, doctors may give radiation to those areas later if needed. The goal is to measure how long patients in each group live without their cancer getting worse.

Learn more about EA8191/INDICATE at ecog-acrin.org.

Aggressive upper urinary tract cancer

The EA8192 study is for people with high-grade upper urinary tract cancer. This cancer starts in the lining of the part of the kidney that collects urine or in the ureter, the tube that carries urine to the bladder. It differs from bladder cancer or kidney cancer. Doctors determine the grade by looking at a tumor sample under a microscope. Compared with low-grade cancer, high-grade cancer has more irregular-looking cells and is more likely to grow and spread.

Surgery is standard to remove the affected kidney, ureter, and a small piece of the bladder. A combination of chemotherapy drugs that includes cisplatin is a standard option before surgery for patients who can receive it. In EA8192, patients who can receive cisplatin are randomly assigned by a computer to one of two groups. Both groups receive treatment before surgery. One group receives chemotherapy alone. The other receives the same chemotherapy plus an immunotherapy drug called durvalumab. The study also includes a separate group for people who cannot receive cisplatin.

Learn more about EA8192 at ecog-acrin.org.

Helpful resources are available

• For more information and to find resources and support, contact the National Cancer Institute’s Cancer Information Service
• For prostate cancer information and support, visit ZERO Prostate Cancer
• For upper urinary tract cancer information and support, visit the Bladder Cancer Advocacy Network