Hormone Therapy, Radiation Therapy, and Steroid 17alpha-monooxygenase TAK-700 in Treating Patients With High-Risk Prostate Cancer

OBJECTIVES:

Primary

* To evaluate the difference in overall survival of patients with clinically localized prostate cancer with unfavorable prognostic features between a) standard treatment (androgen-deprivation therapy \[ADT\] + radiotherapy) and b) standard treatment with the addition of 24 months of steroid 17alpha-monooxygenase TAK-700 (TAK-700).

Secondary

* To characterize differences between the treatment groups with respect to incidence of unexpected grade ≥ 3 adverse events and/or clinically significant decrement in patient-reported quality of life (QOL) among subjects treated with TAK-700. * To compare rates and cumulative incidence of biochemical control (freedom from PSA failure), local/regional progression, and distant metastases. * To compare rate and cumulative incidence of clinical failure, defined as prostate-specific antigen (PSA) \> 25 ng/mL, documented local disease progression, regional or distant metastasis, or initiation of ADT. * To compare prostate cancer-specific survival and other-cause mortality. * To compare the change in severity of fatigue as measured by the Patient-Reported Outcome Measurement Information System (PROMIS) fatigue short form. * To compare changes in patient-reported QOL as measured by Expanded Prostate Cancer Index Composite (EPIC). * To assess quality-adjusted survival using the EQ-5D. * To compare nadir and average serum testosterone at 12 and 24 months during treatment. * To compare changes in hemoglobin A1C, fasting glucose, and fasting insulin during 24 months of systemic treatment and during the first three years of follow-up. * To compare changes in fasting lipid levels during 24 months of treatment and during the first three years of follow-up. * To compare changes in body mass index (BMI) during 24 months of treatment and during the first three years of follow-up. * To compare the incidence of adverse events ascertained via CTCAE version 4. * To compare the rate of recovery of testosterone to \> 230 ng/dL (accepted threshold for supplementation) after 12 and 24 months of follow-up. * To compare the median time to recovery of testosterone to \> 230 ng/dL during the first five years of follow-up. * To assess cumulative incidence of relevant clinical survivorship endpoints including new diagnosis of type 2 diabetes, coronary artery disease, myocardial infarction, stroke, pulmonary embolism, deep vein thrombosis, or osteoporotic fracture.

OUTLINE: This is a multicenter, randomized study. Patients are stratified according to risk group (see Disease Characteristics) and type of radiation therapy (RT) boost (intensity-modulated RT (IMRT) vs brachytherapy). Patients are randomized to 1 of 2 treatment arms.

After completion of study therapy, patients are followed every 3 months for 2 years, every 6 months for 1 year, and then annually thereafter.