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NCT05946213ClinicalTrials.gov

Testing Shorter Duration Radiation Therapy Versus the Usual Radiation Therapy in Patients With High Risk Prostate Cancer

The Phase III 'High Five Trial' Five Fraction Radiation For High-Risk Prostate Cancer

RecruitingTaking participants now, according to the registry record.
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In brief

This phase III trial compares stereotactic body radiation therapy (SBRT), (five treatments over two weeks using a higher dose per treatment) to usual radiation therapy (20 to 45 treatments over 4 to 9 weeks) for the treatment of high-risk prostate…

Phase 31,209 participants sought413 sites4 countries

Categories

Registered in 1 registry

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Trial information is shown as published by the registry, in its original language.

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

  • Present: Registered before enrolment beganFirst posted 2023-07-14; recorded start 2023-12-14
  • Present: Has a defined primary outcomeA primary outcome measure is listed in the record
  • Present: The primary outcome states a time frameThe primary outcome measure records a time frame
  • Present: Participants are randomly assignedAllocation is recorded as randomised
  • Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
  • Not stated: Open label (no blinding)Masking is recorded as none (open label)
  • Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
  • Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
  • Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
  • Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
  • Present: Sponsor has 49 other studies in this databaseCounted from the lead sponsor named in the record (NRG Oncology)
  • Present: Sponsor has posted results for at least one studyBased on the sponsor’s studies in this database
  • The record lists 3 conditions.
  • Lead sponsor type recorded as: other.
  • Intervention regulatory context: investigational, within a phased regulatory pathway.

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourSTRONG

A strong methodological design for a phase 3 study, judged from its ClinicalTrials.gov record.

How this score is built
  • Randomised allocation20/20

    Participants are randomly allocated between arms

  • Blinding0/20

    Open-label

  • Control arm15/15

    Active-comparator control arm

  • Primary-outcome specificity10/10

    Named primary outcome with a defined time frame

  • Endpoint type10/10

    Mortality / MACE endpoint (hard clinical outcome)

  • Multi-centre8/8

    Multi-centre: 413 sites

  • Data monitoring committee0/7

    No data monitoring committee stated

  • Prospective registration5/5

    Registered before the study start date

  • Protocol / SAP posted0/5

    No protocol or SAP posted to the registry

ScaleLARGE

A large study, international in scope: 1,209 participants (target), run at 413 sites, across 4 countries.

How this score is built
  • Enrolment31/40

    1,209 participants (target)

  • Site count25/25

    413 sites

  • Country count7/15

    4 countries

  • Planned duration10/10

    Planned over about 150 months

  • Sponsor scale6/10

    NRG Oncology has led 49 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built
  • Investigator standing0/100

    No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Summary

This phase III trial compares stereotactic body radiation therapy (SBRT), (five treatments over two weeks using a higher dose per treatment) to usual radiation therapy (20 to 45 treatments over 4 to 9 weeks) for the treatment of high-risk prostate cancer. SBRT uses special equipment to position a patient and deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period of time. This trial is evaluating if shorter duration radiation prevents cancer from coming back as well as the usual radiation treatment.

PRIMARY OBJECTIVE: I. To compare metastasis-free survival, determined using conventional imaging, between men with high-risk prostate cancer randomized to ultrahypofractionation (stereotactic body radiation therapy \[SBRT\]) to those randomized to moderate hypofractionation and conventional fractionation. SECONDARY OBJECTIVES: I. To compare physician-reported toxicity as measured by Common Terminology Criteria for Adverse Events (CTCAE) version (v)5 between treatment arms. II. To determine if ultrahypofractionation is non-inferior to moderate hypofractionation and conventional fractionation with respect to patient-reported urinary function (assessed by Expanded Prostate Cancer Index Composite \[EPIC\]-26 urinary domains). III. To determine if ultrahypofractionation is non-inferior to moderate hypofractionation and conventional fractionation with respect to patient-reported bowel function (assessed by EPIC-26 bowel domain). IV. To compare patient-reported fatigue (assessed by Patient Reported Outcomes Measurement Information System \[PROMIS\]-Fatigue) between treatment arms. V. To compare failure-free survival between treatment arms. VI. To compare metastasis-free survival based on molecular imaging between treatment arms. VII. To compare overall survival between treatment arms. EXPLORATORY OBJECTIVES: I. To compare patient-reported sexual function (assessed by EPIC-26 sexual domain) between treatment arms. II. To compare patient-reported quality of life (assessed by European Quality of Life Five Dimension Five Level Scale Questionnaire \[EQ-5D-5L\]) between treatment arms. III. To compare patient-reported treatment burden (assessed by COmprehensive Score for financial Toxicity (COST)) between treatment arms OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients undergo SBRT for a total of 5 treatments over 2 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan and/or computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)/CT during screening and CT and/or MRI on study. Additionally, patients may optionally undergo blood and urine sample collection on study. ARM II: Patients undergo external beam radiation treatment (EBRT) for 20-45 treatments over 4 to 9 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan and/or CT, MRI, or PET/CT during screening and CT and/or MRI on study. Additionally, patients may optionally undergo blood and urine sample collection on study. Patients are followed up every 6 months for 5 years.

Conditions

  • Prostate Adenocarcinoma
  • Stage III Prostate Cancer AJCC v8
  • Stage IVA Prostate Cancer AJCC v8

Eligibility

Eligibility
SexMale
Ages18 YearsNo maximum
Healthy volunteersNo

Eligibility as written in the registry

Inclusion Criteria: * Pathologically (histologically or cytologically) proven diagnosis of adenocarcinoma of prostate cancer * High-risk disease defined as having at least one or more of the following: * cT3a-T3b by digital exam or imaging (American Joint Committee on Cancer \[AJCC\] 8th edition \[Ed.\]) Note: cT4 by imaging or on digital rectal exam is not allowed * The patient's prostate specific antigen (PSA) value \> 20 ng/mL prior to starting androgen deprivation therapy (ADT) Note: Patients taking a 5-alpha reductase inhibitor (ex finasteride or dutasteride) are eligible The baseline PSA value should be doubled for PSAs taken while on 5-alpha reductase inhibitors * Gleason Score of 8-10 * Pelvic node positive by conventional imaging with a short axis of at least 1.0 cm * Prostate gland volume less than 100 cc prior to initiation of ADT as reported at time of biopsy or by separate measure with ultrasound or other imaging modalities including MRI or CT scan * No definitive clinical or radiologic evidence of metastatic disease outside of the pelvic nodes (M1a, M1b or M1c) on conventional imaging (i.e. bone scan, CT scan, MRI); Negative prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is an acceptable substitute * Age \>= 18 * Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 * No prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields * No prior radical prostatectomy * No prior ablative or focal therapy to the prostate (including, but not limited to, transrectal or transurethral high-intensity focused ultrasound \[HIFU\], laser ablation, cryotherapy, irreversible electroporation \[IRE\], and vascular-targeted photodynamic therapy) * Prior pharmacologic androgen ablation for prostate cancer is allowed only if the onset of androgen ablation (both luteinizing hormone releasing hormone \[LHRH\] agonist and oral anti-androgen) is =\< 185 days prior to registration; Please note: PSA prior to the start of any ADT will be used to define disease * No contraindication to prostate MRI (required for planning of radiotherapy in both arms) * Patients enrolled in NRG-GU009 must be enrolled in NRG-GU013 prior to radiation therapy treatment planning and start of radiation therapy

Eligibility in plain statements

This record's criteria have not been broken into separate statements yet. The registry text above is complete and is the authoritative version.

Study design

Study design
Study typeInterventional
PhasePhase 3
AllocationRandomised
Intervention modelPARALLEL
Primary purposeTREATMENT
MaskingNONE (0)
Enrolment1,209 participants sought

Sponsor and collaborators

  • NRG Oncology Sponsor

Arms and interventions

  • Arm I (SBRT)EXPERIMENTAL

    Patients undergo SBRT for a total of 5 treatments over 2 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan and/or CT, MRI, or PET/CT during screening and CT and/or MRI on study. Additionally, patients may optionally undergo blood and urine sample collection on study.

  • Arm II (EBRT)ACTIVE_COMPARATOR

    Patients undergo EBRT for 20 to 45 treatments over 4 to 9 weeks in the absence of disease progression or unacceptable toxicity. Patients also undergo bone scan and/or CT, MRI, or PET/CT during screening and CT and/or MRI on study. Additionally, patients may optionally undergo blood and urine sample collection on study.

Interventions

  • Procedure Biospecimen Collection

    Undergo blood and urine sample collection

  • Procedure Bone Scan

    Undergo bone scan

  • Procedure Computed Tomography

    Undergo CT or PET/CT

  • Radiation External Beam Radiation Therapy

    Undergo EBRT

  • Procedure Magnetic Resonance Imaging

    Undergo MRI

  • Procedure Positron Emission Tomography

    Undergo PET/CT

  • Other Quality-of-Life Assessment

    Ancillary studies

  • Other Questionnaire Administration

    Ancillary studies

  • Radiation Stereotactic Body Radiation Therapy

    Undergo SBRT

Outcome measures

  1. Primary outcome

    Metastasis-free survival (MFS)

    Based on conventional imaging. Median MFS time comparing the curves.

    Time frame From randomization to the date of distant metastasis, or death from any cause, assessed up to 15 years

  2. Secondary outcome

    Failure-free survival

    Median failure-free survival time comparing the curves.

    Time frame From randomization to the date of distant metastasis, or death from any cause, assessed up to 15 years

  3. Secondary outcome

    Overall survival

    Median survival time comparing the curves.

    Time frame From the date of randomization to the date of death or last known follow-up date, with patients alive at the last known follow-up time treated as censored, assessed up to 15 years

  4. Secondary outcome

    MFS

    Median MFS time comparing the curves.

    Time frame From randomization to the date of distant metastasis, or death from any cause, assessed up to 15 years

  5. Secondary outcome

    Incidence of adverse events (AEs)

    AEs will be graded using National Cancer Institute's (NCI's) Common Terminology Criteria for Adverse Events (CTCAE) version (v)5. Counts of all AEs by grade will be provided by treatment arm.

    Time frame Up to 15 years

  6. Secondary outcome

    Urinary incontinence

    Proportion of patients with a decline, as measured by the urinary incontinence domain of the Expanded Prostate Cancer Index Composite (EPIC-26).

    Time frame Up to 5 years

  7. Secondary outcome

    Urinary irritative/obstructive

    Proportion of patients with a decline, as measured by the urinary irritative/obstructive domain of the Expanded Prostate Cancer Index Composite (EPIC-26).

    Time frame Up to 5 years

  8. Secondary outcome

    Bowel function

    Proportion of patients with a decline, as measured by the bowel domain of the Expanded Prostate Cancer Index Composite (EPIC-26).

    Time frame Up to 5 years

  9. Secondary outcome

    Fatigue

    Proportion of patients with a decline, as measured by the Patient Reported Outcomes Measurement Information System-Fatigue.

    Time frame Up to 5 years

  10. Other outcome

    Patient-reported outcomes

    The EPIC-26 sexual domain will be assessed as an exploratory endpoint but following the analysis plan specified for the EPIC-26 urinary and bowel domains.

    Time frame Up to 5 years

  11. Other outcome

    Cost

    Measured by the Functional Assessment of Chronic Illness Therapy-COST.

    Time frame Up to 1 year

  12. Other outcome

    Estimate of treatment effect by sex

    Will estimate the primary outcome treatment effect and the corresponding 95% confidence intervals (CIs) by sex.

    Time frame Up to 15 years

  13. Other outcome

    Estimate of treatment effect by race

    Will estimate the primary outcome treatment effect and the corresponding 95% CIs by race.

    Time frame Up to 15 years

  14. Other outcome

    Estimate of treatment effect by ethnicity

    Will estimate the primary outcome treatment effect and the corresponding 95% CIs by ethnicity.

    Time frame Up to 15 years

Dates

Dates
Start dateDecember 14, 2023 (actual)
Primary completionMarch 31, 2036 (estimated)
CompletionMarch 31, 2041 (estimated)
First postedJuly 14, 2023 (actual)
Last updatedSeptember 10, 2026
Results postedNot stated in the registry record
Status last verifiedSeptember 2026

Actual means the event happened. Estimated means the sponsor expects it. The two mean different things.

Locations

409 sites are recruiting

Canada

Canada
FacilityCityState or regionStatus
CHUM - Centre Hospitalier de l'Universite de MontrealMontrealQuebecRecruiting
The Research Institute of the McGill University Health Centre (MUHC)MontrealQuebecRecruiting
CIUSSSEMTL-Hopital Maisonneuve-RosemontMontrealQuebecRecruiting
Ottawa Hospital and Cancer Center-General CampusOttawaOntarioRecruiting
CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)QuébecQuebecRecruiting
Atlantic Health Sciences Corporation-Saint John Regional HospitalSaint JohnNew BrunswickRecruiting
Centre Hospitalier Universitaire de Sherbrooke-FleurimontSherbrookeQuebecRecruiting
Odette Cancer Centre- Sunnybrook Health Sciences CentreTorontoOntarioRecruiting
University Health Network-Princess Margaret HospitalTorontoOntarioRecruiting

Hong Kong

Hong Kong
FacilityCityState or regionStatus
Pamela Youde Nethersole Eastern HospitalChai WanSuspended

Switzerland

Switzerland
FacilityCityState or regionStatus
Kantonsspital AarauAarauRecruiting

United States

United States
FacilityCityState or regionStatus
Cleveland Clinic Akron GeneralAkronOhioRecruiting
University of New Mexico Cancer CenterAlbuquerqueNew MexicoRecruiting
Alton Memorial HospitalAltonIllinoisRecruiting
American Fork Hospital / Huntsman Intermountain Cancer CenterAmerican ForkUtahRecruiting
McFarland Clinic - AmesAmesIowaRecruiting
University of Michigan Rogel Cancer CenterAnn ArborMichiganRecruiting
Trinity Health Saint Joseph Mercy Hospital Ann ArborAnn ArborMichiganRecruiting
Langlade Hospital and Cancer CenterAntigoWisconsinRecruiting
Kaiser Permanente-Deer Valley Medical CenterAntiochCaliforniaRecruiting
Northwest Wisconsin Cancer CenterAshlandWisconsinRecruiting
Duluth Clinic AshlandAshlandWisconsinRecruiting
Emory Saint Joseph's HospitalAtlantaGeorgiaRecruiting
Emory University Hospital/Winship Cancer InstituteAtlantaGeorgiaRecruiting
Emory Proton Therapy CenterAtlantaGeorgiaRecruiting
Emory University Hospital MidtownAtlantaGeorgiaRecruiting
Grady Health SystemAtlantaGeorgiaRecruiting
Advocate Outpatient Center - AuroraAuroraIllinoisRecruiting
UCHealth University of Colorado HospitalAuroraColoradoRecruiting
Mount Sinai Comprehensive Cancer Center at AventuraAventuraFloridaRecruiting
UH Seidman Cancer Center at UH Avon Health CenterAvonOhioRecruiting
Johns Hopkins University/Sidney Kimmel Cancer CenterBaltimoreMarylandRecruiting
Veterans Administration Medical Center-BaltimoreBaltimoreMarylandRecruiting
University of Maryland/Greenebaum Cancer CenterBaltimoreMarylandRecruiting
Maryland Proton Treatment CenterBaltimoreMarylandRecruiting
Advocate Good Shepherd HospitalBarringtonIllinoisRecruiting
MaineHealth Coastal Cancer Treatment CenterBathMaineRecruiting
Mary Bird Perkins Cancer CenterBaton RougeLouisianaRecruiting
Bay Pines VA Healthcare SystemBay PinesFloridaRecruiting
Northwell Health Imbert Cancer CenterBay ShoreNew YorkRecruiting
UHHS-Chagrin Highlands Medical CenterBeachwoodOhioRecruiting
UPMC-Heritage Valley Health System BeaverBeaverPennsylvaniaRecruiting
UM Upper Chesapeake Medical CenterBel AirMarylandRecruiting
Nebraska Medicine-BellevueBellevueNebraskaRecruiting
PeaceHealth Saint Joseph Medical CenterBellinghamWashingtonRecruiting
Sanford Joe Lueken Cancer CenterBemidjiMinnesotaRecruiting
Saint Charles Health SystemBendOregonRecruiting
Central Vermont Medical Center/National Life Cancer TreatmentBerlin CornersVermontRecruiting
Tower Cancer Research FoundationBeverly HillsCaliforniaRecruiting
Billings Clinic Cancer CenterBillingsMontanaRecruiting

363 further sites are listed in the registry record.

Study documents

No documents are linked in this registry record.

Changes over time

No changes have been recorded since we first ingested this record.

A change is recorded each time the sponsor updates the registry record. Status, dates, enrolment and sites appear here as they move.