Scandinavian Prostate Cancer Group Explained

The Scandinavian Prostate Cancer Group (SPCG) is a group of scientific researchers who have conducted a series of clinical trials of treatments for prostate cancer.^{[1] [2]} The group was founded in 1981 and the first study, SPCG-1, began in 1984.

Clinical trials

The studies conducted by the SPCG include the following:^[3]

• SPCG-1 – estramustine phosphate versus diethylstilbestrol for high-risk advanced prostate cancer^{[4] [5]}
• SPCG-2 – orchiectomy plus cyproterone acetate versus placebo for metastatic prostate cancer^{[6] [7]}
• SPCG-3 – cancelled
• SPCG-4 – radical prostatectomy versus watchful waiting for localized prostate cancer^{[8] [9] [10] [11]}
• SPCG-5 – polyestradiol phosphate versus triptorelin or orchiectomy plus flutamide for advanced prostate cancer^{[12] [13] [14] [15] [16] [17]}
• SPCG-6 – bicalutamide monotherapy versus standard care (watchful waiting) for localized prostate cancer^{[18] [19] [20] [21] [22]}
• SPCG-7 – endocrine therapy with versus without radiotherapy for locally advanced or aggressive localized prostate cancer^{[23] [24] [25]}
• SPCG-8 – cancelled
• SPCG-9 – cancelled
• SPCG-10 – cancelled^[26]
• SPCG-11 (Zometa European Study [ZEUS]) – zoledronic acid with standard prostate cancer therapy versus standard prostate cancer therapy alone for prevention of bone metastases in high-risk localized prostate cancer^{[27] [28] [29]}
• SPCG-12 – docetaxel versus surveillance after radical prostatectomy without androgen deprivation therapy for high-risk localized prostate cancer^{[30] [31]}
• SPCG-13 – docetaxel versus surveillance after radical prostatectomy with androgen deprivation therapy for high-risk localized prostate cancer^[32]
• SPCG-14 – docetaxel versus bicalutamide for prostate-specific antigen recurrence after radical prostatectomy or radiotherapy for localized prostate cancer^[33]
• SPCG-15 – radical prostatectomy versus radiotherapy plus androgen deprivation therapy for locally advanced prostate cancer^[34]

The SPCG-6 study was also known as Trial 25 of the Early Prostate Cancer (EPC) clinical trial programme.^[35]

Other work

The SPCG also published a 1997 literature review on combined androgen blockade for advanced prostate cancer.^[36]

See also

• FinnProstate Group

Notes and References

1. Hedlund PO . The Scandinavian Prostatic Cancer Group. A short review of its history and work . Scand J Urol Nephrol Suppl . 33 . 203. 53–6 . 1999 . 10636572 . 10.1080/003655999750016285-2 .
2. Høisaeter PA, Vaage S, Hedlund PO . Clinical research done by the Scandinavian Prostate Cancer Group during the first 20 years . Scand J Urol Nephrol Suppl . 37. 212 . 7–10 . 2003 . 12841320 . 10.1080/03008880310006878 .
3. Fizazi K, Abrahamsson PA, Ahlgren G, Bellmunt J, Castellano D, Culine S, de Wit R, Gillessen S, Gschwend JE, Hamdy F, James N, McDermott R, Miller K, Wiegel T, Wirth M, Tombal B . Achievements and perspectives in prostate cancer phase 3 trials from genitourinary research groups in Europe: introducing the Prostate Cancer Consortium in Europe . Eur Urol . 67 . 5 . 904–12 . May 2015 . 25218582 . 10.1016/j.eururo.2014.08.076 .
4. Hedlund PO, Jacobsson H, Vaage S, Hahne B, Sandin T, Kontturi M, Nordle O, Esposti P . Treatment of high-grade, high-stage prostate cancer with estramustine phosphate or diethylstilbestrol. A double-blind study. The SPCG-1 Study Group. Scandinavian Prostate Cancer Group . Scand J Urol Nephrol . 31 . 2 . 167–72 . April 1997 . 9165581 . 10.3109/00365599709070324 .
5. Hedlund PO, Esposti P, Falkmer U, Jacobsson H . DNA as a prognostic marker in advanced high-grade prostatic cancer. A preliminary report. SPCG-I study . Acta Oncol . 30 . 2 . 215–7 . 1991 . 2029409 . 10.3109/02841869109092354 . free .
6. Jørgensen T, Tveter KJ, Jørgensen LH . Total androgen suppression: experience from the Scandinavian Prostatic Cancer Group Study No. 2 . Eur Urol . 24 . 4 . 466–70 . 1993 . 8287887 . 10.1159/000474351 .
7. Jørgensen T, Müller C, Kaalhus O, Danielsen HE, Tveter KJ . Extent of disease based on initial bone scan: important prognostic predictor for patients with metastatic prostatic cancer. Experience from the Scandinavian Prostatic Cancer Group Study No. 2 (SPCG-2) . Eur Urol . 28 . 1 . 40–6 . 1995 . 8521893 . 10.1159/000475018 .
8. Bill-Axelson A, Holmberg L, Filén F, Ruutu M, Garmo H, Busch C, Nordling S, Häggman M, Andersson SO, Bratell S, Spångberg A, Palmgren J, Adami HO, Johansson JE . Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian prostate cancer group-4 randomized trial . J Natl Cancer Inst . 100 . 16 . 1144–54 . August 2008 . 18695132 . 2518167 . 10.1093/jnci/djn255 .
9. Holmberg L, Bill-Axelson A, Steineck G, Garmo H, Palmgren J, Johansson E, Adami HO, Johansson JE . Results from the Scandinavian Prostate Cancer Group Trial Number 4: a randomized controlled trial of radical prostatectomy versus watchful waiting . J Natl Cancer Inst Monogr . 2012 . 45 . 230–3 . December 2012 . 23271778 . 3540876 . 10.1093/jncimonographs/lgs025 .
10. McDermott DW, Sanda MG . Health-related quality-of-life effects of watchful waiting re-evaluated in SPCG-4 . Nat Clin Pract Urol . 6 . 3 . 124–5 . March 2009 . 19190593 . 10.1038/ncpuro1314 . 205341171 .
11. Albertsen P . Words of wisdom. Re: Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian Prostate Cancer Group-4 randomized trial . Eur Urol . 55 . 4 . 989–90 . April 2009 . 19650212 . 10.1016/j.eururo.2009.01.009 . free .
12. Hedlund PO, Henriksson P . Parenteral estrogen versus total androgen ablation in the treatment of advanced prostate carcinoma: effects on overall survival and cardiovascular mortality. The Scandinavian Prostatic Cancer Group (SPCG)-5 Trial Study . Urology . 55 . 3 . 328–33 . March 2000 . 10699602 . 10.1016/s0090-4295(99)00580-4 .
13. Spetz AC, Hammar M, Lindberg B, Spångberg A, Varenhorst E . Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate . J Urol . 166 . 2 . 517–20 . August 2001 . 11458057 . 10.1016/S0022-5347(05)65973-3.
14. Vuong W, Sartor O, Pal SK . Management of localized prostate cancer: the pendulum swings (back to the middle) . Asian J Androl . 16 . 4 . 570–1 . 2014 . 24875822 . 4104085 . 10.4103/1008-682X.131072 . free .
15. Hedlund PO, Ala-Opas M, Brekkan E, Damber JE, Damber L, Hagerman I, Haukaas S, Henriksson P, Iversen P, Pousette A, Rasmussen F, Salo J, Vaage S, Varenhorst E . Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer -- Scandinavian Prostatic Cancer Group (SPCG) Study No. 5 . Scand J Urol Nephrol . 36 . 6 . 405–13 . 2002 . 12623503 . 10.1080/003655902762467549 . 2799580 .
16. Hedlund PO, Damber JE, Hagerman I, Haukaas S, Henriksson P, Iversen P, Johansson R, Klarskov P, Lundbeck F, Rasmussen F, Varenhorst E, Viitanen J . Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer: part 2. Final evaluation of the Scandinavian Prostatic Cancer Group (SPCG) Study No. 5 . Scand J Urol Nephrol . 42 . 3 . 220–9 . 2008 . 18432528 . 10.1080/00365590801943274 . 38638336 .
17. Adolfsson J . Words of wisdom. Re: Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer: part 2. Final evaluation of the Scandinavian Prostatic Cancer Group (SPCG) Study No. 5 . Eur Urol . 55 . 2 . 525 . February 2009 . 19606537 . 10.1016/j.eururo.2008.11.018 .
18. Iversen P, Tammela TL, Vaage S, Lukkarinen O, Lodding P, Bull-Njaa T, Viitanen J, Hoisaeter P, Lundmo P, Rasmussen F, Johansson JE, Persson BE, Carroll K . A randomised comparison of bicalutamide ('Casodex') 150 mg versus placebo as immediate therapy either alone or as adjuvant to standard care for early non-metastatic prostate cancer. First report from the Scandinavian Prostatic Cancer Group Study No. 6 . Eur Urol . 42 . 3 . 204–11 . September 2002 . 12234503 . 10.1016/s0302-2838(02)00311-1 .
19. Iversen P, Johansson JE, Lodding P, Lukkarinen O, Lundmo P, Klarskov P, Tammela TL, Tasdemir I, Morris T, Carroll K . Bicalutamide (150 mg) versus placebo as immediate therapy alone or as adjuvant to therapy with curative intent for early nonmetastatic prostate cancer: 5.3-year median followup from the Scandinavian Prostate Cancer Group Study Number 6 . J Urol . 172 . 5 Pt 1 . 1871–6 . November 2004 . 15540741 . 10.1097/01.ju.0000139719.99825.54 .
20. Iversen P, Johansson JE, Lodding P, Kylmälä T, Lundmo P, Klarskov P, Tammela TL, Tasdemir I, Morris T, Armstrong J . Bicalutamide 150 mg in addition to standard care for patients with early non-metastatic prostate cancer: updated results from the Scandinavian Prostate Cancer Period Group-6 Study after a median follow-up period of 7.1 years . Scand J Urol Nephrol . 40 . 6 . 441–52 . 2006 . 17130095 . 10.1080/00365590601017329 . 25862814 .
21. Thomsen FB, Brasso K, Christensen IJ, Johansson JE, Angelsen A, Tammela TL, Iversen P . Survival benefit of early androgen receptor inhibitor therapy in locally advanced prostate cancer: long-term follow-up of the SPCG-6 study . Eur J Cancer . 51 . 10 . 1283–92 . July 2015 . 25892647 . 10.1016/j.ejca.2015.03.021 .
22. Thomsen FB, Brasso K, Berg KD, Gerds TA, Johansson JE, Angelsen A, Tammela TL, Iversen P . Association between PSA kinetics and cancer-specific mortality in patients with localised prostate cancer: analysis of the placebo arm of the SPCG-6 study . Ann Oncol . 27 . 3 . 460–6 . March 2016 . 26681677 . 10.1093/annonc/mdv607 . free .
23. Fransson P, Lund JA, Damber JE, Klepp O, Wiklund F, Fosså S, Widmark A . Quality of life in patients with locally advanced prostate cancer given endocrine treatment with or without radiotherapy: 4-year follow-up of SPCG-7/SFUO-3, an open-label, randomised, phase III trial . Lancet Oncol . 10 . 4 . 370–80 . April 2009 . 19286422 . 10.1016/S1470-2045(09)70027-0 .
24. Widmark A, Klepp O, Solberg A, Damber JE, Angelsen A, Fransson P, Lund JA, Tasdemir I, Hoyer M, Wiklund F, Fosså SD . Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial . Lancet . 373 . 9660 . 301–8 . January 2009 . 19091394 . 10.1016/S0140-6736(08)61815-2 . 11694500 . free .
25. Fosså SD, Wiklund F, Klepp O, Angelsen A, Solberg A, Damber JE, Hoyer M, Widmark A . Ten- and 15-yr Prostate Cancer-specific Mortality in Patients with Nonmetastatic Locally Advanced or Aggressive Intermediate Prostate Cancer, Randomized to Lifelong Endocrine Treatment Alone or Combined with Radiotherapy: Final Results of The Scandinavian Prostate Cancer Group-7 . Eur Urol . 70 . 4 . 684–691 . October 2016 . 27025586 . 10.1016/j.eururo.2016.03.021 .
26. Greenberger BA, Taylor JM, Chen VE, Den RB . Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer: A Narrative Review of Mortality and Quality-of-Life Outcomes . Cancer J . 26 . 1 . 29–37 . 2020 . 31977382 . 10.1097/PPO.0000000000000420 . 210891064 . Multiple efforts have been attempted to adequately power randomized trials to compare mortality outcomes between RP and RT, although the vast majority have failed to accrue,3–6 including proposed collaborations in ACOSOG SPIRIT, SPCG-10, MRC PR06, and SWOG8890..
27. Wirth M, Tammela T, Cicalese V, Gomez Veiga F, Delaere K, Miller K, Tubaro A, Schulze M, Debruyne F, Huland H, Patel A, Lecouvet F, Caris C, Witjes W . Prevention of bone metastases in patients with high-risk nonmetastatic prostate cancer treated with zoledronic acid: efficacy and safety results of the Zometa European Study (ZEUS) . Eur Urol . 67 . 3 . 482–91 . March 2015 . 24630685 . 10.1016/j.eururo.2014.02.014 .
28. Reza M, Wirth M, Tammela TL, Cicalese V, Veiga FG, Mulders P, Miller K, Tubaro A, Debruyne F, Patel A, Caris C, Witjes W, Thorsson O, Wollmer P, Edenbrandt L, Ohlsson M, Trägårdh E, Bjartell A . Automated Bone Scan Index as an Imaging Biomarker to Predict Overall Survival in the Zometa European Study/SPCG11 . Eur Urol Oncol . 4 . 1 . 49–55 . February 2021 . 31186177 . 10.1016/j.euo.2019.05.002 . 186204429 .
29. Reza . Mariana . Wirth . Manfred . Tammela . Teuvo L. J. . Cicalese . Virgilio . Veiga . Francisco Gomez . Miller . Kurt . Tubaro . Andrea . Debruyne . Frans . Patel . Anup . Caris . Christien . Witjes . Wim . Thorsson . Ola . Wollmer . Per . Edenbrandt . Lars . Ohlsson . Mattias . Tragardh . Elin . Bjartell . Anders . Bone Scan Index as an imaging biomarker to predict overall survival in the Zeus/SPCG11 study. . Journal of Clinical Oncology . 20 May 2016 . 34 . 15 suppl . e16599 . 0732-183X . 1527-7755 . 10.1200/JCO.2016.34.15_suppl.e16599 .
30. Ahlgren GM, Flodgren P, Tammela TL, Kellokumpu-Lehtinen P, Borre M, Angelsen A, Iversen JR, Sverrisdottir A, Jonsson E, Sengelov L . Docetaxel Versus Surveillance After Radical Prostatectomy for High-risk Prostate Cancer: Results from the Prospective Randomised, Open-label Phase 3 Scandinavian Prostate Cancer Group 12 Trial . Eur Urol . 73 . 6 . 870–876 . June 2018 . 29395502 . 10.1016/j.eururo.2018.01.012 . 2397739 .
31. D'Andrea D, Shariat SF, Soria F . Re: Docetaxel Versus Surveillance After Radical Prostatectomy for High-risk Prostate Cancer: Results from the Prospective Randomised, Open-label Phase 3 Scandinavian Prostate Cancer Group 12 Trial . Eur Urol . 74 . 5 . 680–681 . November 2018 . 30072209 . 10.1016/j.eururo.2018.07.022 . 51906145 .
32. Lehtonen M, Sormunen J, Hjälm-Eriksson M, Thellenberg-Karlsson C, Huttunen T, Ginman C, Kellokumpu-Lehtinen PL . Health-related Quality of Life in Intermediate- or High-risk Patients Treated With Radical External Radiotherapy and Adjuvant Docetaxel for Localized Prostate Cancer: A Randomized, Phase III SPCG-13 Study . Anticancer Res . 42 . 1 . 87–92 . January 2022 . 34969712 . 10.21873/anticanres.15460 . 245568841 . free .
33. Shiota M, Yokomizo A, Eto M . Taxane Chemotherapy for Hormone-Naïve Prostate Cancer with Its Expanding Role as Breakthrough Strategy . Front Oncol . 5 . 304 . 2015 . 26793621 . 4707543 . 10.3389/fonc.2015.00304 . free .
34. Stranne J, Brasso K, Brennhovd B, Johansson E, Jäderling F, Kouri M, Lilleby W, Meidahl Petersen P, Mirtti T, Pettersson A, Rannikko A, Thellenberg C, Akre O . SPCG-15: a prospective randomized study comparing primary radical prostatectomy and primary radiotherapy plus androgen deprivation therapy for locally advanced prostate cancer . Scand J Urol . 52 . 5–6 . 313–320 . 2018 . 30585526 . 10.1080/21681805.2018.1520295 . 58659462 .
35. See WA, McLeod D, Iversen P, Wirth M . The bicalutamide Early Prostate Cancer Program. Demography . Urol Oncol . 6 . 2 . 43–47 . March 2001 . 11166619 . 10.1016/s1078-1439(00)00118-6 .
36. Iversen P . Combined androgen blockade in the treatment of advanced prostate cancer--an overview. The Scandinavian Prostatic Cancer Group . Scand J Urol Nephrol . 31 . 3 . 249–54 . June 1997 . 9249887 . 10.3109/00365599709070342 .