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Ixabepilone With or Without Estramustine in Treating Patients With Progressive Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
estramustine phosphate sodium
ixabepilone
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring adenocarcinoma of the prostate, stage IV prostate cancer, recurrent prostate cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically or cytologically confirmed adenocarcinoma of the prostate Must have disease progression meeting 1 of the following criteria: Rising prostate-specific antigen (PSA) on at least 3 consecutive measurements taken more than 1 week apart Measurable disease, defined as new or progressive soft tissue masses on CT scan or MRI New metastatic lesions by radionuclide bone scan The most recent PSA must be at least 4 ng/mL if no measurable disease is present Ineligible if sole manifestation of progressive disease is an increase in disease-related symptoms Serum testosterone no greater than 50 ng/mL One of the following therapies for maintenance of castrate status required: Must continue on gonadotropin-releasing hormone analogs (e.g., leuprolide or goserelin) to maintain castrate levels of serum testosterone Developed disease progression after discontinuation of the antiandrogen that was part of the first-line hormonal therapy Prior surgical orchiectomy Developed disease progression after discontinuation of megestrol No known brain metastases PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 70-100% Life expectancy: Not specified Hematopoietic: WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of bleeding disorder that would preclude anticoagulation with warfarin Hepatic: Bilirubin normal AST/ALT no greater than 2.5 times upper limit of normal (ULN) PT/PTT normal (unless anticoagulated for other reasons [e.g., atrial fibrillation]) Renal: Creatinine no greater than 1.5 times ULN Cardiovascular: No significant cardiovascular disease No symptomatic congestive heart failure No New York Heart Association class III or IV heart disease No active unstable angina pectoris No cardiac arrhythmia No myocardial infarction within the past 6 months No history of hemorrhagic or thrombotic cerebrovascular accident or deep venous thrombosis within the past 6 months Pulmonary: No pulmonary embolism within the past 6 months Other: Fertile patients must use effective contraception No history of allergic reactions to compounds of similar chemical or biological composition to the epothilones No history of recent gastrointestinal bleeding that would preclude anticoagulation with warfarin No other concurrent active malignancy except nonmelanomatous skin cancer Disease not considered currently active if completely treated with less than a 30% risk for relapse No other concurrent uncontrolled illness No ongoing or active infection No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy: No concurrent routine filgrastim (G-CSF) or sargramostim (GM-CSF) except for neutropenic fever No concurrent immunotherapy Chemotherapy: No prior chemotherapy No other concurrent chemotherapy Endocrine therapy: See Disease Characteristics Radiotherapy: No prior palliative radiotherapy to more than 25% of bone marrow No prior radioisotope therapy with strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium No concurrent therapeutic radiotherapy Concurrent focal radiotherapy for palliation of bone disease-related symptoms allowed at the investigator's discretion Surgery: See Disease Characteristics At least 4 weeks since prior major surgery Other: No other concurrent anticancer investigational or commercial agents or therapies No concurrent herbal, alternative, or food supplements (e.g., PC-SPES, saw palmetto, or St. John's Wort) No concurrent combination antiretroviral therapy for HIV-positive patients No initiation of bisphosphonates immediately before or during study Concurrent bisphosphonates allowed if developed disease progression while on stable doses Concurrent daily multivitamin allowed

Sites / Locations

  • UCSF Comprehensive Cancer Center
  • Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
  • University of Michigan Comprehensive Cancer Center
  • Memorial Sloan-Kettering Cancer Center

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
October 11, 2001
Last Updated
June 20, 2013
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00025194
Brief Title
Ixabepilone With or Without Estramustine in Treating Patients With Progressive Prostate Cancer
Official Title
A Phase I And Randomized Phase 2 Trial Of Epothilone B Analogue BMS 247550 (NSC # 710428) Administered Every 21 Days With Or Without Oral Estramustine Phosphate In Patients With Androgen Independent Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2005
Overall Recruitment Status
Completed
Study Start Date
July 2001 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
July 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as ixabepilone and estramustine, use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether BMS-247550 is more effective with or without estramustine in treating prostate cancer. PURPOSE: This randomized phase I/II trial is studying the best dose of ixabepilone when given together with estramustine and to see how well giving ixabepilone together with estramustine works compared to ixabepilone alone in treating patients with progressive prostate cancer.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose of ixabepilone combined with estramustine in patients with progressive androgen-independent adenocarcinoma of the prostate. (Phase I) Compare the safety and efficacy of ixabepilone with or without estramustine in this patient population. (Phase II) Correlate the clinical outcomes with reverse transcriptase-polymerase chain reaction-based assay for prostate-specific antigen mRNA in patients treated with these regimens. OUTLINE: This is a dose-escalation study of ixabepilone (phase I) followed by a randomized, multicenter study (phase II). Phase I: Patients receive ixabepilone IV over 3 hours on day 2 and oral estramustine 3 times daily on days 1-5. Courses repeat every 3 weeks in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of ixabepilone until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity. Phase II: Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive ixabepilone IV over 3 hours at the MTD on day 2 and estramustine as in phase I. Arm II: Patients receive ixabepilone IV over 3 hours at the MTD on day 1. Treatment in both arms repeats as in phase I. Patients are followed every 12 weeks until disease progression. PROJECTED ACCRUAL: A total of 3-12 patients will be accrued for phase I of this study and a total of 44-92 patients (22-46 per treatment arm) will be accrued for phase II of this study within 12-18 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
adenocarcinoma of the prostate, stage IV prostate cancer, recurrent prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Allocation
Randomized

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
estramustine phosphate sodium
Intervention Type
Drug
Intervention Name(s)
ixabepilone

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically or cytologically confirmed adenocarcinoma of the prostate Must have disease progression meeting 1 of the following criteria: Rising prostate-specific antigen (PSA) on at least 3 consecutive measurements taken more than 1 week apart Measurable disease, defined as new or progressive soft tissue masses on CT scan or MRI New metastatic lesions by radionuclide bone scan The most recent PSA must be at least 4 ng/mL if no measurable disease is present Ineligible if sole manifestation of progressive disease is an increase in disease-related symptoms Serum testosterone no greater than 50 ng/mL One of the following therapies for maintenance of castrate status required: Must continue on gonadotropin-releasing hormone analogs (e.g., leuprolide or goserelin) to maintain castrate levels of serum testosterone Developed disease progression after discontinuation of the antiandrogen that was part of the first-line hormonal therapy Prior surgical orchiectomy Developed disease progression after discontinuation of megestrol No known brain metastases PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 70-100% Life expectancy: Not specified Hematopoietic: WBC at least 3,000/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 No history of bleeding disorder that would preclude anticoagulation with warfarin Hepatic: Bilirubin normal AST/ALT no greater than 2.5 times upper limit of normal (ULN) PT/PTT normal (unless anticoagulated for other reasons [e.g., atrial fibrillation]) Renal: Creatinine no greater than 1.5 times ULN Cardiovascular: No significant cardiovascular disease No symptomatic congestive heart failure No New York Heart Association class III or IV heart disease No active unstable angina pectoris No cardiac arrhythmia No myocardial infarction within the past 6 months No history of hemorrhagic or thrombotic cerebrovascular accident or deep venous thrombosis within the past 6 months Pulmonary: No pulmonary embolism within the past 6 months Other: Fertile patients must use effective contraception No history of allergic reactions to compounds of similar chemical or biological composition to the epothilones No history of recent gastrointestinal bleeding that would preclude anticoagulation with warfarin No other concurrent active malignancy except nonmelanomatous skin cancer Disease not considered currently active if completely treated with less than a 30% risk for relapse No other concurrent uncontrolled illness No ongoing or active infection No psychiatric illness or social situation that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy: No concurrent routine filgrastim (G-CSF) or sargramostim (GM-CSF) except for neutropenic fever No concurrent immunotherapy Chemotherapy: No prior chemotherapy No other concurrent chemotherapy Endocrine therapy: See Disease Characteristics Radiotherapy: No prior palliative radiotherapy to more than 25% of bone marrow No prior radioisotope therapy with strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium No concurrent therapeutic radiotherapy Concurrent focal radiotherapy for palliation of bone disease-related symptoms allowed at the investigator's discretion Surgery: See Disease Characteristics At least 4 weeks since prior major surgery Other: No other concurrent anticancer investigational or commercial agents or therapies No concurrent herbal, alternative, or food supplements (e.g., PC-SPES, saw palmetto, or St. John's Wort) No concurrent combination antiretroviral therapy for HIV-positive patients No initiation of bisphosphonates immediately before or during study Concurrent bisphosphonates allowed if developed disease progression while on stable doses Concurrent daily multivitamin allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Morris, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Study Chair
Facility Information:
Facility Name
UCSF Comprehensive Cancer Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
University of Michigan Comprehensive Cancer Center
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-0942
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
15735119
Citation
Galsky MD, Small EJ, Oh WK, Chen I, Smith DC, Colevas AD, Martone L, Curley T, Delacruz A, Scher HI, Kelly WK. Multi-institutional randomized phase II trial of the epothilone B analog ixabepilone (BMS-247550) with or without estramustine phosphate in patients with progressive castrate metastatic prostate cancer. J Clin Oncol. 2005 Mar 1;23(7):1439-46. doi: 10.1200/JCO.2005.09.042.
Results Reference
result
PubMed Identifier
14504052
Citation
Smaletz O, Galsky M, Scher HI, DeLaCruz A, Slovin SF, Morris MJ, Solit DB, Davar U, Schwartz L, Kelly WK. Pilot study of epothilone B analog (BMS-247550) and estramustine phosphate in patients with progressive metastatic prostate cancer following castration. Ann Oncol. 2003 Oct;14(10):1518-24. doi: 10.1093/annonc/mdg415.
Results Reference
result
Citation
Smaletz O, Kelly WK, Horse-Grant D, et al.: Epothilone B analogue (BMS-247550) with estramustine phosphate (EMP) in patients (pts) with progressive castrate-metastatic prostate cancer (PC). [Abstract] Proceedings of the American Society of Clinical Oncology 21: A-732, 184a, 2002.
Results Reference
result

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Ixabepilone With or Without Estramustine in Treating Patients With Progressive Prostate Cancer

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