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Neoadjuvant CCI-779 Followed By Radical Prostatectomy in Treating Patients With Newly Diagnosed Prostate Cancer Who Have a High Risk of Relapse

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
temsirolimus
conventional surgery
neoadjuvant therapy
Sponsored by
Jonsson Comprehensive 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 IIB prostate cancer, stage IIA prostate cancer, stage I prostate cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed adenocarcinoma of the prostate Diagnosis based on a minimum of 6 core biopsy samples Clinically confirmed organ-confined disease Candidate for radical prostatectomy No evidence of metastatic disease by CT scan and bone scan High risk of relapse based on either of the following criteria: Any one of the following: Stage T2C or higher Gleason score greater than 7 Prostate-specific antigen (PSA) greater than 20 ng/mL OR Any two of the following: Gleason score at least 7 PSA 10-20 ng/mL Greater than 50% of total biopsy cores with cancer involvement PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic No active bleeding Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hepatic No acute or chronic hepatitis B Hepatitis B surface antigen negative No acute or chronic hepatitis C No antibodies to hepatitis C Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST and ALT no greater than 2 times ULN Renal No ongoing urinary tract infection necessitating rapid or emergent surgical resection Creatinine no greater than 1.5 times ULN Cardiovascular No unstable angina No myocardial infarction within the past 6 months No life-threatening ventricular arrhythmia requiring ongoing maintenance therapy Pulmonary No known pulmonary hypertension No pneumonitis Other Fertile patients must use effective contraception during and for 12 weeks after study participation HIV negative No other severe immunocompromised states No active infection requiring antibiotic therapy No serious concurrent illness No other major illness that would substantially increase the risk associated with study participation No other malignancy within the past 5 years except basal cell or squamous cell skin cancer PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent immunotherapy Chemotherapy No prior chemotherapy No other concurrent chemotherapy Endocrine therapy More than 3 weeks since prior IV corticosteroids No concurrent systemic corticosteroids No prior or concurrent hormonal therapy for underlying malignancy Radiotherapy No prior or concurrent radiotherapy Surgery More than 3 months since prior major surgery Other More than 1 month since prior experimental drugs More than 3 weeks since prior immunosuppressive agents No concurrent immunosuppressive therapies No other concurrent investigational agents No concurrent enzyme-inducing anticonvulsants (e.g., phenobarbital, phenytoin, or carbamazepine) No concurrent ketoconazole, diltiazem, rifampin, terfenadine, cisapride, astemizole, pimozide, or Hypericum perforatum (St. John's wort) No concurrent grapefruit or grapefruit juice

Sites / Locations

  • Jonsson Comprehensive Cancer Center at UCLA

Outcomes

Primary Outcome Measures

Phosphorylation state of proteins
p70S6 kinase activity
Phosphorylation state of mTOR pathway proteins
Global and targeted gene expression patterns in peripheral blood mononuclear cells

Secondary Outcome Measures

Global and targeted gene expression patterns
Pharmacodynamics and pharmacogenomic surrogate markers
Antitumor effects
Pharmacokinetics
Correlation of phosphatase and tensin homolog gene status with pharmacodynamic and pharmacogenomic effects
Protein expression patterns in the plasma

Full Information

First Posted
November 4, 2003
Last Updated
January 7, 2013
Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00071968
Brief Title
Neoadjuvant CCI-779 Followed By Radical Prostatectomy in Treating Patients With Newly Diagnosed Prostate Cancer Who Have a High Risk of Relapse
Official Title
An Open-Label Study Of Exploratory Pharmacogenomics And Pharmacologic Effects Of Neoadjuvant Oral CCI-779 In Newly Diagnosed Prostate Cancer Patients Undergoing Radical Prostatectomy Who Have A High Risk Of Relapse
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
August 2003 (undefined)
Primary Completion Date
May 2006 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as CCI-779, work in different ways to stop tumor cells from dividing so they stop growing or die. Giving CCI-779 before surgery may shrink the tumor so that it can be removed. PURPOSE: This randomized phase II trial is studying how well CCI-779 works in treating patients who are undergoing radical prostatectomy for newly diagnosed prostate cancer at high risk of relapse.
Detailed Description
OBJECTIVES: Primary Determine the effects of oral CCI-779 on changes in the phosphorylation state of proteins in the mammalian target of rapamycin (mTOR) signaling pathway in the tumor tissue of patients with newly diagnosed prostate cancer undergoing radical prostatectomy. Determine the effects of this drug on changes in p70S6 kinase activity, phosphorylation state of mTOR pathway proteins, and on global and targeted gene expression patterns in the peripheral blood mononuclear cells (PBMCs) of these patients. Secondary Determine the effects of this drug on global and targeted gene expression patterns in these patients. Identify pharmacodynamic/pharmacogenomic surrogate markers of this drug in both tumor tissue and PBMCs and determine if blood may be used as a surrogate tissue source for biomarkers of drug activity in the tumor in these patients. Determine, preliminarily, the potential antitumor effects of this drug in these patients. Determine the pharmacokinetics of this drug in these patients. Correlate phosphatase and tensin homolog (PTEN) gene status with the pharmacodynamic/pharmacogenomic effects of this drug in these patients. Determine the effects of this drug on changes in protein expression patterns in the plasma of these patients. OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 3 treatment arms. Patients randomized to arm III are stratified according to tumor expression of phosphatase and tensin homolog (PTEN) gene mutations (negative vs positive). Arm I: Patients receive oral CCI-779 once daily for a total of 8 weeks. Arm II: Patients receive a higher dose of CCI-779 as in arm I. Arm III: Patients receive a higher dose (higher than arm II) of CCI-779 as in arm I. Approximately 24-48 hours after the last dose of CCI-779, patients in all arms undergo radical prostatectomy. Patients are followed on day 7-10 and then at 4 weeks after study completion. PROJECTED ACCRUAL: A total of 40 patients (5 each for arms I and II and 30 for arm III) will be accrued for this study.

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 IIB prostate cancer, stage IIA prostate cancer, stage I prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
temsirolimus
Intervention Type
Procedure
Intervention Name(s)
conventional surgery
Intervention Type
Procedure
Intervention Name(s)
neoadjuvant therapy
Primary Outcome Measure Information:
Title
Phosphorylation state of proteins
Title
p70S6 kinase activity
Title
Phosphorylation state of mTOR pathway proteins
Title
Global and targeted gene expression patterns in peripheral blood mononuclear cells
Secondary Outcome Measure Information:
Title
Global and targeted gene expression patterns
Title
Pharmacodynamics and pharmacogenomic surrogate markers
Title
Antitumor effects
Title
Pharmacokinetics
Title
Correlation of phosphatase and tensin homolog gene status with pharmacodynamic and pharmacogenomic effects
Title
Protein expression patterns in the plasma

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed adenocarcinoma of the prostate Diagnosis based on a minimum of 6 core biopsy samples Clinically confirmed organ-confined disease Candidate for radical prostatectomy No evidence of metastatic disease by CT scan and bone scan High risk of relapse based on either of the following criteria: Any one of the following: Stage T2C or higher Gleason score greater than 7 Prostate-specific antigen (PSA) greater than 20 ng/mL OR Any two of the following: Gleason score at least 7 PSA 10-20 ng/mL Greater than 50% of total biopsy cores with cancer involvement PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic No active bleeding Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hepatic No acute or chronic hepatitis B Hepatitis B surface antigen negative No acute or chronic hepatitis C No antibodies to hepatitis C Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST and ALT no greater than 2 times ULN Renal No ongoing urinary tract infection necessitating rapid or emergent surgical resection Creatinine no greater than 1.5 times ULN Cardiovascular No unstable angina No myocardial infarction within the past 6 months No life-threatening ventricular arrhythmia requiring ongoing maintenance therapy Pulmonary No known pulmonary hypertension No pneumonitis Other Fertile patients must use effective contraception during and for 12 weeks after study participation HIV negative No other severe immunocompromised states No active infection requiring antibiotic therapy No serious concurrent illness No other major illness that would substantially increase the risk associated with study participation No other malignancy within the past 5 years except basal cell or squamous cell skin cancer PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent immunotherapy Chemotherapy No prior chemotherapy No other concurrent chemotherapy Endocrine therapy More than 3 weeks since prior IV corticosteroids No concurrent systemic corticosteroids No prior or concurrent hormonal therapy for underlying malignancy Radiotherapy No prior or concurrent radiotherapy Surgery More than 3 months since prior major surgery Other More than 1 month since prior experimental drugs More than 3 weeks since prior immunosuppressive agents No concurrent immunosuppressive therapies No other concurrent investigational agents No concurrent enzyme-inducing anticonvulsants (e.g., phenobarbital, phenytoin, or carbamazepine) No concurrent ketoconazole, diltiazem, rifampin, terfenadine, cisapride, astemizole, pimozide, or Hypericum perforatum (St. John's wort) No concurrent grapefruit or grapefruit juice
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charles Sawyers, MD
Organizational Affiliation
Jonsson Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center at UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1738
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Thomas G, Speicher L, Reiter R, et al.: Demonstration that temsirolimus preferentially inhibits the mTOR pathway in the tumors of prostate cancer patients with PTEN deficiencies. [Abstract] Clin Cancer Res 11 (Suppl 24): A-C131, 2005.
Results Reference
result

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Neoadjuvant CCI-779 Followed By Radical Prostatectomy in Treating Patients With Newly Diagnosed Prostate Cancer Who Have a High Risk of Relapse

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