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Docetaxel, Estramustine, and Thalidomide in Treating Patients With Androgen-Independent Metastatic Adenocarcinoma of the Prostate

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
docetaxel
estramustine phosphate sodium
thalidomide
Sponsored by
National Institutes of Health Clinical Center (CC)
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, recurrent prostate cancer, stage IV prostate cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed adenocarcinoma of the prostate Metastatic disease Androgen-independent disease Clinically progressive disease documented by at least 1 of the following parameters: Two consecutively rising prostate-specific antigen (PSA) levels taken at least 1 week apart PSA ≥ 5.0 ng/mL Continued rise in PSA 4 weeks after discontinuation of prior flutamide OR 6 weeks after discontinuation of prior bicalutamide or nilutamide (for patients treated with anti-androgen agents) At least 1 new lesion on bone scan Progressive measurable disease Must have undergone bilateral surgical castration OR continue on a gonadotropin-releasing hormone agonist No brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count > 1,500/mm^3 Platelet count ≥ 100,000/mm^3* Hemoglobin ≥ 7.5 g/dL* NOTE: *No transfusions within the past 2 weeks Hepatic AST and ALT < 2.5 times upper limit of normal (ULN) Bilirubin < ULN (≤ 3.0 times ULN for patients with Gilbert's syndrome) Alkaline phosphatase ≤ 2.5 times ULN OR Fractionated hepatic alkaline phosphatase ≤ 2.5 times ULN Renal Creatinine ≤ 1.5 mg/dL OR Creatinine clearance ≥ 40 mL/min Cardiovascular No transient ischemic attacks or cerebrovascular accident within the past 2 years No myocardial infarction within the past 6 months No uncontrolled congestive heart failure No uncontrolled angina pectoris No thromboembolic disease Other No peripheral neuropathy ≥ grade 2 No cognitive impairment that would preclude study participation or giving informed consent No other active malignancy within the past 2 years except non-melanoma skin cancer or superficial bladder carcinoma Fertile patients must use effective contraception for at least 1 month before, during, and for at least 1 month after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy No prior thalidomide Chemotherapy No prior docetaxel No prior estramustine No prior chemotherapy for metastatic prostate cancer Endocrine therapy See Disease Characteristics Radiotherapy Recovered from prior radiotherapy Surgery See Disease Characteristics Recovered from prior surgery Other No concurrent antiretroviral therapy for HIV-positive patients No concurrent complementary or alternative therapy that would interact with study drugs No concurrent herbal or nutritional products or dietary supplements that would interact with study drugs No concurrent aprepitant as secondary prophylaxis or antiemetic treatment

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
  • NCI - Center for Cancer Research

Outcomes

Primary Outcome Measures

PSA response
Toxicity

Secondary Outcome Measures

Survival

Full Information

First Posted
May 14, 2004
Last Updated
March 14, 2012
Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00083005
Brief Title
Docetaxel, Estramustine, and Thalidomide in Treating Patients With Androgen-Independent Metastatic Adenocarcinoma of the Prostate
Official Title
A Phase II Trial Combining Estramustine, Docetaxel And Thalidomide In Patients With Androgen-Independent Metastatic Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
December 2007 (Actual)
Study Completion Date
December 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institutes of Health Clinical Center (CC)
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as docetaxel and estramustine, work in different ways to stop tumor cells from dividing so they stop growing or die. Thalidomide may stop the growth of prostate cancer by stopping blood flow to the tumor. Giving chemotherapy together with thalidomide may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving docetaxel and estramustine together with thalidomide works in treating patients with androgen-independent metastatic adenocarcinoma (cancer) of the prostate.
Detailed Description
OBJECTIVES: Primary Determine the prostate-specific antigen response in patients with androgen-independent metastatic adenocarcinoma of the prostate treated with docetaxel, estramustine, and thalidomide. Secondary Determine the survival duration in patients treated with this regimen. Determine the pharmacokinetics of both docetaxel and thalidomide in patients treated with this regimen. Determine whether any pharmacodynamic relationships exist between plasma concentrations of docetaxel and/or thalidomide and clinical activity or toxicity of this regimen in these patients. Determine the existence of and quantification of circulating prostate cancer cells in patients before and after treatment with this regimen. Determine genotype, with regard to cytochrome P450 2C19 polymorphism, in patients treated with this regimen. Correlate genotype with pharmacokinetics and efficacy of this regimen in these patients. Determine the changes in molecular markers of angiogenesis (including, but not limited to, serum and urine vascular endothelial growth factor) in patients before and after treatment with this regimen. Determine the toxicity profile of this regimen in these patients. OUTLINE: This is an open-label study. Patients receive docetaxel IV over 30 minutes on days 2, 9, and 16, oral thalidomide once daily on days 1-28, and oral estramustine three times daily on days 1-3, 8-10, and 15-17. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. Patients are followed for survival. PROJECTED ACCRUAL: A total of 33-60 patients will be accrued for this study within 11-20 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, recurrent prostate cancer, stage IV prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
docetaxel
Intervention Type
Drug
Intervention Name(s)
estramustine phosphate sodium
Intervention Type
Drug
Intervention Name(s)
thalidomide
Primary Outcome Measure Information:
Title
PSA response
Title
Toxicity
Secondary Outcome Measure Information:
Title
Survival

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 Metastatic disease Androgen-independent disease Clinically progressive disease documented by at least 1 of the following parameters: Two consecutively rising prostate-specific antigen (PSA) levels taken at least 1 week apart PSA ≥ 5.0 ng/mL Continued rise in PSA 4 weeks after discontinuation of prior flutamide OR 6 weeks after discontinuation of prior bicalutamide or nilutamide (for patients treated with anti-androgen agents) At least 1 new lesion on bone scan Progressive measurable disease Must have undergone bilateral surgical castration OR continue on a gonadotropin-releasing hormone agonist No brain metastases PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count > 1,500/mm^3 Platelet count ≥ 100,000/mm^3* Hemoglobin ≥ 7.5 g/dL* NOTE: *No transfusions within the past 2 weeks Hepatic AST and ALT < 2.5 times upper limit of normal (ULN) Bilirubin < ULN (≤ 3.0 times ULN for patients with Gilbert's syndrome) Alkaline phosphatase ≤ 2.5 times ULN OR Fractionated hepatic alkaline phosphatase ≤ 2.5 times ULN Renal Creatinine ≤ 1.5 mg/dL OR Creatinine clearance ≥ 40 mL/min Cardiovascular No transient ischemic attacks or cerebrovascular accident within the past 2 years No myocardial infarction within the past 6 months No uncontrolled congestive heart failure No uncontrolled angina pectoris No thromboembolic disease Other No peripheral neuropathy ≥ grade 2 No cognitive impairment that would preclude study participation or giving informed consent No other active malignancy within the past 2 years except non-melanoma skin cancer or superficial bladder carcinoma Fertile patients must use effective contraception for at least 1 month before, during, and for at least 1 month after study treatment PRIOR CONCURRENT THERAPY: Biologic therapy No prior thalidomide Chemotherapy No prior docetaxel No prior estramustine No prior chemotherapy for metastatic prostate cancer Endocrine therapy See Disease Characteristics Radiotherapy Recovered from prior radiotherapy Surgery See Disease Characteristics Recovered from prior surgery Other No concurrent antiretroviral therapy for HIV-positive patients No concurrent complementary or alternative therapy that would interact with study drugs No concurrent herbal or nutritional products or dietary supplements that would interact with study drugs No concurrent aprepitant as secondary prophylaxis or antiemetic treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Avi S. Retter, MD
Organizational Affiliation
Eastchester Center for Cancer Care
Official's Role
Study Chair
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States
Facility Name
NCI - Center for Cancer Research
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21106711
Citation
Sissung TM, Danesi R, Kirkland CT, Baum CE, Ockers SB, Stein EV, Venzon D, Price DK, Figg WD. Estrogen receptor alpha and aromatase polymorphisms affect risk, prognosis, and therapeutic outcome in men with castration-resistant prostate cancer treated with docetaxel-based therapy. J Clin Endocrinol Metab. 2011 Feb;96(2):E368-72. doi: 10.1210/jc.2010-2070. Epub 2010 Nov 24.
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Docetaxel, Estramustine, and Thalidomide in Treating Patients With Androgen-Independent Metastatic Adenocarcinoma of the Prostate

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