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17-AAG in Treating Patients With Metastatic Prostate Cancer That Did Not Respond to Previous Hormone Therapy

Primary Purpose

Adenocarcinoma of the Prostate, Recurrent Prostate Cancer, Stage IV Prostate Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
tanespimycin
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adenocarcinoma of the Prostate

Eligibility Criteria

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

Inclusion Criteria: Histologically confirmed adenocarcinoma of the prostate Metastatic disease Measurable or evaluable disease Prostate-specific antigen (PSA) ≥ 5 ng/mL OR new areas of bony metastases on bone scan are required for patients with no measurable disease Objective disease progression OR rising PSA despite receiving androgen deprivation therapy and undergoing antiandrogen withdrawal Patients with a rising PSA must have 2 successive elevations (measured ≥ 1 week apart) Must be castrate (testosterone < 50 ng/mL) Luteinizing hormone-releasing hormone agonist therapy must be continued during study participation to maintain castrate levels of testosterone Must have received ≥ 1 prior chemotherapy regimen for metastatic disease No known brain metastases requiring active therapy Previously treated asymptomatic brain metastases allowed Performance status - ECOG 0-2 At least 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 8.0 g/dL Bilirubin ≤ 1.5 times upper limit of normal (ULN) SGOT and/or SGPT ≤ 2.5 times ULN AND alkaline phosphatase normal Alkaline phosphatase ≤ 4 times ULN AND SGOT and/or SGPT normal Creatinine clearance ≥ 60 mL/min Creatinine normal QTc < 450 msec for male patients LVEF > 40% by MUGA EF normal by MUGA if prior anthracycline therapy No congenital long QT syndrome No left bundle branch block Deep venous thrombosis or other clinically significant thromboembolic event within the past 6 months allowed provided patient is clinically stable on anticoagulation therapy No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row) No myocardial infarction within the past year No cerebrovascular accident or transient ischemic attack within the past 6 months No New York Heart Association class III or IV congestive heart failure No poorly controlled angina No uncontrolled dysrhythmia or dysrhythmias requiring medication No active ischemic heart disease within the past 12 months No other significant cardiac disease Pulmonary embolus allowed within the past 6 months provided patient is clinically stable on anticoagulation therapy Fertile patients must use effective contraception Willing and able to provide blood samples No serious allergy (i.e., hypotension, dyspnea, anaphylaxis, or edema) to eggs No other concurrent malignancy or history of a curatively treated malignancy with a survival prognosis of < 5 years No known HIV positivity No active infection No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study participation At least 4 weeks since prior flutamide (6 weeks for bicalutamide or nilutamide) At least 28 days since prior radiotherapy No prior radiotherapy field that included the heart (e.g., mantle) More than 6 months since prior coronary or peripheral artery bypass grafting More than 28 days since prior investigational agents for prostate cancer No concurrent agents that interact with cytochrome P450 3A4 No concurrent warfarin for anticoagulation Concurrent low molecular weight heparin injection allowed No concurrent medications that would prolong QTc No other concurrent antineoplastic agents Concurrent zoledronate for bone metastases or hypercalcemia allowed

Sites / Locations

  • Mayo Clinic

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (tanespimycin)

Arm Description

Patients receive 17-N-allylamino 17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses of treatment beyond documentation of CR.

Outcomes

Primary Outcome Measures

PSA Response as Defined by the Recommendations of the Prostate-Specific Antigen Working Group
Normalization: PSA ≤4.0 ng/ml. This must be confirmed by a second PSA value measured when patient returns in 4-6 weeks. This qualifies as a CR response. > > 50% decline: A 50% decline in PSA value from baseline which must be confirmed by a second PSA value measured when patient returns in 4-6 weeks later. This qualifies as a PR response.> > Progression: A 25% or greater increase over baseline and an increase in the PSA level by at least 5 ng/mL, which is confirmed by a second value obtained approximately one week later. In addition, radiographic scans are required to confirm that a disease progression is by PSA only.

Secondary Outcome Measures

Proportion of Overall Responses
Confirmed response rate was defined using Response Evaluation Criteria In Solid Tumors (RECIST). A confirmed response is defined as a complete response (CR) or partial response (PR) observed on subsequent scans at least 4 weeks apart. Confirmed response rate was estimated by the number of successes divided by the total number of evaluable patients. Complete Response (CR) is defined as the disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in sum of longest diameter of target lesions. The proportion of confirmed responses will be estimated by the number of patients with confirmed responses divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner.
Overall Survival
Overall survival time is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier.
Disease-free Survival
Disease-free survival time is defined as the time from registration to documentation of disease progression. If a patient dies without a documentation of disease progression, the patient will be considered to have had progressed at the time of their death. In patients who have achieved a PSA response, we will assess the time to PSA progression. If the patient is declared to be a major treatment violation, the patient will be censored on the date the treatment violation was declared to have occurred. In the case of a patient starting treatment and then never returning for any evaluations, the patient will be censored for progression on day 1 post-registration. The distribution of disease-free survival time will be estimated using the method of Kaplan-Meier.
Duration of PSA Response and PSA Control
The distribution of this response duration will be estimated using the method of Kaplan-Meier. In patients whose PSA has declined from baseline by at least 30 %, "duration of PSA response" will be defined as the time from PSA response to time of progression. If a patient goes on to alternate therapy, they will be censored at the date they end treatment on this study. "Duration of PSA Control" is defined as the time from the date of the first 30% decline in PSA until an inflection point is identified. Inflection point is defined as the time to first consistent PSA increase, the point at which PSA began what becomes a continuous increase > (retrospectively identified). The inflection point is the point at which disease control could assume to be lost.

Full Information

First Posted
July 8, 2005
Last Updated
March 20, 2017
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00118092
Brief Title
17-AAG in Treating Patients With Metastatic Prostate Cancer That Did Not Respond to Previous Hormone Therapy
Official Title
A Phase II Trial of 17-Allylamino-17-Demethoxygeldanamycin (17-AAG) in Patients With Hormone-Refractory Metastatic Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
January 2005 (undefined)
Primary Completion Date
May 2006 (Actual)
Study Completion Date
February 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This phase II trial is studying how well 17-AAG works in treating patients with metastatic prostate cancer that did not respond to previous hormone therapy. Drugs used in chemotherapy, such as 17-AAG, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the prostate-specific antigen (PSA) response in patients with hormone-refractory metastatic prostate cancer treated with 17-N-allylamino-17-demethoxygeldanamycin (17-AAG). SECONDARY OBJECTIVES: I. Determine the overall survival and disease-free survival rate in patients treated with this drug. II. Determine the safety profile of this drug in these patients. III. Determine the duration of PSA response and PSA control in patients treated with this drug. IV. Determine the partial and complete response rates in patients with measurable disease treated with this drug. V. Correlate changes in expression levels of interleukin-6, maspin, and NF-kappaB in serum and tissue with cancer and treatment-related outcomes in patients treated with this drug. OUTLINE: This is a multicenter study. Patients receive 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses of treatment beyond documentation of CR. After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months for 3 years. PROJECTED ACCRUAL: A total of 16-28 patients will be accrued for this study within 20 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma of the Prostate, Recurrent Prostate Cancer, Stage IV Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (tanespimycin)
Arm Type
Experimental
Arm Description
Patients receive 17-N-allylamino 17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses of treatment beyond documentation of CR.
Intervention Type
Drug
Intervention Name(s)
tanespimycin
Intervention Description
Given IV
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
PSA Response as Defined by the Recommendations of the Prostate-Specific Antigen Working Group
Description
Normalization: PSA ≤4.0 ng/ml. This must be confirmed by a second PSA value measured when patient returns in 4-6 weeks. This qualifies as a CR response. > > 50% decline: A 50% decline in PSA value from baseline which must be confirmed by a second PSA value measured when patient returns in 4-6 weeks later. This qualifies as a PR response.> > Progression: A 25% or greater increase over baseline and an increase in the PSA level by at least 5 ng/mL, which is confirmed by a second value obtained approximately one week later. In addition, radiographic scans are required to confirm that a disease progression is by PSA only.
Time Frame
Up to 1 year
Secondary Outcome Measure Information:
Title
Proportion of Overall Responses
Description
Confirmed response rate was defined using Response Evaluation Criteria In Solid Tumors (RECIST). A confirmed response is defined as a complete response (CR) or partial response (PR) observed on subsequent scans at least 4 weeks apart. Confirmed response rate was estimated by the number of successes divided by the total number of evaluable patients. Complete Response (CR) is defined as the disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in sum of longest diameter of target lesions. The proportion of confirmed responses will be estimated by the number of patients with confirmed responses divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner.
Time Frame
Up to 3 years
Title
Overall Survival
Description
Overall survival time is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier.
Time Frame
From registration to death due to any cause, assessed up to 3 years
Title
Disease-free Survival
Description
Disease-free survival time is defined as the time from registration to documentation of disease progression. If a patient dies without a documentation of disease progression, the patient will be considered to have had progressed at the time of their death. In patients who have achieved a PSA response, we will assess the time to PSA progression. If the patient is declared to be a major treatment violation, the patient will be censored on the date the treatment violation was declared to have occurred. In the case of a patient starting treatment and then never returning for any evaluations, the patient will be censored for progression on day 1 post-registration. The distribution of disease-free survival time will be estimated using the method of Kaplan-Meier.
Time Frame
From registration to documentation of disease progression, assessed up to 3 years
Title
Duration of PSA Response and PSA Control
Description
The distribution of this response duration will be estimated using the method of Kaplan-Meier. In patients whose PSA has declined from baseline by at least 30 %, "duration of PSA response" will be defined as the time from PSA response to time of progression. If a patient goes on to alternate therapy, they will be censored at the date they end treatment on this study. "Duration of PSA Control" is defined as the time from the date of the first 30% decline in PSA until an inflection point is identified. Inflection point is defined as the time to first consistent PSA increase, the point at which PSA began what becomes a continuous increase > (retrospectively identified). The inflection point is the point at which disease control could assume to be lost.
Time Frame
From PSA response to time of progression, assessed up to 1 year

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed adenocarcinoma of the prostate Metastatic disease Measurable or evaluable disease Prostate-specific antigen (PSA) ≥ 5 ng/mL OR new areas of bony metastases on bone scan are required for patients with no measurable disease Objective disease progression OR rising PSA despite receiving androgen deprivation therapy and undergoing antiandrogen withdrawal Patients with a rising PSA must have 2 successive elevations (measured ≥ 1 week apart) Must be castrate (testosterone < 50 ng/mL) Luteinizing hormone-releasing hormone agonist therapy must be continued during study participation to maintain castrate levels of testosterone Must have received ≥ 1 prior chemotherapy regimen for metastatic disease No known brain metastases requiring active therapy Previously treated asymptomatic brain metastases allowed Performance status - ECOG 0-2 At least 12 weeks Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hemoglobin ≥ 8.0 g/dL Bilirubin ≤ 1.5 times upper limit of normal (ULN) SGOT and/or SGPT ≤ 2.5 times ULN AND alkaline phosphatase normal Alkaline phosphatase ≤ 4 times ULN AND SGOT and/or SGPT normal Creatinine clearance ≥ 60 mL/min Creatinine normal QTc < 450 msec for male patients LVEF > 40% by MUGA EF normal by MUGA if prior anthracycline therapy No congenital long QT syndrome No left bundle branch block Deep venous thrombosis or other clinically significant thromboembolic event within the past 6 months allowed provided patient is clinically stable on anticoagulation therapy No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row) No myocardial infarction within the past year No cerebrovascular accident or transient ischemic attack within the past 6 months No New York Heart Association class III or IV congestive heart failure No poorly controlled angina No uncontrolled dysrhythmia or dysrhythmias requiring medication No active ischemic heart disease within the past 12 months No other significant cardiac disease Pulmonary embolus allowed within the past 6 months provided patient is clinically stable on anticoagulation therapy Fertile patients must use effective contraception Willing and able to provide blood samples No serious allergy (i.e., hypotension, dyspnea, anaphylaxis, or edema) to eggs No other concurrent malignancy or history of a curatively treated malignancy with a survival prognosis of < 5 years No known HIV positivity No active infection No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study participation At least 4 weeks since prior flutamide (6 weeks for bicalutamide or nilutamide) At least 28 days since prior radiotherapy No prior radiotherapy field that included the heart (e.g., mantle) More than 6 months since prior coronary or peripheral artery bypass grafting More than 28 days since prior investigational agents for prostate cancer No concurrent agents that interact with cytochrome P450 3A4 No concurrent warfarin for anticoagulation Concurrent low molecular weight heparin injection allowed No concurrent medications that would prolong QTc No other concurrent antineoplastic agents Concurrent zoledronate for bone metastases or hypercalcemia allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elisabeth Heath
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

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17-AAG in Treating Patients With Metastatic Prostate Cancer That Did Not Respond to Previous Hormone Therapy

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