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Docetaxel, Prednisone, and Vatalanib in Treating Patients With Advanced Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
docetaxel
prednisone
vatalanib
Sponsored by
University of California, San Francisco
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 documented adenocarcinoma of the prostate Progressive, systemic (metastatic) disease despite castrate levels of testosterone due to orchiectomy or luteinizing-hormone releasing hormone (LHRH) agonist, meeting 1 of the following criteria: Measurable disease, defined as any lesion that can be accurately measured in at least 1 dimension ≥ 2 cm by conventional techniques or ≥ 1 cm by spiral CT scan or MRI Nonmeasurable disease with PSA ≥ 5 ng/mL Bone lesions Pleural or pericardial effusions, ascites CNS lesions, leptomeningeal disease Irradiated lesions, unless progression documented after radiotherapy No PSA ≥ 5 ng/mL as only evidence of disease PSA evidence for progressive prostate cancer consists of a PSA level ≥ 5 ng/mL that has risen on ≥ 2 successive occasions, ≥ 2 weeks apart Castrate levels of testosterone (< 50 ng/dL) must be maintained If no prior orchiectomy, patients must remain on testicular androgen suppression (e.g., with an LHRH analogue) Patients receiving an antiandrogen as part of primary androgen ablation must demonstrate disease progression after discontinuation of antiandrogen Disease progression after antiandrogen withdrawal is defined as 2 consecutive rising PSA values, obtained at least 2 weeks apart, or documented osseous or soft tissue progression For patients receiving flutamide or megestrol acetate, at least 1 of the PSA values must be obtained 4 weeks or more after flutamide/megestrol acetate discontinuation For patients receiving bicalutamide or nilutamide, at least 1 of the PSA values must be obtained 6 weeks or more after antiandrogen discontinuation If improvement after antiandrogen withdrawal is noted, disease progression must be established No pleural effusion or ascites that causes respiratory compromise ( ≥ grade 2 dyspnea) No history of CNS disease, including primary brain tumor, seizures, or carcinomatous meningitis PATIENT CHARACTERISTICS: Fertile patients must use effective barrier contraception during and for 3 months after completion of study treatment Karnofsky performance status ≥ 60% Life expectancy > 12 weeks Granulocyte count > 1,500/mm^3 Platelet count > 75,000/mm^3 Hemoglobin > 8.0 g/dL Creatinine < 1.5 times upper limit of normal (ULN) Bilirubin < 1.5 times ULN SGOT/SGPT < 1.5 times ULN Urinalysis ≤ 1+ proteinuria based on dipstick reading OR 2+ proteinuria on dipstick reading AND total urinary protein ≤ 3,500 mg on 24 hour urine collection and creatinine clearance ≥ 50 mL/min on a 24-hour urine collection No impairment of gastrointestinal (GI) function or GI disease that may affect or alter absorption of vatalanib (i.e., malabsorption syndromes) No myocardial infarction or significant change in anginal pattern within the last 6 months, symptomatic congestive heart failure (New York Heart Association class III or IV), or uncontrolled cardiac arrhythmia No pre-existing grade 3 or 4 clinical peripheral neuropathy No history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80 No deep vein thrombosis or pulmonary embolus within the past year No poorly controlled diabetes (fasting blood glucose > 250) despite optimization of medical therapy No labile or poorly controlled hypertension (systolic blood pressure > 160 mm Hg, diastolic blood pressure > 90 mm Hg) despite maximal management with anti-hypertensives No serious uncontrolled, concurrent medical illness, including ongoing or active infection Patients on Suppressive antibiotic therapy for chronic urinary tract infection are eligible No psychiatric illness or social situation that would limit compliance with treatment No "currently active" second malignancy other than nonmelanoma skin cancers Not considered "currently active" if competed therapy and at < 30% risk of relapse No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung PRIOR CONCURRENT THERAPY: See Disease Characteristics No grapefruit or grapefruit juice during study treatment No history of gastrectomy/small bowel resection At least 4 weeks since prior hormonal therapy, including ketoconazole, aminoglutethimide, systemic steroids (any dose), and megestrol acetate (any dose) At least 4 weeks since prior drug or herbal product known to decrease PSA levels (e.g., finasteride, saw palmetto, or PC-SPES) At least 4 weeks since prior major surgery and fully recovered At least 4 weeks since prior radiation therapy and fully recovered At least 8 weeks since the last dose of prior strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium Patients receiving bisphosphonate therapy prior to initiating protocol treatment must have received bisphosphonates for at least the past month No bisphosphonate initiation for 1 month prior to and during study treatment No prior systemic chemotherapy for prostate cancer No prior antiangiogenic agents (thalidomide, bevacizumab) No other concurrent chemotherapy, investigational agents, radiotherapy (including palliative), or biologic therapy No biologic therapy or immunotherapy ≤ 4 weeks prior to study treatment No more than 1 prior therapy with an investigational agent, completed ≥ 4 weeks prior to study treatment No concurrent combination antiretroviral therapy for HIV-positive patients No concurrent therapeutic warfarin or similar oral anticoagulant that is metabolized by the cytochrome p450 system Heparin is allowed No other concurrent hormonal therapy except for the following: Steroids for adrenal failure Hormones for nondisease-related conditions (e.g., insulin for diabetes) Intermittent dexamethasone

Sites / Locations

  • UCSF Comprehensive Cancer Center

Outcomes

Primary Outcome Measures

Time to prostate-specific antigen (PSA) and objective progression
Response rate (PSA and objective)
Toxicity

Secondary Outcome Measures

Full Information

First Posted
February 16, 2006
Last Updated
October 9, 2012
Sponsor
University of California, San Francisco
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00293371
Brief Title
Docetaxel, Prednisone, and Vatalanib in Treating Patients With Advanced Prostate Cancer
Official Title
A Phase I/II Study of Docetaxel/Prednisone and PTK 787/ZK 222584 in Previously Untreated Metastatic Hormone Refractory Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Terminated
Why Stopped
low accrual
Study Start Date
February 2005 (undefined)
Primary Completion Date
September 2006 (Actual)
Study Completion Date
September 2006 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, San Francisco
Collaborators
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Drugs used in chemotherapy, such as docetaxel and prednisone, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Vatalanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving vatalanib together with docetaxel and prednisone may kill more tumor cells. PURPOSE: This phase I/II trial is studying the side effects and best dose of vatalanib when given together with docetaxel and prednisone and to see how well they work in treating patients with advanced prostate cancer.
Detailed Description
OBJECTIVES: Primary Determine the dose-limiting toxicities and maximum tolerated dose of vatalanib when used in combination with docetaxel and prednisone in patients with chemotherapy-naive, metastatic, hormone-refractory prostate cancer. (phase I) Secondary Determine alterations in pharmacokinetics of docetaxel and vatalanib in these patients. (phase I) Determine the clinical efficacy of this regimen as measured by declines in prostate-specific antigen, measurable disease response, time to progression, and overall survival. (phase II) OUTLINE: This is a phase I open-label, dose-escalation study of vatalanib* followed by a phase II study. Phase I: Patients receive docetaxel IV over 1 hour on day 2. Patients also receive oral prednisone twice daily and oral vatalanib once daily on days 1-21. Treatment repeats every 21 days in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of vatalanib until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity. NOTE: *Vatalanib is administered on days 5-21 during the first course only. Phase II: Patients receive prednisone, docetaxel, and vatalanib at the MTD as in phase I. Treatment continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically. PROJECTED ACCRUAL: A total of 93 patients 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, recurrent prostate cancer, stage IV prostate cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Masking
None (Open Label)
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
docetaxel
Intervention Type
Drug
Intervention Name(s)
prednisone
Intervention Type
Drug
Intervention Name(s)
vatalanib
Primary Outcome Measure Information:
Title
Time to prostate-specific antigen (PSA) and objective progression
Title
Response rate (PSA and objective)
Title
Toxicity

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically documented adenocarcinoma of the prostate Progressive, systemic (metastatic) disease despite castrate levels of testosterone due to orchiectomy or luteinizing-hormone releasing hormone (LHRH) agonist, meeting 1 of the following criteria: Measurable disease, defined as any lesion that can be accurately measured in at least 1 dimension ≥ 2 cm by conventional techniques or ≥ 1 cm by spiral CT scan or MRI Nonmeasurable disease with PSA ≥ 5 ng/mL Bone lesions Pleural or pericardial effusions, ascites CNS lesions, leptomeningeal disease Irradiated lesions, unless progression documented after radiotherapy No PSA ≥ 5 ng/mL as only evidence of disease PSA evidence for progressive prostate cancer consists of a PSA level ≥ 5 ng/mL that has risen on ≥ 2 successive occasions, ≥ 2 weeks apart Castrate levels of testosterone (< 50 ng/dL) must be maintained If no prior orchiectomy, patients must remain on testicular androgen suppression (e.g., with an LHRH analogue) Patients receiving an antiandrogen as part of primary androgen ablation must demonstrate disease progression after discontinuation of antiandrogen Disease progression after antiandrogen withdrawal is defined as 2 consecutive rising PSA values, obtained at least 2 weeks apart, or documented osseous or soft tissue progression For patients receiving flutamide or megestrol acetate, at least 1 of the PSA values must be obtained 4 weeks or more after flutamide/megestrol acetate discontinuation For patients receiving bicalutamide or nilutamide, at least 1 of the PSA values must be obtained 6 weeks or more after antiandrogen discontinuation If improvement after antiandrogen withdrawal is noted, disease progression must be established No pleural effusion or ascites that causes respiratory compromise ( ≥ grade 2 dyspnea) No history of CNS disease, including primary brain tumor, seizures, or carcinomatous meningitis PATIENT CHARACTERISTICS: Fertile patients must use effective barrier contraception during and for 3 months after completion of study treatment Karnofsky performance status ≥ 60% Life expectancy > 12 weeks Granulocyte count > 1,500/mm^3 Platelet count > 75,000/mm^3 Hemoglobin > 8.0 g/dL Creatinine < 1.5 times upper limit of normal (ULN) Bilirubin < 1.5 times ULN SGOT/SGPT < 1.5 times ULN Urinalysis ≤ 1+ proteinuria based on dipstick reading OR 2+ proteinuria on dipstick reading AND total urinary protein ≤ 3,500 mg on 24 hour urine collection and creatinine clearance ≥ 50 mL/min on a 24-hour urine collection No impairment of gastrointestinal (GI) function or GI disease that may affect or alter absorption of vatalanib (i.e., malabsorption syndromes) No myocardial infarction or significant change in anginal pattern within the last 6 months, symptomatic congestive heart failure (New York Heart Association class III or IV), or uncontrolled cardiac arrhythmia No pre-existing grade 3 or 4 clinical peripheral neuropathy No history of severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80 No deep vein thrombosis or pulmonary embolus within the past year No poorly controlled diabetes (fasting blood glucose > 250) despite optimization of medical therapy No labile or poorly controlled hypertension (systolic blood pressure > 160 mm Hg, diastolic blood pressure > 90 mm Hg) despite maximal management with anti-hypertensives No serious uncontrolled, concurrent medical illness, including ongoing or active infection Patients on Suppressive antibiotic therapy for chronic urinary tract infection are eligible No psychiatric illness or social situation that would limit compliance with treatment No "currently active" second malignancy other than nonmelanoma skin cancers Not considered "currently active" if competed therapy and at < 30% risk of relapse No interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung PRIOR CONCURRENT THERAPY: See Disease Characteristics No grapefruit or grapefruit juice during study treatment No history of gastrectomy/small bowel resection At least 4 weeks since prior hormonal therapy, including ketoconazole, aminoglutethimide, systemic steroids (any dose), and megestrol acetate (any dose) At least 4 weeks since prior drug or herbal product known to decrease PSA levels (e.g., finasteride, saw palmetto, or PC-SPES) At least 4 weeks since prior major surgery and fully recovered At least 4 weeks since prior radiation therapy and fully recovered At least 8 weeks since the last dose of prior strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium Patients receiving bisphosphonate therapy prior to initiating protocol treatment must have received bisphosphonates for at least the past month No bisphosphonate initiation for 1 month prior to and during study treatment No prior systemic chemotherapy for prostate cancer No prior antiangiogenic agents (thalidomide, bevacizumab) No other concurrent chemotherapy, investigational agents, radiotherapy (including palliative), or biologic therapy No biologic therapy or immunotherapy ≤ 4 weeks prior to study treatment No more than 1 prior therapy with an investigational agent, completed ≥ 4 weeks prior to study treatment No concurrent combination antiretroviral therapy for HIV-positive patients No concurrent therapeutic warfarin or similar oral anticoagulant that is metabolized by the cytochrome p450 system Heparin is allowed No other concurrent hormonal therapy except for the following: Steroids for adrenal failure Hormones for nondisease-related conditions (e.g., insulin for diabetes) Intermittent dexamethasone
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric J. Small, MD
Organizational Affiliation
University of California, San Francisco
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

12. IPD Sharing Statement

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Docetaxel, Prednisone, and Vatalanib in Treating Patients With Advanced Prostate Cancer

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