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Quinacrine Treatment in Patients With Androgen-Independent Prostate Cancer

Primary Purpose

Prostatic Cancer

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Quinacrine
Sponsored by
Cleveland BioLabs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostatic Cancer focused on measuring Cancer of Prostate, Prostate Cancer, Cancer of the Prostate, Neoplasms, Prostate, Neoplasms, Prostatic, Prostate Neoplasms, Prostatic Cancer, Androgen-Independent Prostate Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients must be males, at least 18 years of age, with pathologically confirmed adenocarcinoma of the prostate
  • Patients must have evidence of androgen-independent metastatic prostate cancer (AIMPC) following standard antiandrogen withdrawal. AIMPC will be defined as the category of patients with metastatic prostate cancer with radiologic evidence of metastases (bone scan, CT, etc.) and castrate levels of testosterone (~ 50 ng/dL).

    1. All patients must be receiving ongoing therapy to ensure testicular androgen suppression (LHRH agonists therapy or bilateral orchiectomy).
    2. All patients receiving anti-androgen therapy [e.g., flutamide (Eulexin), bicalutamide (Casodex), or nilutamide (Nilandron)] must have initiated therapy at least 3 months (90 days) prior to the Baseline visit.
  • Patients must have received prior docetaxel-based or mitoxantrone-based chemotherapy, or refused or been ineligible for chemotherapy. Previous chemotherapy treatments must be completed at least 4 week prior to Screening, and patients must not have any residual therapy-related toxicities present at Screening.
  • Patients must have evidence of disease progression defined as any of the following:

    1. New sites of metastatic disease on radiographic imaging (bone scan or CT scan of chest/abdomen/pelvis) as determined by the referring physician.
    2. PSA progression, defined as a 50% or greater rise in PSA value over a baseline level of at least 1.0 ng/mL, confirmed after an interval of at least two weeks.
  • ECOG performance status 0-2 (see Appendix 4)
  • Patients must have adequate organ and bone marrow function as defined below:

    1. Absolute neutrophil count greater than 1500/mL
    2. Platelets greater than 100,000/mL
    3. Serum creatinine less than 2.0 mg/dL
    4. Total bilirubin less than 1.5 mg/dL
    5. AST (SGOT) and ALT (SGPT) less than 2 times the ULN [less than 5 times the ULN if liver metastases are present].
  • Sexually active men whose sexual partners are women of childbearing potential must agree to use a medically acceptable form of barrier contraception or abstinence during their participation in the study and for at least six weeks after study drug discontinuation.
  • Written informed consent/HIPAA authorization must be provided prior to the performance of any study-related procedures.

Exclusion Criteria:

  • Prior allergic reactions or a history of intolerance attributed to quinacrine or other acridine derivatives
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, hematological disorders, hepatic disease, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Lifetime history of porphyria or psoriasis
  • Documented glucose-6-phosphate dehydrogenase deficiency
  • Lifetime history of seizure disorder (except infant febrile seizures)
  • Lifetime history of schizophrenia, bipolar disorder, or any other psychotic disorders.
  • Lifetime history of dermatitis as an allergic/toxic reaction to any medication
  • Clinical evidence of CNS metastases
  • Patients with a history of any malignancy (other than basal, squamous cell cancers and Ta bladder cancers) within 5 years of baseline visit
  • Any grade 2 sensory neuropathy
  • QTc (Bazett) >450 msec
  • Patients with NYHA class 3 or 4 failure
  • Patients with myocardial infarction or acute coronary syndrome within the previous 6 months
  • Patients who require anti-arrhythmic treatment

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Quinacrine

    Arm Description

    Uncontrolled treatment arm

    Outcomes

    Primary Outcome Measures

    Efficacy of Quinacrine, Based on Prostate Specific Antigen (PSA) Response in Patients With Androgen-independent Metastatic Prostate Cancer
    Patients who achieved a complete response (CR) or a partial response (PR) to therapy were allowed to continue to receive treatment until disease progression or unacceptable toxicity occurred, until the patient discontinued treatment for another reason, or for a total of 6 months. Patients who continued to show a CR or PR or who maintained stable disease (SD) after 6 months of therapy were to be allowed to continue therapy at the investigator's discretion.

    Secondary Outcome Measures

    Full Information

    First Posted
    December 27, 2006
    Last Updated
    March 6, 2013
    Sponsor
    Cleveland BioLabs
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00417274
    Brief Title
    Quinacrine Treatment in Patients With Androgen-Independent Prostate Cancer
    Official Title
    An Open-Label, Phase II Safety, Tolerability, Drug Level and Efficacy Trial of Quinacrine in Patients With Androgen-Independent Metastatic Prostate Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2012
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2006 (undefined)
    Primary Completion Date
    May 2008 (Actual)
    Study Completion Date
    May 2008 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Cleveland BioLabs

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to determine whether quinacrine is effective in the treatment of Androgen-Independent Prostate Cancer.
    Detailed Description
    Despite a modest improvement in survival with available chemotherapy treatments, androgen-independent metastatic prostate cancer remains essentially incurable. Several changes in gene function that characterize malignancy have been identified. For example the p53 gene in normal tissue lessens the risk of cancer through growth arrest or cell suicidal programs. Thus the silenced p53 gene present in cancer tissue contributes to the growth of the cancer. In addition when the p53 gene is silenced, a cell survival pathway, controlled by the NF-kB gene, is activated leading increased cell survival. Quinacrine can activate p53 and inhibit NF-kB, thus reestablishing cell suicidal programs and decreasing cell survival in cancer tissue. Moreover, quinacrine is effective against several prostate tumor cell lines in vitro, and has anti-tumor effects against prostate cancer xenografts in mice.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Prostatic Cancer
    Keywords
    Cancer of Prostate, Prostate Cancer, Cancer of the Prostate, Neoplasms, Prostate, Neoplasms, Prostatic, Prostate Neoplasms, Prostatic Cancer, Androgen-Independent 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
    31 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Quinacrine
    Arm Type
    Experimental
    Arm Description
    Uncontrolled treatment arm
    Intervention Type
    Drug
    Intervention Name(s)
    Quinacrine
    Other Intervention Name(s)
    CBLB102
    Intervention Description
    100 mg daily
    Primary Outcome Measure Information:
    Title
    Efficacy of Quinacrine, Based on Prostate Specific Antigen (PSA) Response in Patients With Androgen-independent Metastatic Prostate Cancer
    Description
    Patients who achieved a complete response (CR) or a partial response (PR) to therapy were allowed to continue to receive treatment until disease progression or unacceptable toxicity occurred, until the patient discontinued treatment for another reason, or for a total of 6 months. Patients who continued to show a CR or PR or who maintained stable disease (SD) after 6 months of therapy were to be allowed to continue therapy at the investigator's discretion.
    Time Frame
    End of treatment

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients must be males, at least 18 years of age, with pathologically confirmed adenocarcinoma of the prostate Patients must have evidence of androgen-independent metastatic prostate cancer (AIMPC) following standard antiandrogen withdrawal. AIMPC will be defined as the category of patients with metastatic prostate cancer with radiologic evidence of metastases (bone scan, CT, etc.) and castrate levels of testosterone (~ 50 ng/dL). All patients must be receiving ongoing therapy to ensure testicular androgen suppression (LHRH agonists therapy or bilateral orchiectomy). All patients receiving anti-androgen therapy [e.g., flutamide (Eulexin), bicalutamide (Casodex), or nilutamide (Nilandron)] must have initiated therapy at least 3 months (90 days) prior to the Baseline visit. Patients must have received prior docetaxel-based or mitoxantrone-based chemotherapy, or refused or been ineligible for chemotherapy. Previous chemotherapy treatments must be completed at least 4 week prior to Screening, and patients must not have any residual therapy-related toxicities present at Screening. Patients must have evidence of disease progression defined as any of the following: New sites of metastatic disease on radiographic imaging (bone scan or CT scan of chest/abdomen/pelvis) as determined by the referring physician. PSA progression, defined as a 50% or greater rise in PSA value over a baseline level of at least 1.0 ng/mL, confirmed after an interval of at least two weeks. ECOG performance status 0-2 (see Appendix 4) Patients must have adequate organ and bone marrow function as defined below: Absolute neutrophil count greater than 1500/mL Platelets greater than 100,000/mL Serum creatinine less than 2.0 mg/dL Total bilirubin less than 1.5 mg/dL AST (SGOT) and ALT (SGPT) less than 2 times the ULN [less than 5 times the ULN if liver metastases are present]. Sexually active men whose sexual partners are women of childbearing potential must agree to use a medically acceptable form of barrier contraception or abstinence during their participation in the study and for at least six weeks after study drug discontinuation. Written informed consent/HIPAA authorization must be provided prior to the performance of any study-related procedures. Exclusion Criteria: Prior allergic reactions or a history of intolerance attributed to quinacrine or other acridine derivatives Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, hematological disorders, hepatic disease, or psychiatric illness/social situations that would limit compliance with study requirements. Lifetime history of porphyria or psoriasis Documented glucose-6-phosphate dehydrogenase deficiency Lifetime history of seizure disorder (except infant febrile seizures) Lifetime history of schizophrenia, bipolar disorder, or any other psychotic disorders. Lifetime history of dermatitis as an allergic/toxic reaction to any medication Clinical evidence of CNS metastases Patients with a history of any malignancy (other than basal, squamous cell cancers and Ta bladder cancers) within 5 years of baseline visit Any grade 2 sensory neuropathy QTc (Bazett) >450 msec Patients with NYHA class 3 or 4 failure Patients with myocardial infarction or acute coronary syndrome within the previous 6 months Patients who require anti-arrhythmic treatment
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Edwin Posadas, MD
    Organizational Affiliation
    University of Chicago Hospitals
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    16287968
    Citation
    Gurova KV, Hill JE, Guo C, Prokvolit A, Burdelya LG, Samoylova E, Khodyakova AV, Ganapathi R, Ganapathi M, Tararova ND, Bosykh D, Lvovskiy D, Webb TR, Stark GR, Gudkov AV. Small molecules that reactivate p53 in renal cell carcinoma reveal a NF-kappaB-dependent mechanism of p53 suppression in tumors. Proc Natl Acad Sci U S A. 2005 Nov 29;102(48):17448-53. doi: 10.1073/pnas.0508888102. Epub 2005 Nov 15.
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    Quinacrine Treatment in Patients With Androgen-Independent Prostate Cancer

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