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Study Combining Imatinib Mesylate (Gleevec) With Sorafenib in Patients With Androgen-independent Prostate Cancer (AIPC)

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gleevec + Sorafenib
Sponsored by
Oncology Specialists, S.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring AIPC, Prostate cancer, prostate

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients 18 years of age or older.
  2. Histologically documented diagnosis of Prostate Cancer regardless of Gleason score.
  3. Androgen-Independent Prostate Cancer
  4. At least one measurable site of disease
  5. Patients must have failed one or more lines of systemic chemotherapy, regardless of the chemotherapeutic agent used. There is NO limit to how many lines of chemotherapy a patient can receive
  6. Patients receiving anti-coagulation treatment with an agent such as heparin may be allowed to participate. Patients on Warfarin are NOT allowed to participate.
  7. Last chemotherapy exposure 4 weeks prior to study entry
  8. Prior exposure to Sorafenib is allowed as long as last Sorafenib dose was 3 weeks or more from study entry
  9. Prior exposure to Gleevec is an EXCLUSION
  10. Progression after chemotherapy can be demonstrated radiographically (as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria) or biochemically with prostate-specific antigen (PSA) being elevated more than 25% than previous value as long as a repeat PSA confirms progression. (repeat PSA should be done within 3 weeks from the last one). Patients with bone-only disease are considered progressing if there are two more lesions on a new bone scan.
  11. Performance status 0,1, 2 (ECOG)
  12. Adequate end organ function, defined as the following:

    • total bilirubin < 1.5 x Upper Limit of Normal (ULN), serum glutamate oxaloacetate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) < 2.5 x Upper Limit of Normal (UNL), creatinine < 1.5 x Upper Limit of Normal (ULN), absolute neutrophil count (ANC) > 1.0 x 109/L, platelets > 75 x 109/L.
  13. Men of childbearing potential must agree to employ an effective barrier method of birth control prior to the study entry, throughout the duration of the study and for up to 3 months following discontinuation of study drug.
  14. Written, voluntary informed consent.
  15. Patients are allowed the following concurrent therapies:

    • Intravenous bisphosphonates if administered for bone metastases
    • luteinizing hormone releasing hormone (LHRH) analogues
    • Narcotic-type medical interventions to control malignancy-related pain

Exclusion Criteria:

  1. Patient has received any other investigational agents within 21 days of first day of study drug dosing, unless the disease is rapidly progressing.
  2. Patient is < 3 years free of another primary malignancy except: if the other primary malignancy is not currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal or squamous cell skin cancer. Existence of any other malignant disease is not allowed.
  3. Patient with Grade III/IV cardiac problems
  4. Patient has a severe and/or uncontrolled medical disease
  5. Patient has a known brain metastasis.
  6. Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
  7. Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
  8. Pulmonary hemorrhage/bleeding event > Common Toxicity Criteria for Adverse Effects (CTCAE) Grade 2 within 4 weeks of first dose of study drug.
  9. Any other hemorrhage/bleeding event > CTCAE Grade 3 within 4 weeks of first dose of study drug.
  10. Serious non-healing wound, ulcer, or bone fracture.
  11. Use of St. John's Wort or rifampin (rifampicin).
  12. Any condition that impairs patient's ability to swallow whole pills.
  13. Patient has known chronic liver disease (i.e., chronic active hepatitis, and cirrhosis).
  14. Patient has a known diagnosis of human immunodeficiency virus (HIV) infection.
  15. Patient previously received radiotherapy to ³ 25 % of the bone marrow
  16. Patient had a major surgery within 2 weeks prior to study entry.
  17. Patient with any significant history of non-compliance to medical regimens or with inability to grant reliable informed consent.

Sites / Locations

  • Oncology Specialists, S.C
  • Oncology Specialists, S.C

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Only 1 arm for the study - this arm gets both drugs, gleevec and sorafenib

Outcomes

Primary Outcome Measures

Number of Patients Experiencing Dose Limiting Toxicities (DLT's)
Eligible patients were enrolled in one of 4 cohorts, where each cohort allowed 3 evaluable patients to be on study, patients withdrawn from treatment for reasons other than toxicity were not considered evaluable. If one of the three evaluable patients experienced a dose limiting toxicity (DLT) the cohort was expanded to 6 evaluable patients. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. If 2 out of six evaluable patients experience a dose limiting toxicity this would show that the Maximum Tolerated Dose (MTD) was the dose from the prior cohort.

Secondary Outcome Measures

Overall Clinical Benefit
Overall Clinical Benefit was measured as the sum of complete response (CR), partial response (PR), and stable disease (SD).
Time to Disease Progression (TTP)
Medium TTP is 2 months (range 1-5). 10 patients were evaluable for disease progression for these patients occurred between 1-5 months after starting the study. The TTP was calculated per protocol. For radiographic assessment Response Evaluation Criteria in Solid Tumors (RECIST) was used. Complete response = disappearance of all lesions. Partial response (PR)=30% or greater decrease in sum of longest diameter of measureable lesions SD. Lesions have no sufficient decrease for progressive disease and no sufficient increase to meet Progressive Disease (PD). PD more than 20% increase in sum of longest diameter of measurable lesions or 2 or more new bone mets. prostate-specific antigen (PSA) assessment for patients with measurable disease, PSA progression in the absence of measurable disease progression will not be considered progressive disease.

Full Information

First Posted
January 17, 2007
Last Updated
June 19, 2014
Sponsor
Oncology Specialists, S.C.
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1. Study Identification

Unique Protocol Identification Number
NCT00424385
Brief Title
Study Combining Imatinib Mesylate (Gleevec) With Sorafenib in Patients With Androgen-independent Prostate Cancer (AIPC)
Official Title
Phase I Study Investigating the Safety and Feasibility of Combining Imatinib Mesylate (Gleevec) With Sorafenib in Patients With Androgen-Independent Chemotherapy-Failure Prostate Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
January 2007 (undefined)
Primary Completion Date
February 2012 (Actual)
Study Completion Date
February 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Oncology Specialists, S.C.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Eligible patients will be enrolled in one of 4 cohorts where each cohort will allow 3 patients to be on study. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. Once the pre-specified 400 mg by mouth two times a day (PO BID) dosing for both drugs is reached without toxicity, the study will close for accrual. If toxicity is noted prior to reaching the 400 mg PO BID dosing, then the dosing schedule that is deemed safest as per study design will be the one used for any future phase II study.
Detailed Description
Gleevec and Sorafenib have modest efficacy in androgen-independent prostate cancer (AIPC) and the fact that both agents can be given orally with what appears to be tolerable side effects, we hypothesize that combining both agents may provide patients with another effective regimen in a disease where therapeutic options are limited. This study is designed to investigate the safety of combining Gleevec and Sorafenib as well as feasibility in AIPC patients who have failed one or more lines of systemic chemotherapy. Once safety is established, a follow-up phase II study will commence to investigate efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
AIPC, Prostate cancer, prostate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Only 1 arm for the study - this arm gets both drugs, gleevec and sorafenib
Intervention Type
Drug
Intervention Name(s)
Gleevec + Sorafenib
Other Intervention Name(s)
Imatinib mesylate; Nexavar
Intervention Description
400 mg Sorafenib every day (QD) 300mg Gleevec QD
Primary Outcome Measure Information:
Title
Number of Patients Experiencing Dose Limiting Toxicities (DLT's)
Description
Eligible patients were enrolled in one of 4 cohorts, where each cohort allowed 3 evaluable patients to be on study, patients withdrawn from treatment for reasons other than toxicity were not considered evaluable. If one of the three evaluable patients experienced a dose limiting toxicity (DLT) the cohort was expanded to 6 evaluable patients. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. If 2 out of six evaluable patients experience a dose limiting toxicity this would show that the Maximum Tolerated Dose (MTD) was the dose from the prior cohort.
Time Frame
up to 20 weeks
Secondary Outcome Measure Information:
Title
Overall Clinical Benefit
Description
Overall Clinical Benefit was measured as the sum of complete response (CR), partial response (PR), and stable disease (SD).
Time Frame
up to 20 weeks
Title
Time to Disease Progression (TTP)
Description
Medium TTP is 2 months (range 1-5). 10 patients were evaluable for disease progression for these patients occurred between 1-5 months after starting the study. The TTP was calculated per protocol. For radiographic assessment Response Evaluation Criteria in Solid Tumors (RECIST) was used. Complete response = disappearance of all lesions. Partial response (PR)=30% or greater decrease in sum of longest diameter of measureable lesions SD. Lesions have no sufficient decrease for progressive disease and no sufficient increase to meet Progressive Disease (PD). PD more than 20% increase in sum of longest diameter of measurable lesions or 2 or more new bone mets. prostate-specific antigen (PSA) assessment for patients with measurable disease, PSA progression in the absence of measurable disease progression will not be considered progressive disease.
Time Frame
up to 5 cycles, an average of 20 weeks, from the day of first treatment until the date of the last dose of study drug

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients 18 years of age or older. Histologically documented diagnosis of Prostate Cancer regardless of Gleason score. Androgen-Independent Prostate Cancer At least one measurable site of disease Patients must have failed one or more lines of systemic chemotherapy, regardless of the chemotherapeutic agent used. There is NO limit to how many lines of chemotherapy a patient can receive Patients receiving anti-coagulation treatment with an agent such as heparin may be allowed to participate. Patients on Warfarin are NOT allowed to participate. Last chemotherapy exposure 4 weeks prior to study entry Prior exposure to Sorafenib is allowed as long as last Sorafenib dose was 3 weeks or more from study entry Prior exposure to Gleevec is an EXCLUSION Progression after chemotherapy can be demonstrated radiographically (as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria) or biochemically with prostate-specific antigen (PSA) being elevated more than 25% than previous value as long as a repeat PSA confirms progression. (repeat PSA should be done within 3 weeks from the last one). Patients with bone-only disease are considered progressing if there are two more lesions on a new bone scan. Performance status 0,1, 2 (ECOG) Adequate end organ function, defined as the following: total bilirubin < 1.5 x Upper Limit of Normal (ULN), serum glutamate oxaloacetate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) < 2.5 x Upper Limit of Normal (UNL), creatinine < 1.5 x Upper Limit of Normal (ULN), absolute neutrophil count (ANC) > 1.0 x 109/L, platelets > 75 x 109/L. Men of childbearing potential must agree to employ an effective barrier method of birth control prior to the study entry, throughout the duration of the study and for up to 3 months following discontinuation of study drug. Written, voluntary informed consent. Patients are allowed the following concurrent therapies: Intravenous bisphosphonates if administered for bone metastases luteinizing hormone releasing hormone (LHRH) analogues Narcotic-type medical interventions to control malignancy-related pain Exclusion Criteria: Patient has received any other investigational agents within 21 days of first day of study drug dosing, unless the disease is rapidly progressing. Patient is < 3 years free of another primary malignancy except: if the other primary malignancy is not currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal or squamous cell skin cancer. Existence of any other malignant disease is not allowed. Patient with Grade III/IV cardiac problems Patient has a severe and/or uncontrolled medical disease Patient has a known brain metastasis. Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management. Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months. Pulmonary hemorrhage/bleeding event > Common Toxicity Criteria for Adverse Effects (CTCAE) Grade 2 within 4 weeks of first dose of study drug. Any other hemorrhage/bleeding event > CTCAE Grade 3 within 4 weeks of first dose of study drug. Serious non-healing wound, ulcer, or bone fracture. Use of St. John's Wort or rifampin (rifampicin). Any condition that impairs patient's ability to swallow whole pills. Patient has known chronic liver disease (i.e., chronic active hepatitis, and cirrhosis). Patient has a known diagnosis of human immunodeficiency virus (HIV) infection. Patient previously received radiotherapy to ³ 25 % of the bone marrow Patient had a major surgery within 2 weeks prior to study entry. Patient with any significant history of non-compliance to medical regimens or with inability to grant reliable informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chadi Nabhan, MD
Organizational Affiliation
Oncology Specialists, SC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oncology Specialists, S.C
City
Niles
State/Province
Illinois
ZIP/Postal Code
60714
Country
United States
Facility Name
Oncology Specialists, S.C
City
Park Ridge
State/Province
Illinois
ZIP/Postal Code
60068
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study Combining Imatinib Mesylate (Gleevec) With Sorafenib in Patients With Androgen-independent Prostate Cancer (AIPC)

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