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Gefitinib and Etoposide in Treating Patients With Advanced Prostate Cancer That Did Not Respond to Hormone Therapy

Primary Purpose

Prostate Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Gefitinib plus etoposide
Sponsored by
University of Nebraska
About
Eligibility
Locations
Arms
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 III prostate cancer, stage IV prostate cancer

Eligibility Criteria

19 Years - 120 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma of the prostate
  • Progressive disease after a prior docetaxel-based regimen OR failed a prior docetaxel-based regimen
  • Hormone-refractory disease, meeting 1 of the following criteria:

    • Radiologically measurable disease
    • Prostate-specific antigen (PSA) progression* while on hormonal therapy (including withdrawal from a direct antagonist) NOTE: *If the confirmatory PSA value is less than the screening PSA value, then an additional test for rising PSA is required to document progression
  • Must have underwent prior surgical castration OR currently be on a luteinizing hormone-releasing hormone agonist

PATIENT CHARACTERISTICS:

  • ANC > 1,500/mm³
  • Platelet count > 100,000/mm³
  • Hemoglobin > 10 g/dL (in the absence of packed red blood cell transfusions within the past 4 weeks)
  • Creatinine < 2 mg/dL
  • AST and ALT < 2 times upper limit of normal (ULN)
  • Alkaline phosphatase < 2 times ULN
  • Fertile patients must use effective double-method contraception during and for 1 month after completion of study treatment
  • No other malignancy within the past 5 years except basal cell carcinoma
  • No clinically significant New York Heart Association class II-IV cardiovascular disease
  • No evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease)
  • No unresolved chronic toxicity > grade 2 from prior anticancer therapy, with the exception of alopecia
  • No other significant clinical disorder or laboratory finding that would preclude study participation
  • No known severe hypersensitivity to gefitinib or any of the excipients of this product
  • No evidence of clinically active interstitial lung disease

    • Patients with chronic, stable radiographic changes who are asymptomatic are eligible

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 4 weeks since prior cytotoxic therapy
  • At least 4 weeks since prior direct antagonists, including flutamide and nilutamide
  • At least 6 weeks since prior bicalutamide
  • At least 30 days since prior nonapproved or investigational drugs
  • More than 4 weeks since prior palliative radiotherapy

    • The irradiated lesion must not be used to assess response rate
  • No prior gefitinib or etoposide
  • No concurrent palliative radiotherapy
  • No concurrent chemotherapeutic agents
  • No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or Hypericum perforatum (St. John's wort)
  • No concurrent hormones except antiandrogen therapy, steroids for adrenal failure, hormones for nondisease-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic
  • No concurrent initiation of IV and/or oral bisphosphonates specifically for symptomatic bone metastases

Sites / Locations

  • University of Nebraska Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gefitinib plus Etoposide

Arm Description

Gefitinib 250 mg p.o. daily, starting on Day 1and taken on a continuous basis throughout the trial. Etoposide 50 mg/m2/day for Days 1-14 out of a 28-day cycle. (Etoposide capsules come in a 50-mg dose formulation, and the patient's dose will be rounded to the nearest 50-mg multiple).

Outcomes

Primary Outcome Measures

Overall Response Rate as Measured by RECIST Criteria and PSA Criteria
If there is at least 1 response, then 7 additional patients will be enrolled. If there are 4 or more responders overall, then the combination will be considered active and warrant further study. Overall response rate (ORR) is defined as the proportion of patients who have a partial or complete response to therapy.

Secondary Outcome Measures

Biomarkers

Full Information

First Posted
June 6, 2007
Last Updated
August 22, 2023
Sponsor
University of Nebraska
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00483561
Brief Title
Gefitinib and Etoposide in Treating Patients With Advanced Prostate Cancer That Did Not Respond to Hormone Therapy
Official Title
A Phase II Study Evaluating the Efficacy of Iressa Plus Etoposide in Patients With Advanced Hormone Refractory Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Terminated
Why Stopped
PI left UNMC
Study Start Date
January 2004 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
January 2010 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Gefitinib 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. Drugs used in chemotherapy, such as etoposide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving gefitinib together with etoposide may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving gefitinib together with etoposide works in treating patients with advanced prostate cancer that did not respond to hormone therapy.
Detailed Description
OBJECTIVES: Primary Determine the activity of gefitinib and etoposide, in terms of overall response rate, in patients with hormone-refractory advanced prostate cancer previously treated with docetaxel-based therapy. Secondary Determine the toxicity of this regimen in these patients. Determine whether related biomarkers can help predict response in patients treated with this regimen. OUTLINE: This is a nonrandomized study. Patients receive oral gefitinib once daily on days 1-28 and oral etoposide once daily on days 1-14. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo blood sample collection at baseline and periodically during study for correlative studies. Blood samples are analyzed by enzyme-linked immunosorbent assays for biomarkers (e.g., VEGF, basic fibroblast growth factor, and anti-EGFR antibody titers) in order to determine whether one or more of these biomarkers can predict response. After completion of study therapy, patients are followed periodically.

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 III 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
26 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gefitinib plus Etoposide
Arm Type
Experimental
Arm Description
Gefitinib 250 mg p.o. daily, starting on Day 1and taken on a continuous basis throughout the trial. Etoposide 50 mg/m2/day for Days 1-14 out of a 28-day cycle. (Etoposide capsules come in a 50-mg dose formulation, and the patient's dose will be rounded to the nearest 50-mg multiple).
Intervention Type
Drug
Intervention Name(s)
Gefitinib plus etoposide
Other Intervention Name(s)
Iressa, ZD1839
Intervention Description
Gefitinib 250 mg p.o. daily, starting on Day 1and taken on a continuous basis throughout the trial with Etoposide 50 mg/m2/day for Days 1-14 out of a 28-day cycle. (Etoposide capsules come in a 50-mg dose formulation, and the patient's dose will be rounded to the nearest 50-mg multiple).
Primary Outcome Measure Information:
Title
Overall Response Rate as Measured by RECIST Criteria and PSA Criteria
Description
If there is at least 1 response, then 7 additional patients will be enrolled. If there are 4 or more responders overall, then the combination will be considered active and warrant further study. Overall response rate (ORR) is defined as the proportion of patients who have a partial or complete response to therapy.
Time Frame
Approximately 3 years
Secondary Outcome Measure Information:
Title
Biomarkers
Time Frame
At every cycle

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed adenocarcinoma of the prostate Progressive disease after a prior docetaxel-based regimen OR failed a prior docetaxel-based regimen Hormone-refractory disease, meeting 1 of the following criteria: Radiologically measurable disease Prostate-specific antigen (PSA) progression* while on hormonal therapy (including withdrawal from a direct antagonist) NOTE: *If the confirmatory PSA value is less than the screening PSA value, then an additional test for rising PSA is required to document progression Must have undergone prior surgical castration OR currently be on a luteinizing hormone-releasing hormone agonistANC > 1,500/mm³Platelet count > 100,000/mm³Hemoglobin > 10 g/dL (in the absence of packed red blood cell transfusions within the past 4 weeks)Creatinine < 2 mg/dLAST and ALT < 2 times upper limit of normal (ULN)Alkaline phosphatase < 2 times ULNFertile patients must use effective double-method contraception during and for 1 month after completion of study treatmentAt least 4 weeks since prior cytotoxic therapy At least 4 weeks since prior direct antagonists, including flutamide and nilutamide At least 6 weeks since prior bicalutamide At least 30 days since prior nonapproved or investigational drugs More than 4 weeks since prior palliative radiotherapy o The irradiated lesion must not be used to assess response rate Exclusion Criteria: No other malignancy within the past 5 years except basal cell carcinoma No clinically significant New York Heart Association class II-IV cardiovascular disease No evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease) No unresolved chronic toxicity > grade 2 from prior anticancer therapy, with the exception of alopecia No other significant clinical disorder or laboratory finding that would preclude study participation No known severe hypersensitivity to gefitinib or any of the excipients of this product No evidence of clinically active interstitial lung disease o Asymptomatic Patients with chronic, stable radiographic changes are eligible No prior gefitinib or etoposide No concurrent palliative radiotherapy No concurrent chemotherapeutic agents No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or Hypericum perforatum (St. John's wort) No concurrent hormones except antiandrogen therapy, steroids for adrenal failure, hormones for nondisease-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic No concurrent initiation of IV and/or oral bisphosphonates specifically for symptomatic bone metastases
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ralph Hauke, MD
Organizational Affiliation
University of Nebraska
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Elizabeth C Reed, MD
Organizational Affiliation
University of Nebraska
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States

12. IPD Sharing Statement

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Gefitinib and Etoposide in Treating Patients With Advanced Prostate Cancer That Did Not Respond to Hormone Therapy

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