Paclitaxel Poliglumex and Estradiol in Treating Patients With Stage IV Prostate Cancer
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Purpose
RATIONALE: Drugs used in chemotherapy, such as paclitaxel poliglumex, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Estradiol may kill prostate cancer cells that no longer respond to hormone therapy. Giving paclitaxel poliglumex together with estradiol may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving paclitaxel poliglumex together with estradiol works in treating patients with stage IV prostate cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Prostate Cancer |
Drug: transdermal estradiol Drug: paclitaxel poliglumex |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study of Paclitaxel Poliglumex (PPX) in Combination With Transdermal Estradiol for the Treatment of Androgen Independent Prostate Cancer After Docetaxel Chemotherapy |
- Prostate Specific Antigen (PSA) Response Rate: Number of Subjects With Decreases in PSA of at Least 50% [ Time Frame: While receiving study agents (on average, 3 months) ] [ Designated as safety issue: No ]PSA response rate is defined at the number of patients who experienced a PSA decline of equal to or greater than 50%, confirmed by a second measurement at least 4 weeks later.
- Measurable Disease Response Rate (Soft Tissue) [ Time Frame: While receiving study agents (on average, 3 months) ] [ Designated as safety issue: No ]Measurable disease response rate by RECIST criteria. Response is defined as at least a 30% decrease in the sum of the longest diameter in measurable lesions (larger than 10mm at baseline).
- Time to Disease Progression [ Time Frame: At time of progression by PSA or RECIST criteria ] [ Designated as safety issue: No ]Time from Day 1 to Day of meeting criteria for PSA or Measurable Disease Progression
- Time to Death [ Time Frame: Measured at Date of Death from any cause ] [ Designated as safety issue: No ]Defined as time from Day 1 of study regimen to Date of death from any cause.
- Correlation of Levels of Serum Estradiol, Serum Cathepsin B, and Bone Turnover Markers With PSA Response [ Time Frame: Measured after 4 cycles of combination therapy ] [ Designated as safety issue: No ]These correlative analyses were not completed. As there were no PSA responses, it was not possible to correlate serum estradiol, serum cathepsin B, or bone turnover markers with PSA response.
| Enrollment: | 21 |
| Study Start Date: | February 2007 |
| Study Completion Date: | July 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
-
Drug: transdermal estradiol
OBJECTIVES:
Primary
- Determine the PSA response rate in patients with androgen independent metastatic prostate cancer treated with paclitaxel poliglumex and transdermal estradiol.
Secondary
- Determine the toxicity of this regimen in these patients.
- Determine the response rate in patients treated with this regimen.
- Determine the time to PSA progression and measurable disease progression in patients treated with this regimen.
- Determine time to death from all causes in patients treated with this regimen.
- Correlate levels of serum estradiol, serum cathepsin B, and bone turnover markers with PSA response in patients treated with this regimen.
OUTLINE: This is a multicenter study.
Patients receive transdermal estradiol continuously (patches changed every 7 days) until the PSA level rises. Patients whose PSA increases above baseline or PSA decreases < 10% after 4 weeks of estradiol therapy or whose serum PSA reduction is < 50% after 12 weeks of estradiol therapy also receive paclitaxel poliglumex therapy. These patients receive paclitaxel poliglumex IV over 10-20 minutes on day 1. Treatment with paclitaxel poliglumex repeats every 28 days for up to 10 courses in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed every 6 months.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed adenocarcinoma of the prostate
Stage IV disease
- Radiographic evidence of regional or distant metastases
Evidence of disease progression (by PSA and/or imaging studies) despite standard hormonal therapy and after exposure to docetaxel-containing chemotherapy, as evidenced by any of the following:
- Measurable or evaluable disease progression, defined as the appearance of new lesion(s) or unequivocal increase in previously existing lesions or masses
Disease progression by PSA*, defined by 1 of the following:
- 3 consecutively rising PSA with the second PSA taken ≥ 1 week after the first PSA
- 2 consecutively rising PSA with a fourth PSA > the second PSA NOTE: *The last required PSA must be after the required antiandrogen washout period for patients who have been on antiandrogen therapy
Must have received prior therapy with at least two 3-weekly doses or six weekly doses of docetaxel
- Patients may have discontinued therapy due to progression, intolerance, completion of planned therapy, or other reasons
- Prior treatment with combinations of docetaxel with estramustine phosphate sodium or noncytotoxic agents (biologic agents) allowed
Serum testosterone < 50 ng/dL (unless surgically castrate)
- Patients must continue androgen deprivation with a luteinizing hormone-releasing hormone agonist if they have not undergone orchiectomy
- No known or suspected brain metastases
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Life expectancy > 3 months
- Absolute neutrophil count ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Creatinine ≤ 1.5 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 times ULN
- AST and ALT ≤ 2.5 times ULN
- No other active malignancy except adequately treated nonmelanoma skin cancer or other noninvasive or in situ neoplasm
- No other significant active medical illness or infection that would preclude study compliance
No significant cardiovascular illness, including any of the following:
- NYHA class III or IV congestive heart failure
- Unstable angina
- Myocardial infarction within the past 6 months
- Acute deep venous thrombosis
- Acute pulmonary embolism
- No significant peripheral neuropathy ≥ grade 2
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
At least 6 weeks since prior antiandrogen therapy (4 weeks for flutamide)
- No current evidence of an antiandrogen withdrawal response
- More than 4 weeks since prior radiotherapy
- More than 8 weeks since prior radiopharmaceutical therapy (strontium chloride Sr 89, samarium Sm 153 lexidronam pentasodium)
- No prior paclitaxel
- No other concurrent cytotoxic agents
- No other concurrent chemotherapy or biologic response modifiers
- No concurrent supplements known or suspected to contain supplemental estrogens
Contacts and Locations| United States, California | |
| UCSF Helen Diller Family Comprehensive Cancer Center | |
| San Francisco, California, United States, 94115 | |
| United States, Oregon | |
| OHSU Knight Cancer Institute | |
| Portland, Oregon, United States, 97239-3098 | |
| Principal Investigator: | Tomasz M. Beer, MD | OHSU Knight Cancer Institute |
More Information
No publications provided
| Responsible Party: | OHSU Knight Cancer Institute |
| ClinicalTrials.gov Identifier: | NCT00459810 History of Changes |
| Other Study ID Numbers: | CDR0000540438, OHSU-2656 |
| Study First Received: | April 11, 2007 |
| Results First Received: | May 25, 2010 |
| Last Updated: | March 28, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by OHSU Knight Cancer Institute:
|
adenocarcinoma of the prostate recurrent prostate cancer stage IV prostate cancer |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms Genital Diseases, Male Prostatic Diseases Estradiol Polyestradiol phosphate Estradiol valerate Estradiol 3-benzoate Estradiol 17 beta-cypionate Paclitaxel Estrogens |
Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Contraceptive Agents Reproductive Control Agents Therapeutic Uses Contraceptive Agents, Female Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Phytogenic Antineoplastic Agents |
ClinicalTrials.gov processed this record on June 17, 2013