Study of Docetaxel +153 Sm-EDTMP in Patients With Hormone-Refractory Prostate Cancer (Tax-Sam)

Inclusion Criteria:

• Patients age >18 with HRPC including patients who failed conventional systemic treatments. Conventional eligibility criteria for HRPC are applicable, pain is not a requisite.
• Histologically proven adenocarcinoma of the prostate (metastatic) that is unresponsive to hormone therapy.
• Evidence of progressive disease following appropriate hormonal deprivation. Disease progression is defined by a confirmed PSA rise at least 1 week apart and/or evidence of disease progression on bone scan, CT scan or physical examination.
• Evidence of progressing disease despite antiandrogen withdrawal (i.e., must have PSA rise noted >four weeks following cessation of flutamide therapy, nilandron therapy. For those patients treated with bicalutamide (Casodex), patients must have a rising PSA noted >six weeks after cessation of therapy.
• For patients treated by medical means of gonadal ablation (GnRH analogues), or estrogens, evidence of appropriate testosterone suppression should be obtained prior to study entry (testosterone <50 ng/L). Continuation of gonadal androgen suppression should be carried out with GnRH analogues only. Antiandrogens or other steroidal compounds (except for dexamethasone used in this study) should be discontinued as noted in section 4.1.3 prior to study entry. Patients receiving low dose (<10 mg of prednisone/day) continuous corticosteroids >6 months, who present with objective evidence of disease progression may continue on the steroids (prednisone 10 mg) and are considered eligible. Prior orchiectomy is allowed and at least 4 weeks must have elapsed since completion of surgery. Patients may not be receiving Megace.
• Patients must have metastatic disease documented within 28 days prior to study entry. X-rays, scans, and physical exam of all measurable and non- measurable disease must be completed within 28 days prior to study entry.
• No concomitant chemotherapeutic, biological response modifiers or radiation therapy. At least 28 days must have lapsed since the last treatment with chemotherapy or biological response modifiers.
• Patients may have received prior taxane treatment and is considered by the treating physician as a candidate for further treatment with this class of compounds.
• ECOG performance status of 0-2 and life expectancy >3 months
• WBC ≥3500/ mm3, ANC ≥1500/ mm3,and platelet count ≥100,000/ mm3 and hemoglobin ≥8.0 g/dl.
• BUN <30 and serum creatinine <2.0 mg/dl.
• Total Bilirubin <ULN, AST < 1.5 x ULN and ALT < 1.5 x ULN.
• Recovered from major infections and/or surgical procedure and, in the opinion of the investigator, not have significant active concurrent medical illness.
• No prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, adequately treated and controlled stage I or II transitional cell carcinoma of the bladder or any other cancer from which the patient has been disease-free for 5 years.
• Peripheral neuropathy must be <grade 1
• Ability to understand and sign an IRB approved informed consent.
• Patient must agree to use effective contraception from the day of initiation of treatment and for one year after completion of chemotherapy.

Exclusion Criteria:

• Patients with a history of brain metastases.
• Uncontrolled medical problems (neurological, cardiovascular, or other illness considered by the primary investigator as unwarranted high risk for investigational drug treatment.
• Non adenocarcinoma cell type.
• Known hypersensitivity to steroids, docetaxel, polysorbate 80 or Samarium153.
• Patients who received > whole pelvic radiation for therapeutic or palliative reasons are excluded from study.
• Peripheral neuropathy ≥ grade 1