RAD001 in Patients With Metastatic, Hormone-Refractory Prostate Cancer

This study has been completed.
Sponsor:
Collaborator:
Novartis Pharmaceuticals
Information provided by (Responsible Party):
Daniel George, Duke University Medical Center
ClinicalTrials.gov Identifier:
NCT00629525
First received: February 27, 2008
Last updated: April 16, 2013
Last verified: April 2013
  Purpose

The purpose of this study is to determine the biochemical response rate (PSA) to single agent RAD001 in patients with metastatic hormone-refractory prostate cancer (HRPC).


Condition Intervention Phase
Hormone Refractory Prostate Cancer
Drug: RAD001
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Single Arm, Two Center, Phase II Study of RAD001 in Patients With Metastatic, Hormone-Refractory Prostate Cancer

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Biochemical Response Rate [ Time Frame: Patients were followed for a median of 315 days ] [ Designated as safety issue: No ]
    Number of participants with 50% decline in serum PSA from baseline was pre-set as the primary measure of disease response.


Secondary Outcome Measures:
  • Pathologic Response [ Time Frame: Patients were followed for a median of 315 days ] [ Designated as safety issue: No ]
    Number of participants with either a 50% or greater decrease in proliferation index or a 50% or greater increase in apoptotic index

  • Progression Free Survival [ Time Frame: Patients were followed for a median of 315 days, with the last patient censored at 1309 days. ] [ Designated as safety issue: No ]
    Time in months from the start of study treatment to the date of first progression according to RECIST 1.0, or to death due to any cause. Patients alive who had not progressed as of the last follow-up had PFS censored at the last follow-up date. Median PFS was estimated using a Kaplan-Meier curve.

  • Molecular Response [ Time Frame: Patients were followed for a median of 315 days ] [ Designated as safety issue: No ]
    Functional extent of mTOR inhibition by changes in the phosphorylation status of pS6 in prostate tumors.

  • Clinical Response [ Time Frame: Patients were followed for a median of 315 days ] [ Designated as safety issue: No ]

    The percentage of participants with a complete or partial response as defined by RECIST 1.0. Response Criteria are defined below:

    Complete Response: Disappearance of all target lesions Partial Response: At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD Progressive Disease: At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions Stable Disease: Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum LD



Enrollment: 35
Study Start Date: August 2005
Study Completion Date: January 2010
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: RAD001
RAD001 at a dose of 10 mg PO daily
Drug: RAD001
RAD001 at a dose of 10 mg PO daily
Other Name: Everolimus

Detailed Description:

This is a single center, Phase II study of RAD001 in men with HRPC. The study design is a straight forward, two-stage design with tumor biopsies scheduled at screening and again at 4 weeks. FLT-PET scans are performed at screening and again at day 28, following initiation of treatment in the first 10 patients. Patients are assessed for adverse events every two weeks for the first month and monthly thereafter. Patients are assessed for response by PSA every 4 weeks and when applicable, for objective response every 2 months. If 4 or more responses are seen in the first 39 patients then the study will expand to 60 patients.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed diagnosis of adenocarcinoma of the prostate
  • Clinical or radiographic evidence of metastatic disease
  • ADT using LHRH agonist (eg leuprolide, goserelin) must continue on therapy. However, ketoconazole, estrogens, and all other forms of hormonal manipulation are not permitted on study.
  • Evidence of disease progression on ADT as evidenced by:

    • 2 consecutive PSA levels 50% or greater above the PSA nadir achieved on ADT and separated at least 1 week apart, or
    • Radiographic evidence of disease progression defined by RECIST criteria and compared to prior studies on ADT.
  • A minimum of 6 weeks has elapsed off of anti-androgen therapy without withdrawal response.
  • A minimum of 4 weeks from any prior radiation therapy, surgery, chemotherapy or other investigational agent
  • Biopsies will not be performed if platelet counts < 75,000/ ul, PTT, PT or INR > 1.4 times control
  • Patients must have normal organ and marrow function as defined below:
  • hemoglobin > 9.0g/dL
  • absolute neutrophil count > 1,500/μl
  • platelets > 100,000/μl
  • total bilirubin < 1.5 X upper limit of normal (ULN)
  • AST(SGOT)/ALT(SGPT) < 2.5 X ULN
  • creatinine < 1.5 X ULN
  • total fasting cholesterol < 350
  • total triglycerides < 300
  • Patients on antilipid therapy may participate in this study.
  • Age > 18 years
  • ECOG performance status 0 or 1
  • Ability to swallow and retain oral medication
  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • History of solid organ or stem cell transplantation
  • Also, no current use of chronic immunosuppressive therapy is allowed
  • Patients with known brain metastases (or history of brain metastases)
  • History of HIV, hepatitis B, or hepatitis C infection
  • Patients who have received investigational, biologic, hormonal (other than ADT), immunotherapy, or chemotherapy less than 4 weeks prior to entry on this study or have not recovered from the toxic effects of such therapy
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (requiring antifungal, antibiotic or antiviral therapy), symptomatic congestive heart failure (NYHC III or greater), unstable angina pectoris, cardiac arrhythmia (uncontrolled SVT or any VT), or psychiatric illness/social situations that would limit compliance with study requirements
  • History of malabsorption syndrome, disease significantly affecting gastrointestinal function or major resection of the stomach or small bowel that could affect absorption, distribution, metabolism or excretion of study drugs.
  • Any unresolved bowel obstruction or diarrhea
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00629525

Locations
United States, North Carolina
Duke University MEdical Center
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Daniel George
Novartis Pharmaceuticals
Investigators
Principal Investigator: Daniel J George, MD Duke University Health System
  More Information

No publications provided

Responsible Party: Daniel George, Associate Professor of Medicine, Duke University Medical Center
ClinicalTrials.gov Identifier: NCT00629525     History of Changes
Other Study ID Numbers: Pro00009495 (7521)
Study First Received: February 27, 2008
Results First Received: January 4, 2013
Last Updated: April 16, 2013
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Diseases, Male
Genital Neoplasms, Male
Neoplasms
Neoplasms by Site
Prostatic Diseases
Urogenital Neoplasms
Everolimus
Sirolimus
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents
Antineoplastic Agents
Immunologic Factors
Immunosuppressive Agents
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on October 29, 2014