Mitoxantrone ± Cetuximab 2nd Line Androgen Independent Prostate Cancer (AIPC)
Recruitment status was Active, not recruiting
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Purpose
To determine the time to progression produced by the combination of Novantrone (mitoxantrone) and Erbitux (cetuximab) versus Novantrone alone in metastatic AIPC patients previously treated with docetaxel-based chemotherapy. TTP is defined as time from the start of treatment date to the date the patient is first recorded as having disease progression, even in patients who discontinue study treatment early due to toxicity.
| Condition | Intervention | Phase |
|---|---|---|
|
Androgen-independent Prostate Cancer |
Drug: Erbitux (cetuximab) and Novantrone (mitoxantrone) Drug: Novantrone (mitoxantrone) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Phase II Study of Mitoxantrone vs. Mitoxantrone With Cetuximab in Metastatic Androgen Independent Prostate Cancer (AIPC) Previously Treated With Docetaxel-based Chemotherapy |
- To determine the time to progression produced by the combination of Novantrone (mitoxantrone) and Erbitux (cetuximab) versus Novantrone alone in metastatic AIPC patients previously treated with docetaxel-based chemotherapy. [ Time Frame: approximately 2 years ] [ Designated as safety issue: No ]
- Time to radiographically evident disease progression, response rate in measurable disease, time to PSA, PSA response rate, PSA doubling time, overall survival, response rate attributable to the addition of Erbitux and Novatrone [ Time Frame: approximately 2 years ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 130 |
| Study Start Date: | May 2008 |
| Estimated Study Completion Date: | May 2010 |
| Estimated Primary Completion Date: | May 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Arm 1 |
Drug: Erbitux (cetuximab) and Novantrone (mitoxantrone)
Arm 1: Erbitux (cetuximab) IV over 2 hours (loading dose) on Day 1 (Cycle 1 only), followed by Erbitux (cetuximab) IV over 1 hour weekly thereafter and Novantrone (mitoxantrone) IV Day 1 + Prednisone QD for ten (10) 21-day cycles
Other Name: Erbitux (cetuximab)
|
| Experimental: Arm 2 |
Drug: Novantrone (mitoxantrone)
Novantrone (mitoxantrone) IV Day 1 + Prednisone QD for ten (10) 21-day cycles Standard androgen deprivation therapy (ADT) will be continued in all patients who enter study on LHRH agonists
Other Name: Novantrone (mitoxantrone)
|
Detailed Description:
This is a nonblinded, randomized phase II study to determine the activity of Novantrone (mitoxantrone) with or without Erbitux (cetuximab) in patients with androgen independent prostate cancer (AIPC) who have been treated previously with docetaxel chemotherapy. The Novantrone (mitoxantrone)-only treatment arm will serve as a concurrent control arm to aid in the determination of the benefit of the Novantrone (mitoxantrone)-Erbitux (cetuximab) combination in this setting.
Patients will be randomly assigned 2:1 to 1 of 2 treatment arms; 93 patients in Arm 1 and 47 patients in Arm 2. A balanced randomization procedure will be performed utilizing a code list that will be developed prior to the study opening. Because the patients will be stratified by performance status (ECOG 0 and 1 vs. ECOG 2), the list will be developed to ensure a balance between the 2 treatment arms.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically confirmed adenocarcinoma of the prostate. Note: Patients may have either measurable or non-measurable disease.
- Radiographic evidence of regional or distant metastases
- Current evidence of progression (by PSA and/or imaging studies) despite standard hormonal therapy.
- Progression by PSA will be defined as: A rising PSA defined as: at least 2 rises in PSA over a reference value (PSA #1). The first rising PSA (PSA #2) must be taken at least 1 week after PSA #1. A third PSA (PSA #3) is required to be greater than PSA #2; if not, a fourth PSA (PSA #4) is required to be greater than PSA #2. Progression for nonmeasurable disease will be defined as 2 or more new bone lesions; for measurable disease, progression will be defined by standard RECIST criteria.
- For patients who have been on antiandrogen therapy (ie, bicalutamide, flutamide, etc.), patients must have discontinued anti-androgen therapy for at least 6 weeks (4 weeks for flutamide) without evidence of an antiandrogen withdrawal response. A washout period will not be required for patients who did not respond to an antiandrogen prescribed as second line hormonal therapy. For patients whose progression is documented by PSA, the last required PSA must be after the required anti-androgen washout period (4-6 weeks as appropriate).
- One prior docetaxel-containing regimen. Patients must have received at least 2 doses in an every 3-week schedule or 6 doses on a weekly schedule of docetaxel. Patients may have discontinued therapy due to progression, intolerance, completion of planned therapy, or other reasons. Chemotherapy treatment with any second-line regimen will not be permitted. Patients who have been previously treated with a first-line docetaxel-based doublet regimen will be eligible for this study, (eg, patients treated on a prior first-line trial containing a docetaxel/carboplatin or other docetaxel-based doublet).
- Serum testosterone levels (See protocol for specific details) (unless surgically castrate). Patients must continue androgen deprivation with an LHRH agonist if they have not undergone orchiectomy
- ECOG performance status
Laboratory criteria for entry:
- absolute neutrophil count
- platelets
- bilirubin
- AST or ALT
- Life expectancy greater than 3 months
- Age greater than or equal to 18 years
- Agree to use contraceptives while on study if sexually active, and for 2 months after the last dose of study drug.
- Has signed a Patient Informed Consent Form
- Has signed a Patient Authorization Form
Exclusion Criteria:
- More than 1 prior chemotherapy regimen for metastatic disease
- Prior history of uncontrolled congestive heart failure or left ventricular ejection fraction (LVEF) that is less than the institution's lower limit of normal on MUGA or echocardiogram
- A second active malignancy (diagnosed within 5 years) except adequately treated non-melanoma skin cancer or other non-invasive or in-situ neoplasm
- Significant active concurrent medical illness or infection
- Treatment with chemotherapy for AIPC within the past 21 days
- Prior treatment with Novantrone (mitoxantrone)
- Prior therapy which specifically and directly targets the EGFR pathway
- Prior severe infusion reaction to a monoclonal antibody
- Recent myocardial infarction (within prior 6 months)
- Prior treatment with radionuclides, with the exception of prior treatment with samarium, which will be allowed provided at least 8 weeks have passed since administration.
- Is receiving concurrent immunotherapy, hormonal therapy, radiation therapy, or any other non-protocol therapy (excluding LHRH antagonist)
- Is receiving concurrent investigational therapy or has received such therapy within the past 30 days
- Has evidence of CNS involvement
- Has a serious uncontrolled intercurrent medical or psychiatric illness, including serious infection.
- Is unable to comply with requirements of study
Contacts and Locations
Show 55 Study Locations| Principal Investigator: | Mark T. Fleming, MD | Virginia Oncology Associates/US Oncology |
More Information
No publications provided by US Oncology Research
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Angelica McCallister, US Oncology |
| ClinicalTrials.gov Identifier: | NCT00661492 History of Changes |
| Other Study ID Numbers: | 06-118 |
| Study First Received: | April 4, 2008 |
| Last Updated: | April 6, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by US Oncology Research:
|
Androgen-independent prostate cancer(AIPC) |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms Genital Diseases, Male Prostatic Diseases Androgens Cetuximab Mitoxantrone |
Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Analgesics Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents |
ClinicalTrials.gov processed this record on May 23, 2013