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Satraplatin and Prednisone to Treat Prostate Cancer
This study is ongoing, but not recruiting participants.

First Received on March 12, 2008.   Last Updated on February 9, 2012   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT00634647
  Purpose

Background:

Satraplatin is an experimental drug that may be of benefit to patients with prostate cancer.

Prednisone is approved for treating prostate cancer.

The gene ERCC1 helps repair cell damage caused by satraplatin. It is possible that patients who have a variant of this gene will not benefit from treatment with satraplatin because the drug will not be able to damage the cancer cells effectively.

Objectives:

To determine if satraplatin may help treat prostate cancer in patients with certain variants of the ERCC1 gene.

Eligibility:

Patients with advanced androgen-independent prostate cancer whose disease has not responded to hormonal therapy or at least one type of chemotherapy and whose x-rays, scans or other tests have shown their cancer to be spreading.

Design:

Participants have a blood test to determine if they have a variant of the ERCC1 gene.

Participants take satraplatin by mouth every day for 5 consecutive days out of every 35 days and prednisone by mouth every day. These 35-day treatment cycles may continue for 6 months or longer, depending on the benefits and side effects of the treatment.

During the treatment period, patients undergo the following tests and procedures:

  • Blood tests on days 1 of the treatment cycle.
  • Weekly blood draws for the first 3 treatment cycles.
  • maging studies (e.g., bone scans, CT scans) every two cycles to determine the response to treatment.
  • Surgical or medical suppression of testosterone in patients whose cancer cells continue to grow due to exposure to the hormone....

Condition Intervention Phase
Prostate Cancer
Genetic Polymorphism
Drug: Satraplatin
Drug: prednisone
Phase II

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Satraplatin and Prednisone in Metastatic Androgen Independent Prostate Cancer (AIPC)

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • Progression free survival. [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Overall survival. [ Designated as safety issue: No ]
  • Toxicity [ Designated as safety issue: Yes ]
  • Genotyping [ Designated as safety issue: No ]
  • Prostate-specific antigen [ Designated as safety issue: No ]
  • Molecular endpoints [ Designated as safety issue: No ]

Enrollment: 24
Study Start Date: February 2008
Estimated Study Completion Date: January 2013
Estimated Primary Completion Date: January 2013 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Satraplatin
    N/A
    Drug: prednisone
    N/A
Detailed Description:

Background:

  • Satraplatin is an oral, third-generation platinum analog that has recently been shown to increase PSA decline rates and progression-free survival in hormone-resistant prostate cancer.
  • Satraplatin acts by binding to DNA forming intra- and interstrand cross links (DNA adducts), resulting in cell-cycle arrest in G2 phase and eventual apoptosis. One of the mechanisms that bring about resistance to platinum-based chemotherapy is removal of the platinum-DNA adducts by DNA repair pathways, called nucleotide excision repair (NER) and base excision repair (BER) pathways.
  • Polymorphisms in the DNA repair genes causing impaired NER and BER capability has recently been shown in some cancers, including head and neck squamous cell carcinoma, non-small cell lung carcinoma, and ovarian carcinoma to predict better treatment outcome and response to platinum treatment.

Objectives:

  • Primary objective of this single arm study is to determine if the presence of ERCC1 variant gene polymorphism which is involved with DNA damage repair may be associated with an impact on the progression-free survival of patients with metastatic prostate cancer.
  • Secondary objectives of this study includes demonstration of biologic effect by the drug satraplatin in the patient and in the tumor whenever possible, by obtaining tissue biopsy and white blood cell collections, to determine correlation of biologic or clinical effects with PSA progression, evaluate correlations between genotype expression, repair pathways and clinical events, and obtain laboratory correlates which will include pharmacogenetic analysis of prostate cancer patients with genotyping using Polymerasechain reaction (PCR) followed by either restriction fragment length polymorphism or direct sequencing to genotype single nucleotide polymorphisms of ERCC1, XRCC1, and PARP1.

Eligibility:

  • Patients with metastatic androgen-independent prostate cancer.
  • Had docetaxel-based chemotherapy, but no more than 1 previous cytotoxic chemotherapy line.
  • Good organ function.

Design:

  • Phase II trial with single stage design and a planned accrual of 66 patients.
  • Progression-free survival will be determined using a Fisher's exact test.
  • Will treat all enrolled patients with oral satraplatin 80 mg/m2 dose on days 1-5 of every 35-days cycle plus Prednisone 5 mg twice daily every 35 days.
  • Genotyping will be performed after the first 20 patients to determine if the proportion for wild-type ERCC1 and variants follow a 20:80 split.
  Eligibility

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

A. Patients must have histopathological confirmation of prostate cancer by the Laboratory of Pathology of the NCI or Pathology Department of the National Naval Medical Center or Walter Reed Army Medical Center prior to entering this study. Patients whose pathology specimens are not available may be enrolled in the trial if the patient has a clinical course consistent with prostate cancer and available documentation from an outside pathology laboratory of the diagnosis. In cases where original tissue blocks or archival biopsy material is available, all efforts should be made to have the material forwarded to the research team for use in correlative studies.

B. Patients must have metastatic progressive androgen-independent prostate cancer. There must be radiographic evidence of disease (by CT scan or bone scan) after primary treatment that has continued to progress despite hormonal agents. Progression requires that a measurable lesion is expanding, new lesions have appeared, and/or that PSA is continuing to rise on successive measurements. Patients must have progressive disease after receiving 1 prior docetaxel-based cytotoxic chemotherapy. Patients on flutamide for the prior 6 months must have disease progression at least 4 weeks after withdrawal. Patients on bicalutamide or nilutamide must have progression at least 6 weeks after withdrawal.

C. Patients may only have received 1 prior cytotoxic chemotherapy. For the purpose of this study, multiple courses of a taxane-based regimen may count as a single regimen. Multiple courses of a non-taxane agent or a combination chemotherapy regimen, administered in a similar fashion may count as a single regimen.

D. Patients must have a life expectancy of more than 3 months.

E. Patients must have a performance status of 0 to 2 according to the ECOG criteria.

F. Patients must have adequate organ function as defined below:

Leukocytes greater than or equal to 3,000/microl.

Absolute Neutrophil Count greater than or equal to 1,500/microl.

Platelets greater than or equal to 100,000/microl.

Total bilirubin less than or equal to 1.5 times institutional upper limits of normal (Except patients with Gilbert's disease who may proceed despite elevated total bilirubin).

AST(SGOT) and ALT(SGPT) less than or equal to 2.5 times institutional upper limit of normal

Creatinine less than or equal to 1.5 times institutional upper limits of normal.

OR

Creatinine clearance greater than or equal to 60 mL/min/1.73 m(2) for patients with creatinine levels above institutional normal.

G. Patients must have recovered from any acute toxicity related to prior therapy, including surgery. Toxicity should be <= grade 1 or returned to baseline.

H. Hormonal profile: all patients who have not undergone bilateral surgical castration must continue suppression of testosterone production by appropriate usage of GnRH agonists.

I. Patients must not have any ongoing malignancies requiring active therapy.

J. Patients must be able to understand and sign an informed consent form.

K. Concurrent use of bisphosphonates will be allowed if patients have previously been on it; if patients are not on bisphosphonates at the time of study enrollment, bisphosphonates may be started at cycle 2.

L. Patients who require hematopoietic growth factor support (e.g. epogen, darbepoetin), but not myeloid growth factors (except after cycle 1 day 1 if clinically indicated), NSAIDs, and other maintenance medications prior to study entry will be allowed to continue their supportive therapies.

M. Results from embryo-fetal development indicated that satraplatin should be considered a teratogen in women of childbearing potential and hazardous in respect to spermatogenesis for men. For this reason, men must agree to use adequate contraception (abstinence; hormonal or barrier method of birth control) prior to study entry and for the duration of study participation.

N. Patients must be able to swallow capsules.

O. Patients on chronic stable steroids (equivalent to no more than 10 mg of prednisone daily dose) used for non-cancer treatment may be allowed on study.

EXCLUSION CRITERIA:

A. Patients who have had prior treatment with satraplatin or other platinum containing compounds will be excluded.

B. Patients may not be receiving any other investigational agents.

C. Patients with known active brain metastases are excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.

D. History of allergic reactions attributed to compounds of similar chemical or biologic composition to satraplatin or prednisone.

E. Uncontrolled intercurrent illness including, but not limited to ongoing or active serious infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit patient compliance with study requirements.

F. Prior radiation therapy to greater than 30 percent of the bone marrow, or who have received strontium-89, rehenium-186, or rhenium-188 will be excluded from this trial. Patients who have received prior radiotherapy must have recovered from acute toxicity due to radiation. Patients who have received samarium-153 are eligible for the study because samarium has a significantly reduced half-life compared to aforementioned isotopes.

G. Patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy. Therefore, HIV-positive patients are excluded from the study.

H. Patients with a history of major gastrointestinal surgery or pathology likely to influence absorption of oral medications, like bypass surgeries, Whipple's procedure, or any surgery that would impair reliable absorption of oral drugs.

I. Patients with a disease where corticosteroids are contraindicated, e.g. active gastric or duodenal ulcer, or poorly controlled insulin dependent diabetes. Patients with well-controlled insulin-dependent diabetes mellitus may be considered, providing they understand their glucose levels will increase, and their insulin dose will require adjusting.

J. Because no dosing or adverse event data are currently available on the use of satraplatin in patients less than 18 years of age, children are excluded from this study.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00634647

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892
Associates in Oncology and Hematology
Rockville, Maryland, United States, 20850
Sponsors and Collaborators
  More Information

Additional Information:
Publications:
Responsible Party: William L. Dahut, M.D./National Cancer Institute, National Institutes of Health
ClinicalTrials.gov Identifier: NCT00634647     History of Changes
Other Study ID Numbers: 080074, 08-C-0074
Study First Received: March 12, 2008
Last Updated: February 9, 2012
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Chemotherapy
Pharmacokinetics
Gene Polymorphisms
Prostate Cancer

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Prostatic Diseases
Prednisone
Satraplatin
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Pharmacologic Actions
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Therapeutic Uses
Anti-Inflammatory Agents

ClinicalTrials.gov processed this record on February 12, 2012