A Phase I/II Trial of 2-Deoxyglucose (2DG) for the Treatment of Advanced Cancer and Hormone Refractory Prostate Cancer (2-Deoxyglucose)

Inclusion Criteria:

• Patients with any histologically proven metastatic solid tumor malignancy, without a standard option of therapy will be eligible for the Phase I portion of this trial. Patients with prostate cancer with metastatic disease, and progression after initial hormonal therapy will be eligible for both the Phase I and II portion of this trial. Phase II patients must have either measurable disease or a PSA value > 5 ng/ml.
• Patients with prostate cancer in whom bicalutamide or flutamide has been recently withdrawn, must demonstrate progression of disease and be at least 6 weeks and 4 weeks respectively beyond the discontinuation of such agents. LHRH agonists will be continued.
• Age >18 years and an estimated life expectancy of at least 6 months.
• ECOG performance status < 2. (see Appendix B)
• Patients must be ³ 4 weeks since last prior therapy (including surgery, chemotherapy, radiation therapy). All previous clinically significant treatment-related toxicities have resolved to less than or equal to Grade 1.
• An ANC >1500/µl, hemoglobin > 10 g/dl, and platelet count >100,000/µl are required.
• Adequate renal function (serum creatinine < 1.5 mg/dL or creatinine clearance > 50 ml/min)
• Total bilirubin must be within normal limits. Transaminases (SGOT and/or SGPT) must be less than 2.5X the institutional upper limit of normal.
• Serum potassium within institutional limit of normal.
• Fasting blood glucose < institutional ULN.
• In the Phase I portion of this study patients may have had prior chemotherapy.
• In the Phase II portion of this study patients may not have had prior chemotherapy.
• Women of childbearing potential must have a negative pregnancy test (Phase I trial).
• Men and women of childbearing potential must consent to using effective contraception while on treatment and for 3 months thereafter.

Exclusion Criteria:

• Known infection with HIV. Patients without prior HIV testing will not be required to be tested.
• History of glucose intolerance.
• Patients with ongoing coagulopathies and/or receiving oral anticoagulants.
• Second primary malignancy except most situ carcinoma (e.g. in situ carcinoma of the of the cervix, adequately treated non-melanomatous carcinoma of the skin) or other malignancy treated at least 5 years previously with no evidence of recurrence.
• Patients with known brain metastases should be 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
• Patients with diabetes mellitus, hypoglycemia, history of seizure disorder, known autonomic dysfunction, clinically significant uncontrolled gastrointestinal disorder, known G6PD deficiency, and allergy to methylparaben or propylparaben will be excluded, based on known potential toxicities.
• The effects of 2-deoxyglucose on the developing human fetus at the recommended therapeutic dose are unknown. For this reason and because Agent Class as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation and for 3 months thereafter. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
• Active clinically significant infection requiring antibiotics.
• History of clinically significant unexplained episodes of hypotension, fainting, dizziness, or lightheadedness.5.2.10 History or symptoms of cardiovascular disease (NYHA Class 2, 3, or 4; see Appendix D, New York Heart Association Criteria) within the last 6 months, particularly coronary artery disease, arrhythmias, or conduction defects with risk of cardiovascular instability, uncontrolled hypertension, clinically significant pericardial effusion, or congestive heart failure.
• History of transient ischemic attack, stroke, or seizure disorder or any other CNS disease considered to be significant by the investigator.
• Major surgery within 4 weeks of the start of study treatment, without complete recovery.
• Antitumor therapy within 28 days of the start of study treatment (within 6 or 4 weeks for bicalutamide or flutamide, respectively).
• Phase I only: Inability to discontinue prohibited medications for 24 hours before and after dosing on Cycle 1, Day 1 of Weeks 1 and 2.
• Patients who are unable (as per Investigator discretion) or unwilling to give written informed consent.