Neoadjuvant CCI-779 Followed By Radical Prostatectomy in Treating Patients With Newly Diagnosed Prostate Cancer Who Have a High Risk of Relapse

This study has been completed.
Sponsor:
Collaborator:
Information provided by:
Jonsson Comprehensive Cancer Center
ClinicalTrials.gov Identifier:
NCT00071968
First received: November 4, 2003
Last updated: January 7, 2013
Last verified: January 2013
  Purpose

RATIONALE: Drugs used in chemotherapy, such as CCI-779, work in different ways to stop tumor cells from dividing so they stop growing or die. Giving CCI-779 before surgery may shrink the tumor so that it can be removed.

PURPOSE: This randomized phase II trial is studying how well CCI-779 works in treating patients who are undergoing radical prostatectomy for newly diagnosed prostate cancer at high risk of relapse.


Condition Intervention Phase
Prostate Cancer
Drug: temsirolimus
Procedure: conventional surgery
Procedure: neoadjuvant therapy
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open-Label Study Of Exploratory Pharmacogenomics And Pharmacologic Effects Of Neoadjuvant Oral CCI-779 In Newly Diagnosed Prostate Cancer Patients Undergoing Radical Prostatectomy Who Have A High Risk Of Relapse

Resource links provided by NLM:


Further study details as provided by Jonsson Comprehensive Cancer Center:

Primary Outcome Measures:
  • Phosphorylation state of proteins [ Designated as safety issue: No ]
  • p70S6 kinase activity [ Designated as safety issue: No ]
  • Phosphorylation state of mTOR pathway proteins [ Designated as safety issue: No ]
  • Global and targeted gene expression patterns in peripheral blood mononuclear cells [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Global and targeted gene expression patterns [ Designated as safety issue: No ]
  • Pharmacodynamics and pharmacogenomic surrogate markers [ Designated as safety issue: No ]
  • Antitumor effects [ Designated as safety issue: No ]
  • Pharmacokinetics [ Designated as safety issue: No ]
  • Correlation of phosphatase and tensin homolog gene status with pharmacodynamic and pharmacogenomic effects [ Designated as safety issue: No ]
  • Protein expression patterns in the plasma [ Designated as safety issue: No ]

Enrollment: 15
Study Start Date: August 2003
Primary Completion Date: May 2006 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the effects of oral CCI-779 on changes in the phosphorylation state of proteins in the mammalian target of rapamycin (mTOR) signaling pathway in the tumor tissue of patients with newly diagnosed prostate cancer undergoing radical prostatectomy.
  • Determine the effects of this drug on changes in p70S6 kinase activity, phosphorylation state of mTOR pathway proteins, and on global and targeted gene expression patterns in the peripheral blood mononuclear cells (PBMCs) of these patients.

Secondary

  • Determine the effects of this drug on global and targeted gene expression patterns in these patients.
  • Identify pharmacodynamic/pharmacogenomic surrogate markers of this drug in both tumor tissue and PBMCs and determine if blood may be used as a surrogate tissue source for biomarkers of drug activity in the tumor in these patients.
  • Determine, preliminarily, the potential antitumor effects of this drug in these patients.
  • Determine the pharmacokinetics of this drug in these patients.
  • Correlate phosphatase and tensin homolog (PTEN) gene status with the pharmacodynamic/pharmacogenomic effects of this drug in these patients.
  • Determine the effects of this drug on changes in protein expression patterns in the plasma of these patients.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 3 treatment arms. Patients randomized to arm III are stratified according to tumor expression of phosphatase and tensin homolog (PTEN) gene mutations (negative vs positive).

  • Arm I: Patients receive oral CCI-779 once daily for a total of 8 weeks.
  • Arm II: Patients receive a higher dose of CCI-779 as in arm I.
  • Arm III: Patients receive a higher dose (higher than arm II) of CCI-779 as in arm I.

Approximately 24-48 hours after the last dose of CCI-779, patients in all arms undergo radical prostatectomy.

Patients are followed on day 7-10 and then at 4 weeks after study completion.

PROJECTED ACCRUAL: A total of 40 patients (5 each for arms I and II and 30 for arm III) will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma of the prostate

    • Diagnosis based on a minimum of 6 core biopsy samples
    • Clinically confirmed organ-confined disease
  • Candidate for radical prostatectomy
  • No evidence of metastatic disease by CT scan and bone scan
  • High risk of relapse based on either of the following criteria:

    • Any one of the following:

      • Stage T2C or higher
      • Gleason score greater than 7
      • Prostate-specific antigen (PSA) greater than 20 ng/mL OR
    • Any two of the following:

      • Gleason score at least 7
      • PSA 10-20 ng/mL
      • Greater than 50% of total biopsy cores with cancer involvement

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • No active bleeding
  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 10 g/dL

Hepatic

  • No acute or chronic hepatitis B

    • Hepatitis B surface antigen negative
  • No acute or chronic hepatitis C

    • No antibodies to hepatitis C
  • Bilirubin no greater than 1.5 times upper limit of normal (ULN)
  • AST and ALT no greater than 2 times ULN

Renal

  • No ongoing urinary tract infection necessitating rapid or emergent surgical resection
  • Creatinine no greater than 1.5 times ULN

Cardiovascular

  • No unstable angina
  • No myocardial infarction within the past 6 months
  • No life-threatening ventricular arrhythmia requiring ongoing maintenance therapy

Pulmonary

  • No known pulmonary hypertension
  • No pneumonitis

Other

  • Fertile patients must use effective contraception during and for 12 weeks after study participation
  • HIV negative
  • No other severe immunocompromised states
  • No active infection requiring antibiotic therapy
  • No serious concurrent illness
  • No other major illness that would substantially increase the risk associated with study participation
  • No other malignancy within the past 5 years except basal cell or squamous cell skin cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No concurrent immunotherapy

Chemotherapy

  • No prior chemotherapy
  • No other concurrent chemotherapy

Endocrine therapy

  • More than 3 weeks since prior IV corticosteroids
  • No concurrent systemic corticosteroids
  • No prior or concurrent hormonal therapy for underlying malignancy

Radiotherapy

  • No prior or concurrent radiotherapy

Surgery

  • More than 3 months since prior major surgery

Other

  • More than 1 month since prior experimental drugs
  • More than 3 weeks since prior immunosuppressive agents
  • No concurrent immunosuppressive therapies
  • No other concurrent investigational agents
  • No concurrent enzyme-inducing anticonvulsants (e.g., phenobarbital, phenytoin, or carbamazepine)
  • No concurrent ketoconazole, diltiazem, rifampin, terfenadine, cisapride, astemizole, pimozide, or Hypericum perforatum (St. John's wort)
  • No concurrent grapefruit or grapefruit juice
  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: NCT00071968

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1738
Sponsors and Collaborators
Jonsson Comprehensive Cancer Center
Investigators
Principal Investigator: Charles Sawyers, MD Jonsson Comprehensive Cancer Center
  More Information

Additional Information:
Publications:
Thomas G, Speicher L, Reiter R, et al.: Demonstration that temsirolimus preferentially inhibits the mTOR pathway in the tumors of prostate cancer patients with PTEN deficiencies. [Abstract] Clin Cancer Res 11 (Suppl 24): A-C131, 2005.

ClinicalTrials.gov Identifier: NCT00071968     History of Changes
Other Study ID Numbers: CDR0000331979, UCLA-0306091, WYETH-C-3066A1-132-US
Study First Received: November 4, 2003
Last Updated: January 7, 2013
Health Authority: United States: Federal Government

Keywords provided by Jonsson Comprehensive Cancer Center:
adenocarcinoma of the prostate
stage IIB prostate cancer
stage IIA prostate cancer
stage I prostate cancer

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

ClinicalTrials.gov processed this record on August 21, 2014