Study of Erlotinib in Patients With Non-Metastatic Prostate Cancer With a Rising Prostate Specific Antigen (PSA) on Hormone Therapy

This study has been completed.
Sponsor:
Collaborators:
Genentech
Northwestern University
Information provided by:
NorthShore University HealthSystem Research Institute
ClinicalTrials.gov Identifier:
NCT00148772
First received: September 6, 2005
Last updated: June 24, 2011
Last verified: August 2005
  Purpose

The primary objective of this study is to evaluate the effect of erlotinib on the PSA response rate in patients with non-metastatic prostate cancer and a rising PSA on androgen deprivation therapy.

The secondary objectives are to evaluate the effect of erlotinib on the duration of PSA response, to evaluate the effect on the time to PSA progression, to evaluate the toxicity of erlotinib in this patient population, and lastly, to correlate the effect of erlotinib with various epidermal growth factor receptor (EGFR)-related proteins using baseline immunohistochemical (IHC) studies on tissue blocks and peripheral blood mononuclear cells.


Condition Intervention Phase
Prostate Cancer
Drug: Erlotinib (Tarceva)
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Phase II Study of Erlotinib in Patients With Non-Metastatic Prostate Cancer With a Rising PSA on Hormone Therapy

Resource links provided by NLM:


Further study details as provided by NorthShore University HealthSystem Research Institute:

Primary Outcome Measures:
  • To evaluate the effect of erlotinib on the PSA response rate in patients with non-metastatic prostate cancer and a rising PSA on androgen deprivation therapy

Secondary Outcome Measures:
  • To evaluate the effect of erlotinib on the duration of PSA response
  • To evaluate the effect of erlotinib on the time to PSA progression
  • To evaluate the toxicity of erlotinib in this patient population
  • To correlate the effect of erlotinib with various EGFR downstream proteins and androgen receptor, using baseline IHC studies on tissue blocks and analysis of protein phosphorylation in peripheral blood mononuclear cells

Estimated Enrollment: 29
Study Start Date: August 2005
Study Completion Date: August 2008
Primary Completion Date: August 2008 (Final data collection date for primary outcome measure)
Detailed Description:

Patients with prostate cancer who are treated with surgery or radiation often develop recurrence of their cancer which is manifest only by a rising PSA (Prostate Specific Antigen) level. Many of these patients are treated with hormone therapy. After a fall in the PSA, these patients eventually display evidence of tumor progression clearly demonstrated by another rise in PSA level while receiving hormone therapy. Evaluation for evidence of tumor spread is usually negative. There is currently no effective therapy approved for use in these patients.

The drug erlotinib works by blocking the activity of a protein called Epidermal Growth Factor Receptor (EGFR), which is located on the surface of many prostate cancer cells. Blockage of this protein has been shown to inhibit the growth of prostate tumor cells in a laboratory setting and in animal experiments. Erlotinib has been given to patients with other types of cancers. A recently completed study showed that erlotinib improved the survival of patients with advanced lung cancer who failed standard chemotherapy.

There is currently no effective therapy approved for use in patients with this condition. The purpose of this study is to evaluate the effectiveness and side effects of the drug erlotinib in patients with this condition. Erlotinib is an investigational drug that has not yet been approved by the Federal Drug Administration (FDA) for use in prostate cancer, but has been approved for use in lung cancer.

As previously stated: The primary objective of this study is to evaluate the effect of erlotinib on the PSA response rate in patients with non-metastatic prostate cancer and a rising PSA on androgen deprivation therapy.

Secondary objectives are to evaluate the effect of erlotinib on the duration of PSA response, to evaluate the effect on the time to PSA progression, to evaluate the toxicity of erlotinib in this patient population, and lastly, to correlate the effect of erlotinib with various EGFR-related proteins using baseline immunohistochemical (IHC) studies on tissue blocks and peripheral blood mononuclear cells.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Patients must have documented adenocarcinoma of the prostate, treated with androgen suppression, and now present with a rising PSA .
  • Prior therapy with hydrocortisone is allowed (must have discontinued > 4 weeks prior to study treatment). Prior use of ketoconazole for prostate cancer treatment is allowed (must have discontinued > 4 weeks prior to study treatment).
  • Prior therapy with chemotherapy is allowed if it was administered as neoadjuvant or adjuvant therapy related to primary treatment and was completed > 6 months prior to starting study treatment.
  • Testosterone level < 50 ng/dl within 4 weeks prior to study treatment. Patients who have not undergone surgical castration must continue primary androgen suppression therapy (luteinizing hormone-releasing hormone [LHRH] agonist) while on protocol therapy.
  • Patients may be receiving oral bisphosphonate therapy prior to study treatment and continue while receiving treatment, but must not begin treatment with bisphosphonate while receiving study treatment. Patients on oral bisphosphonates must have completed at least 4 weeks of bisphosphonate therapy prior to study treatment.
  • Patients must have adequate major organ function. All values must be obtained within 4 weeks prior to study treatment.

    • Creatinine < 1.7 mg/dL or a creatinine clearance > 50 mL/min,
    • SGOT (AST), SGPT (ALT) < 2X the institution's upper limit of normal,
    • Bilirubin < 1.5 mg/dL,
    • ANC > 1500/mm3,
    • Platelet (PLT) > 100,000/mm3
  • Patients must have Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1.
  • Patients must be > 18.
  • Patients taking warfarin are eligible.
  • Patients taking CYP3A4 inducers or inhibitors are eligible.
  • Patients with a history of prior malignancy are eligible provided they were treated with curative intent and have been free of disease for the time period considered appropriate for the specific cancer.

Exclusion Criteria:

  • No previous palliative radiation. Prior radiation to the primary site is allowed.
  • HIV positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with erlotinib.
  • Patients with gastrointestinal tract disease resulting in an inability to take oral medication are ineligible.
  • Patients must not have ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, symptomatic cardiac arrhythmia, or psychiatric illness that would limit compliance with study requirements.
  • Patients must not have received prior targeted therapy, including no prior EGFR inhibitor.
  • Patients must not have evidence of metastatic disease.
  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: NCT00148772

Locations
United States, Illinois
Northwestern University
Chicago, Illinois, United States, 60611
Evanston Northwestern Healthcare
Evanston, Illinois, United States, 60201
Sponsors and Collaborators
NorthShore University HealthSystem Research Institute
Genentech
Northwestern University
Investigators
Principal Investigator: Daniel Shevrin, MD NorthShore University HealthSystem Research Institute
  More Information

No publications provided

Responsible Party: Daniel Shevrin, MD, NorthShore University HealthSystem
ClinicalTrials.gov Identifier: NCT00148772     History of Changes
Other Study ID Numbers: OSI3316s
Study First Received: September 6, 2005
Last Updated: June 24, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by NorthShore University HealthSystem Research Institute:
Prostate Cancer
Rising PSA
Erlotinib
Tarceva
Androgen Deprivation Therapy
Hormone Therapy
Rising Prostate Specific Antigen (PSA)
Non-Metastatic Prostate Cancer

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Prostatic Diseases
Hormones
Erlotinib
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Pharmacologic Actions
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on August 27, 2014