Lenalidomide and Cyclophosphamide in Treating Patients With Previously Treated Hormone-Refractory Prostate Cancer
This phase I/II trial studies the side effects and best dose of lenalidomide when given together with cyclophosphamide and to see how well they work in treating patients with previously treated hormone-refractory prostate cancer. Lenalidomide may stop the growth of prostate cancer by blocking blood flow to the tumor. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving lenalidomide together with cyclophosphamide may kill more tumor cells.
Adenocarcinoma of the Prostate
Hormone-resistant Prostate Cancer
Recurrent Prostate Cancer
Other: laboratory biomarker analysis
Procedure: quality-of-life assessment
Other: questionnaire administration
|Study Design:||Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase I/II Clinical Trial of Lenalidomide in Combination With Oral Cyclophosphamide in Patients With Previously Treated Hormone Refractory Prostate Cancer|
- Maximum tolerated dose of lenalidomide administered in combination with oral cyclophosphamide (Phase I) [ Time Frame: 28 days ] [ Designated as safety issue: Yes ]Defined to be the dose cohort below which 2 of 3 or 3 of 6 patients experience dose-limiting toxicities in course 1 or the highest dose cohort of 25 mg.
- Proportion of patients achieving objective PSA response (50% decrease in PSA levels sustained for at least 4 weeks) as defined by PSA working group criteria [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]
- Anti-tumor activity as assessed by the sum of complete response (CR), partial response (PR), and stable disease (SD) measured by Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1 [ Time Frame: Up to 4 months ] [ Designated as safety issue: No ]
- Proportion of patients achieving CR [ Time Frame: At 4 months ] [ Designated as safety issue: No ]Reported with the associated 95% confidence interval.
- Proportion of patients achieving a CR or PR (overall response rate) [ Time Frame: At 4 months ] [ Designated as safety issue: No ]Reported with the associated 95% confidence interval.
- Event-free survival [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]Estimated using the Kaplan-Meier method.
- Overall survival [ Time Frame: Up to 5 years ] [ Designated as safety issue: No ]Estimated using the Kaplan-Meier method.
- Change in quality of life [ Time Frame: At baseline and 8 weeks ] [ Designated as safety issue: No ]Assessed using the disease-specific European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) version 3.0 and the Prostate Cancer Module for the QLQ-C30 (PR-25) questionnaire (with 1 being not at all and 4 being very much).
- Change in bone pain as assessed by the McGill Pain Questionnaire-Short Form (MPQ-SF) (Phase II) [ Time Frame: At baseline and every course for 4 months ] [ Designated as safety issue: No ]Pain intensity assessed by a 4 point pain intensity scale (with 0 being no pain and 3 being severe pain), pain degree assessed on a 0 to 10 numerical scale, and present pain intensity assessed on 0 to 5 scale (with 0 being no pain and 5 being excruciating).
|Study Start Date:||March 2010|
|Primary Completion Date:||February 2014 (Final data collection date for primary outcome measure)|
Experimental: Treatment (lenalidomide and cyclophosphamide)
Patients receive lenalidomide PO QD on days 1-21 and cyclophosphamide PO QD on days 1-28. Treatment repeats every 28 days for at least 4 courses in the absence of disease progression or unacceptable toxicity. Treatment modifications may apply according to response.
Other Names:Drug: cyclophosphamide
Other Names:Other: laboratory biomarker analysis
Correlative studiesProcedure: quality-of-life assessment
Other Name: quality of life assessmentOther: questionnaire administration
I. To determine the maximum tolerated dose (MTD) and the dose limiting toxicities (DLT) of lenalidomide administered in combination with oral cyclophosphamide.
I. To evaluate the objective prostate-specific antigen (PSA) response (50% decrease in PSA levels sustained for at least 4 weeks) as defined by PSA working group criteria; or a decrease in absolute PSA or a decrease in PSA velocity, increase in PSA doubling time, duration of any responses.
II. To explore the anti-tumor activity of the combination of lenalidomide plus oral cyclophosphamide in patients with previously treated hormone refractory prostate cancer.
III. To evaluate baseline and change of quality of life, particularly, bone pain and analgesic consumption, of the patients on this combination chemotherapy.
I. To determine whether related cytokines and biomarkers (serum levels of tumor necrosis factor-alpha, basic fibroblast growth factor, vascular endothelial growth factor [VEGF], T cell inhibitory activity, phytohemagglutinin [PHA] and interleukin [IL]-2, mononuclear cell isolation, VEGF, basic fibroblast growth factor [bFGF], IL-6) can help predict response to patients undergoing treatment with lenalidomide and cyclophosphamide.
OUTLINE: This is a phase I, dose-escalation study of lenalidomide followed by a phase II study.
Patients receive lenalidomide orally (PO) once daily (QD) on days 1-21 and cyclophosphamide PO QD on days 1-28. Treatment repeats every 28 days for at least 4 courses in the absence of disease progression or unacceptable toxicity. Treatment modifications may apply according to response.
After completion of study treatment, patients are followed up periodically.
|United States, Nebraska|
|University of Nebraska Medical Center|
|Omaha, Nebraska, United States, 68198|
|Principal Investigator:||Jue Wang||University of Nebraska|