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Temsirolimus to Reverse Androgen Insensitivity for Castration-resistant Prostate Cancer

This study has been terminated.
(Decision by funding sponsor due to poor accrual)
Sponsor:
Collaborators:
Wyeth is now a wholly owned subsidiary of Pfizer
National Comprehensive Cancer Network
American Society of Clinical Oncology
Information provided by (Responsible Party):
Sandy Srinivas, Stanford University
ClinicalTrials.gov Identifier:
NCT01020305
First received: October 30, 2009
Last updated: October 3, 2014
Last verified: October 2014

October 30, 2009
October 3, 2014
October 2009
April 2012   (final data collection date for primary outcome measure)
Reduction in Serum PSA [ Time Frame: 12 weeks treatment, with primary outcome assessed at 16 weeks ] [ Designated as safety issue: No ]
Proportion of subjects with > 50% drop in serum PSA as compared to baseline, assessed at 16 weeks
PSA response at 13 weeks since Day 1 dosing. PSA response is defined as a decrease >=50% from baseline [ Time Frame: 13 weeks ] [ Designated as safety issue: No ]
Complete list of historical versions of study NCT01020305 on ClinicalTrials.gov Archive Site
Not Provided
  • Safety, Tolerability as defined by the percent of patients who discontinue due to toxicity, Time to PSA Progression, Median number of CTCs pre- and post-therapy, Characterization of pre- and post-therapy CTCs [ Time Frame: 42 days of last Temsirolimis dose Outcome ] [ Designated as safety issue: Yes ]
  • Time TO PSA progression end point [ Time Frame: within in 1 year of last study Temsirolimus ] [ Designated as safety issue: No ]
Not Provided
Not Provided
 
Temsirolimus to Reverse Androgen Insensitivity for Castration-resistant Prostate Cancer
Temsirolimus, an mTOR Inhibitor, to Reverse Androgen Insensitivity in Patients With Castration-resistant Prostate Cancer

This study evaluates if temsirolimus causes a reduction in the serum levels of prostate-specific antigen (PSA) in male subjects with castration-resistant prostate cancer (CRPC).

Castration-resistant prostate cancer (CRPC) is also known as "androgen-insensitive" or "hormone-refractory" prostate cancer. While numerous therapies impact biochemical response in the setting of CRPC, there remains unmet medical need. New therapies that extend survival of patients beyond that provided by chemotherapy are needed.

The mechanisms of tumor progression to castration-resistance are unclear, but preclinical studies suggest that functional loss of the tumor suppressor gene PTEN and subsequent up-regulation of Akt, which is upstream of mTOR, may be involved in prostate cancer progression and metastasis. Based on these observations, it is hypothesized that mTOR inhibitor temsirolimus may prolong hormone sensitivity and delay disease progression in castration-resistant prostate cancer patients before antiandrogen withdrawal.

This study will assess efficacy on the basis of serum levels of PSA, an established surrogate endpoint for efficacy in prostate cancer.

Interventional
Phase 1
Phase 2
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
  • Prostate Cancer
  • Prostatic Neoplasms
  • Castrate-resistant Prostate Cancer (CRPC)
  • Androgen-insensitive Prostate Cancer
  • Hormone-refractory Prostate Cancer
  • Metastatic Disease
  • Drug: Temsirolimus

    Temsirolimus is an inhibitor of the mammalian target of rapamycin (MTOR, aka HGNC:3942)

    IUPAC name: (1R,2R,4S)-4-{(2R)-2-[(3S,6R,7E,9R,10R,12R,14S,15E,17E,19E,21S,23S,26R,27R,34aS)-9,27-dihydroxy-10,21-dimethoxy-6,8,12,14,20,26-hexamethyl-1,5,11,28,29-pentaoxo-1,4,5,6,9,10,11,12,13,14,21,22,23,24,25,26,27,28,29,31,32,33,34,34a-tetracosahydro-3H-23,27-epoxypyrido[2,1-c][1,4]oxazacyclohentriacontin-3-yl]propyl}-2-methoxycyclohexyl 3-hydroxy-2-(hydroxymethyl)-2-methylpropanoate

    Other Names:
    • Torisel
    • CCI-779
  • Drug: Casodex (bicalutamide)
    Casodex (bicalutamide) 50 mg/day PO
    Other Names:
    • Casodex
    • bicalutamide
    • Cosudex
    • Calutide
    • Kalumid
Experimental: Temsirolimus + Bicalutamide

Temsirolimus 25 mg administered intravenously (IV) once weekly for 12 weeks

Casodex (bicalutamide) administered 50 mg/day orally (PO)

Interventions:
  • Drug: Temsirolimus
  • Drug: Casodex (bicalutamide)
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
5
April 2012
April 2012   (final data collection date for primary outcome measure)

INCLUSION CRITERIA

  • Histologically-confirmed adenocarcinoma of the prostate, characterized as symptomatic castration-resistant prostate cancer (CRPC)
  • Serum PSA ≥ 2 ng/mL
  • Rising PSA on 3 consecutive occasions at least 1 week apart (not limited to the 30-day screening period)
  • Failure of bilateral orchiectomy and/or therapy with an LHRH agonist and bicalutamide
  • Castrate level of testosterone (< 50 ng/dL)
  • Currently being treated with bicalutamide
  • No prior antiandrogen therapy except bicalutamide
  • Age ≥ 18 years
  • Life expectancy > 6 months
  • Performance status

    • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
    • OR
    • Karnofsky performance status ≥ 80%
  • Ability to understand and the willingness to sign a written informed consent

EXCLUSION CRITERIA

  • Radiotherapy for prostate cancer within 28 days prior to Day 1, except single-fraction radiotherapy for pain control
  • Prior treatment with mTOR inhibitors
  • Prior treatment with chemotherapy for prostate cancer
  • Symptomatic bone metastases (ie, asymptomatic bone metastases are eligible)
  • Visceral metastases
  • Absolute neutrophil count (ANC) < 1500/uL
  • Platelet count ≤ 100 x 10e9/L
  • Total bilirubin ≥ 1.5 x Upper Limit of Normal (ULN)
  • Alkaline phosphatase > 2.5 x ULN
  • AST > 2.5 x ULN
  • ALT > 2. 5x ULN
  • Serum creatinine > 2.0 mg/dL
  • Hemoglobin < 9 g/dL
  • Men with reproductive potential who do not agree to use an accepted and effective method of contraception during the study treatment period and for at least 3 months after completion of the study treatment
  • History of other malignancies within 5 years except for tumors with a negligible risk for metastasis or death, such as adequately-controlled basal cell carcinoma, squamous-cell carcinoma of the skin, or early-stage bladder cancer
  • Participation in another experimental drug study either planned or within 4 weeks of the first study treatment
  • Persistent Grade ≥ 1 AEs due to prior drug therapy, including investigational drugs, administered more than 14 days before study enrollment
  • Previously treated or other known brain metastases
  • Ongoing or active infection
  • Symptomatic congestive heart failure, New York Heart Association Grade II or greater
  • Unstable angina pectoris
  • Cardiac arrhythmia
  • Significant vascular disease (eg, aortic aneurysm, aortic dissection)
  • Symptomatic peripheral vascular disease
  • Psychiatric illness/social situations that would limit compliance with study requirements
  • Other uncontrolled intercurrent illness
  • Known to be positive for the human immunodeficiency virus (HIV) infection and receiving antiretroviral therapies (HIV positive not requiring antiretroviral therapy iseligible if all other entry criteria are meet)
  • Inability to comply with study and/or follow-up procedures
Male
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01020305
IRB-17242, SU-09292009-4080, PROS0028
Yes
Sandy Srinivas, Stanford University
Sandy Srinivas
  • Wyeth is now a wholly owned subsidiary of Pfizer
  • National Comprehensive Cancer Network
  • American Society of Clinical Oncology
Principal Investigator: Sandhya "Sandy" Srinivas, MD Stanford University
Principal Investigator: Lauren Christine Harshman, MD Stanford University
Stanford University
October 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP