Gefitinib and Etoposide in Treating Patients With Advanced Prostate Cancer That Did Not Respond to Hormone Therapy
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Purpose
RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in chemotherapy, such as etoposide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving gefitinib together with etoposide may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving gefitinib together with etoposide works in treating patients with advanced prostate cancer that did not respond to hormone therapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Prostate Cancer |
Drug: etoposide Other: laboratory biomarker analysis |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase II Study Evaluating the Efficacy of Iressa Plus Etoposide in Patients With Advanced Hormone Refractory Prostate Cancer |
- Overall response rate as measured by RECIST criteria [ Time Frame: After 14 patients are enrolled ] [ Designated as safety issue: No ]If there is at least 1 response, then 7 additional patients will be enrolled. If there are 4 or more responders overall, then the combination will be considered active and warrant further study.
- Adverse events and toxicities as assessed by NCI CTC v2.0 [ Time Frame: When reported by patients, and at physical evaluations ] [ Designated as safety issue: Yes ]
- Laboratory values [ Time Frame: At every cycle ] [ Designated as safety issue: No ]
- Biomarkers [ Time Frame: At every cycle ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 21 |
| Study Start Date: | January 2004 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
-
Drug: etoposide
OBJECTIVES:
Primary
- Determine the activity of gefitinib and etoposide, in terms of overall response rate, in patients with hormone-refractory advanced prostate cancer previously treated with docetaxel-based therapy.
Secondary
- Determine the toxicity of this regimen in these patients.
- Determine whether related biomarkers can help predict response in patients treated with this regimen.
OUTLINE: This is a nonrandomized study.
Patients receive oral gefitinib once daily on days 1-28 and oral etoposide once daily on days 1-14. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Patients undergo blood sample collection at baseline and periodically during study for correlative studies. Blood samples are analyzed by enzyme-linked immunosorbent assays for biomarkers (e.g., VEGF, basic fibroblast growth factor, and anti-EGFR antibody titers) in order to determine whether one or more of these biomarkers can predict response.
After completion of study therapy, patients are followed periodically.
Eligibility| Ages Eligible for Study: | 19 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma of the prostate
- Progressive disease after a prior docetaxel-based regimen OR failed a prior docetaxel-based regimen
Hormone-refractory disease, meeting 1 of the following criteria:
- Radiologically measurable disease
- Prostate-specific antigen (PSA) progression* while on hormonal therapy (including withdrawal from a direct antagonist) NOTE: *If the confirmatory PSA value is less than the screening PSA value, then an additional test for rising PSA is required to document progression
- Must have underwent prior surgical castration OR currently be on a luteinizing hormone-releasing hormone agonist
PATIENT CHARACTERISTICS:
- ANC > 1,500/mm³
- Platelet count > 100,000/mm³
- Hemoglobin > 10 g/dL (in the absence of packed red blood cell transfusions within the past 4 weeks)
- Creatinine < 2 mg/dL
- AST and ALT < 2 times upper limit of normal (ULN)
- Alkaline phosphatase < 2 times ULN
- Fertile patients must use effective double-method contraception during and for 1 month after completion of study treatment
- No other malignancy within the past 5 years except basal cell carcinoma
- No clinically significant New York Heart Association class II-IV cardiovascular disease
- No evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal disease)
- No unresolved chronic toxicity > grade 2 from prior anticancer therapy, with the exception of alopecia
- No other significant clinical disorder or laboratory finding that would preclude study participation
- No known severe hypersensitivity to gefitinib or any of the excipients of this product
No evidence of clinically active interstitial lung disease
- Patients with chronic, stable radiographic changes who are asymptomatic are eligible
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- At least 4 weeks since prior cytotoxic therapy
- At least 4 weeks since prior direct antagonists, including flutamide and nilutamide
- At least 6 weeks since prior bicalutamide
- At least 30 days since prior nonapproved or investigational drugs
More than 4 weeks since prior palliative radiotherapy
- The irradiated lesion must not be used to assess response rate
- No prior gefitinib or etoposide
- No concurrent palliative radiotherapy
- No concurrent chemotherapeutic agents
- No concurrent phenytoin, carbamazepine, rifampin, barbiturates, or Hypericum perforatum (St. John's wort)
- No concurrent hormones except antiandrogen therapy, steroids for adrenal failure, hormones for nondisease-related conditions (e.g., insulin for diabetes), or intermittent dexamethasone as an antiemetic
- No concurrent initiation of IV and/or oral bisphosphonates specifically for symptomatic bone metastases
Contacts and Locations| United States, Nebraska | |
| UNMC Eppley Cancer Center at the University of Nebraska Medical Center | |
| Omaha, Nebraska, United States, 68198-6805 | |
| Principal Investigator: | Ralph Hauke, MD | University of Nebraska |
| Principal Investigator: | Elizabeth C. Reed, MD | University of Nebraska |
More Information
Additional Information:
No publications provided
| Responsible Party: | Elizabeth C. Reed, UNMC Eppley Cancer Center at the University of Nebraska Medical Center |
| ClinicalTrials.gov Identifier: | NCT00483561 History of Changes |
| Other Study ID Numbers: | 285-03, P30CA036727, UNMC-28503, ZENECA-UNMC-28503 |
| Study First Received: | June 6, 2007 |
| Last Updated: | March 8, 2011 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Nebraska:
|
adenocarcinoma of the prostate recurrent prostate cancer stage III prostate cancer stage IV prostate cancer |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms Genital Diseases, Male Prostatic Diseases |
Etoposide Etoposide phosphate Antineoplastic Agents, Phytogenic Antineoplastic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 22, 2013