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| Sponsor: | National Cancer Institute (NCI) |
|---|---|
| Information provided by: | National Institutes of Health Clinical Center (CC) |
| ClinicalTrials.gov Identifier: | NCT00942578 |
Purpose
Background:
Objectives:
Eligibility:
- Men 18 years of age and older who have been diagnosed with metastatic prostate cancer that has not responded to standard treatment, including surgical removal of the testicles or treatment with androgen (sex-hormone) suppressing drugs.
Design:
| Condition | Intervention | Phase |
|---|---|---|
|
Metastatic Prostate Cancer |
Drug: Bevacizumab Drug: Lenalidomide Drug: Docetaxel Drug: Prednisone |
Phase II |
| Study Type: | Interventional |
| Study Design: | Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study |
| Official Title: | A Phase 2 Trial of Bevacizumab, Lenalidomide, Docetaxel, and Prednisone (ART-P) for Treatment of Metastatic Castrate-Resistant Prostate Cancer |
| Estimated Enrollment: | 57 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | June 2012 |
| Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Castrate-resistant metastatic adenocarcinoma of the prostate defined as progressive metastatic disease (see below) while on GnRH agonists or post surgical castration. All patients enrolled will be required to have evaluable disease on imaging studies.
Histopathological documentation of prostate cancer confirmed in the NCI Laboratory of Pathology at the National Institutes of Health, the Pathology Department at Walter Reed Medical Center, or the Pathology Department at National Naval Medical Center, prior to starting this study. In addition, patients whose slides are lost or unavailable will be eligible for the study if they provide documentation of prostate cancer and if they meet criteria of clinically progressive prostate cancer as outlined (see below).
Clinically progressive prostate cancer documented prior to entry. Progression must be evidenced and documented by any of the following parameters:
i) Two consecutively rising PSA levels apart of 2 weeks
ii) At least one new lesion on bone scans.
iii) Progressive measurable disease.
Patients must have undergone bilateral surgical castration or must continue on GnRH agonist.
Those patients receiving an anti-androgen agent for at least 6 months and are entering the trial due to a rise in PSA must demonstrate a continued rise in PSA 4 weeks after stopping flutamide and 6 weeks after stopping bicalutamide or nilutamide.
May not have received any chemotherapy or antiangiogenic therapy (including thalidomide, lenalidomide, bevacizumab and its target's receptor inhibitors) for metastatic prostate cancer. (Prior immunotherapy/vaccine, experimental hormonal therapy, radiation and (neo)adjuvant chemotherapy is permitted)
Age greater than or equal to 18 years
ECOG performance status less than or equal to 2
Must have adequate organ and marrow function as defined below:
Laboratory Test and Required Value:
OR
-Creatinine clearance greater than or equal to 50 mL/min/1.73 m(2) for patients with creatinine levels above institutional normal.
Recovered from any acute toxicity from surgery or radiotherapy, with minimum 4 weeks from major surgical procedures and 2 weeks from radiotherapy
Must be willing to travel from their home to the NIH for follow-up visits
Able and willing to follow instructions and conform to protocol.
Patients may have had no other active malignancy within the past 2 years with the exception of non-melanoma skin cancer and superficial bladder carcinoma.
No history of myocardial infarction within the past 6 months, uncontrolled CHF or uncontrolled angina pectoris
Patients must agree to use adequate contraception (abstinence; hormonal or barrier method of birth control) prior to the study, during the study, and at least six months after completion. Males must agree to use a latex condom during sexual contact with females of childbearing potential while participating in the study and for at least six months following, even if a man has undergone a successful vasectomy. All patients must be counseled at a minimum of every 28 days about pregnancy precautions and risks of fetal exposure as indicated in the consent.
Subjects must agree not to share study drug and not donate blood, sperm, or semen. A female of childbearing potential is a sexually mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months).
Ability to understand and the willingness to sign a written informed consent document.
EXCLUSION CRITERIA:
Present clinical signs or symptoms of current active brain and/or leptomeningeal metastases confirmed by CT or MRI brain scan. Patients with previously treated brain metastases are allowed to participate in the study.
Treated brain metastases are defined as having no ongoing requirement for steroids and no evidence of progression or hemorrhage after treatment for at least 3 months, as ascertained by clinical examination and brain imaging (MRI or CT). (Stable dose of anticonvulsants are allowed). Treatment for brain metastases may include whole brain radiotherapy (WBRT), radiosurgery (RS; Gamma Knife, LINAC, or equivalent) or a combination as deemed appropriate by the treating physician. Patients with CNS metastases treated by neurosurgical resection or brain biopsy performed within 3 months prior to Day 1 will be excluded.
Uncontrolled, intercurrent illness including, but not limited to, symptomatic congestive heart failure (AHA Class II or worse), unstable angina pectoris
Psychiatric illness/social situations that would limit compliance with study requirements.
Prior history of hypertensive crisis or hypertensive encephalopathy
Proteinuria, as demonstrated by a 24 hour protein of greater than or equal to 2000 mg. Urine protein will be screened by urine protein-creatinine ratio (UPC). For UPC ratio greater than 1.0, a 24-hour urine protein will need to be obtained and the level should be less than 2000 mg for patient enrollment.
Serious, non-healing wound, active ulcer, or untreated bone fracture, including tumor-related pathological fracture
Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with docetaxel, bevacizumab, and/or the combination.
Greater than Grade 2 peripheral neuropathy at baseline
History of allergic reaction to docetaxel, prednisone, lenalidomide and/or bevacizumab or related products.
Patients who are unable to ingest oral medication.
Patients on treatment for VTE.
History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 6 months prior to day 1
Major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to Day 1 therapy
Anticipation of need for major surgical procedures during the course of the study
Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to Day 1
Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair, aortic dissection or recent peripheral arterial thrombosis) within 6 months prior to Day 1
Patients with clinically significant cardiovascular disease are excluded
Patients with known hypersensitivity of Chinese hamster ovary cell products or other recombinant human antibodies
Contacts and Locations| Contact: NCI Referral Office | 1-888-NCI-1937 | ncicssc@mail.nih.gov |
| United States, Maryland | |
| National Institutes of Health Clinical Center, 9000 Rockville Pike | Recruiting |
| Bethesda, Maryland, United States, 20892 | |
More Information
| Responsible Party: | National Institutes of Health ( CTEP/National Cancer Institute ) |
| Study ID Numbers: | 090195, 09-C-0195 |
| Study First Received: | July 18, 2009 |
| Last Updated: | January 9, 2010 |
| ClinicalTrials.gov Identifier: | NCT00942578 History of Changes |
| Health Authority: | United States: Federal Government |
|
Dual Antiangiogenic Combination Therapy for mCRPC Efficacy and Toxicity Profile Single Stage Phase 2 With Early Stopping, Run In Phase For Toxicity Correlative Measurements |
Overall Survival Assessment Metastatic Prostate Cancer Prostate Cancer |
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Anti-Inflammatory Agents Prednisone Antineoplastic Agents, Hormonal Genital Neoplasms, Male Prostatic Diseases Antineoplastic Agents Growth Substances Physiological Effects of Drugs Hormones, Hormone Substitutes, and Hormone Antagonists Lenalidomide Urogenital Neoplasms Bevacizumab |
Genital Diseases, Male Angiogenesis Inhibitors Glucocorticoids Hormones Pharmacologic Actions Docetaxel Neoplasms Neoplasms by Site Therapeutic Uses Growth Inhibitors Angiogenesis Modulating Agents Prostatic Neoplasms |