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Safety and Efficacy Studies of Panobinostat and Bicalutamide in Patients With Recurrent Prostate Cancer After Castration

This study has been completed.
ClinicalTrials.gov Identifier:
First Posted: April 9, 2009
Last Update Posted: October 12, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
New York University School of Medicine
This trial is designed to investigate the safety, dosing schedule, and efficacy of the combination treatment of Panobinostat (a histone deacetylase inhibitor) and hormone therapy for recurrent prostate cancer. This trial is at its Phase II stage. As of July 23, 2013 Arm B was closed to accrual, all the remaining slots in accrual will be allocated to Arm A.

Condition Intervention Phase
Prostate Cancer Prostatic Neoplasms Drug: Panobinostat Drug: Bicalutamide Phase 1 Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase I/II Randomized Trial of LBH589 (Panobinostat) at Two Dose Levels Combined With Bicalutamide (Casodex) in Men With Castration-resistant Prostate Cancer

Resource links provided by NLM:

Further study details as provided by New York University School of Medicine:

Primary Outcome Measures:
  • the proportion of patients free of progression and without symptomatic deterioration [ Time Frame: 9 months ]
    measured by PSA and /or metastases progression criteria by body CT following RECIST criteria 1.1 and/or bones scan following the appearance of at least 2 new bone metastases and confirmation of 2 additional bone metastasis on a subsequent bone scan 6-8 weeks later and/or clinical progression.

Secondary Outcome Measures:
  • Time to PSA progression [ Time Frame: up to 2 years ]
    PSA progression is defined as a 25% or greater increase in PSA and an absolute increase value of 2 ng/ml or more over a nadir or baseline documented and confirmed by a second value three weeks later

  • proportion of patients that achieve a 50% or greater PSA decline by 9 months of therapy [ Time Frame: 9 months ]

Enrollment: 57
Study Start Date: June 2009
Study Completion Date: July 2015
Primary Completion Date: March 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm A (120 mg/week)

Each treatment cycle has 21 days:

Bicalutamide (Casodex®) 50mg P.O. daily, continuously, with the addition of:

40 mg Panobinostat 3 times per week (120 mg per week) for 2 consecutive weeks with one week rest

Drug: Panobinostat
Other Name: LBH589
Drug: Bicalutamide
Other Name: Casodex
Experimental: Arm B (60 mg/week)-Closed to accrual

Each treatment cycle has 21 days:

Bicalutamide (Casodex®) 50mg P.O. daily, continuously, with the addition of:

20 mg Panobinostat 3 times per week (60 mg per week) for 2 consecutive weeks with one week rest

Drug: Panobinostat
Other Name: LBH589
Drug: Bicalutamide
Other Name: Casodex

Detailed Description:
The preclinical data indicate that Panobinostat restores the sensitivity of androgen-independent cells to bicalutamide (Casodex®) and the combination has synergistic inhibitory activity. Here, we hypothesize that treatment of castration-resistant patients with Panobinostat will enhance the response to the second line hormone therapy with bicalutamide (Casodex®). In the proposed phase I study, the maximum tolerated dose of tri-weekly, intermittent oral Panobinostat at three different dose levels (60, 90, 120 mg/week) in combination with Casodex (50mg PO) will be determined; The following phase II study will evaluated the efficacies of 9-month treatments of the selected Panobinostat-Casodex combination and also a lower dose of Panobinostat. We expect that Casodex-Panobinostat combination treatment of castration-resistant patients will prevent biochemical and/or metastatic disease progression of these patients compared to historical controls in the same time period.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male patients aged ≥ 18 years old
  • Ability to provide written informed consent obtained prior to participation in the study and any related procedures being performed
  • Patients must meet laboratory criteria
  • Baseline MUGA or ECHO must demonstrate LVEF ≥ the lower limit of the institutional normal.
  • ECOG Performance Status of ≤ 2
  • Documented history of adenocarcinoma of the prostate.
  • Patients must have evidence of disease progression while receiving androgen suppression therapy by orchiectomy or other primary hormonal therapy including, but not limited to (LHRH agonist therapy (e.g., leuprolide or goserelin) or LHRH antagonist (e.g. aberelix). Note: patients who have not undergone bilateral orchiectomy must continue LHRH therapy while on protocol
  • Testosterone must be < 50 ng/dl confirmed within 4 weeks prior to registration for patients on LHRH therapy
  • Patients must have evidence of disease progression with either one or both of the conditions listed:

    • Biochemical progression only
    • Metastases on bone scan
  • Patients may have received one chemotherapy, investigational agent or immunotherapy in the neoadjuvant, adjuvant setting or during initial LHRH therapy with new evidence of disease progression after discontinuation of therapy for ≥ 2 weeks.
  • Patients must have received one or more prior second line hormone therapy for progression while on LHRH treatment or orchiectomy.
  • Patients treated with one first line chemotherapy combination for hormone refractory progression ≥ 4 weeks prior to registration who have evidence of disease progression and had only one second line hormone therapy and did not experience PSA response to bicalutamide (Casodex®) withdrawal.

Exclusion Criteria:

  • Prior treatment with an HDAC inhibitor
  • Impaired cardiac function including any one of the following:

    • Screening ECG with a QTc > 450 msec confirmed by central laboratory prior to enrollment to the study
    • Patients with congenital long QT syndrome
    • History of sustained ventricular tachycardia
    • Any history of ventricular fibrillation or torsades de pointes
    • Bradycardia defined as heart rate < 50 beats per minute. Patients with a pacemaker and heart rate ≥ 50 beats per minute are eligible.
    • Patients with a myocardial infarction or unstable angina within 6 months of study entry
    • Congestive heart failure (NY Heart Association class III or IV)
    • Right bundle branch block in conjunction with left anterior hemi-block (bifasicular block)
  • Uncontrolled hypertension
  • Concomitant use of drugs with a risk of causing torsades de pointes
  • Concomitant use of CYP3A4 inhibitors
  • Patients with unresolved diarrhea greater than CTCAE grade 1
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral LBH589
  • Other concurrent severe and/or uncontrolled medical conditions
  • Patients who have received chemotherapy, any investigational drug or undergone major surgery < 4 weeks prior to starting study drug or who have not recovered from side effects of such therapy.
  • Concomitant use of any anti-cancer therapy or radiation therapy.
  • Male patients whose sexual partners are WOCBP not using effective birth control
  • Patients with a history of another primary malignancy within the last 2 years that was not curatively treated, excluding basal or squamous cell carcinoma of the skin
  • Patients with known positivity for human immunodeficiency virus (HIV) or hepatitis C; baseline testing for HIV and hepatitis C is not required
  • Patients with any significant history of non-compliance to medical regimens or with inability to grant a reliable informed consent
  • Patients previously treated with bicalutamide (Casodex®) who experienced a PSA withdrawal response in the washout period as described in Inclusion #11 will not be eligible
  • Concurrent use of estrogens or estrogen like substances (i.e. PC-SPES, Saw Palmetto, or other herbal product which may contain phytoestrogens) is not allowed. Prior use of these agents will need to be discontinued at least 4 weeks prior to enrollment, for the above.
  • Radiotherapy within the 4 weeks prior to registration
  • Inadequate bone marrow function measured 28 days prior to registration
  • No serious concurrent medical illness or active infection that would jeopardize the ability of the patient to receive therapy as outlined in the protocol with reasonable safety.
  • Liver metastasis.
  • The use of bisphosphonates in the absence of metastasis will not be allowed. Patients on bisphosphonates for more than 4 weeks for asymptomatic bone metastasis and with continued evidence of PSA progression may continue on bisphosphonates every 4 weeks.
  • Hydronephrosis with impaired renal function.
  • Active spinal cord compression.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00878436

United States, New Jersey
The Cancer Institute of New Jersey
New Brunswick, New Jersey, United States, 08903
United States, New York
North Shore University Hospital-Monter Cancer Center
Lake Success, New York, United States, 11042
NYU Cancer Center
New York, New York, United States, 10016
United States, Oregon
Oregon Health & Science University
Portland, Oregon, United States, 97239
Sponsors and Collaborators
New York University School of Medicine
Principal Investigator: Anna Ferrari, MD New York University School of Medicine
  More Information

Responsible Party: New York University School of Medicine
ClinicalTrials.gov Identifier: NCT00878436     History of Changes
Other Study ID Numbers: NYU 08-479
First Submitted: April 8, 2009
First Posted: April 9, 2009
Last Update Posted: October 12, 2017
Last Verified: August 2015

Keywords provided by New York University School of Medicine:
histone deacetylase inhibitor
hormone therapy
androgen receptor

Additional relevant MeSH terms:
Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Genital Diseases, Male
Prostatic Diseases
Histone Deacetylase Inhibitors
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Androgen Antagonists
Hormone Antagonists