GEMOX in Docetaxel-Refractory Castration-Resistant Prostate Cancer - Full Text View

Purpose

Prostate cancer is one of the most common malignancies affecting men all over the World. Metastatic prostate cancer responds to androgen deprivation for a variable period (20-25 months). Prostate cancer that grows despite castrate levels of testosterone and that no longer responds to any form of hormonal manipulation is defined as castrate resistant prostate cancer (CRPC).

Docetaxel combined with prednisolone has been shown to not only improve QOL and PSA response in CRPC, but also extend the overall survival1. However, the efficacy of the drug has not been universally effective, and nearly all patients have disease progression after docetaxel treatment.

After failure of a docetaxel regimen, With the exception of cabazitaxel or abiraterone, which are not widely and easily availabe in Korea, little treatment regimen can be applied to the patients with reasonable response and benefits.

Gemcitabine is a nucleoside analog with activity against a broad spectrum of solid tumors. When gemcitabine is used as first-line therapy for CRPC, disease control rate was 33% with median duration of 7.1 months. When it is combined with prednisone and zoledronic acid in pretreated patients with CRPC, the PSA response rate was 23% with a disease control rate of 57% in patients with measurable disease.

Oxaliplatin is newer platinum agent that has favorable toxicity profile and evidence of activity in cisplatin-resistant cell lines. Droz et al. performed a multicenter phase II study in 54 patients with metastatic CRPC who were randomized to receive oxaliplatin either alone or with 5-FU. More than 50% of the patients had received prior chemotherapy including cisplatin. Despite heavy pretreatment, PSA desclines were noted in 11% and 19% of patients in each arm.

Gemcitabine plus oxaliplatin combination was widely studied and has been reported to be safe and effective in various cancers.

This study is to assess the efficacy and safety of GEMOX in docetaxel-refractory CRPC.

Condition	Intervention	Phase
Prostate Cancer	Drug: GEMOX	Phase 2


Study Type:	Interventional
Study Design:	Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	A Prosepctive Phase II Study of Gemcitabine and Oxaliplatin in Combination With Prednisolone for the Treatment of Hormone Refracotry Metastatic Prostate Cancer Previously Treated With Docetaxel Regimen

Resource links provided by NLM:

MedlinePlus related topics: Cancer Prostate Cancer

Drug Information available for: Docetaxel

U.S. FDA Resources

Further study details as provided by Asan Medical Center:

Primary Outcome Measures:

PSA response [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Based on PCWG 1.0

Secondary Outcome Measures:

PSA decline [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Based on PCWG 2.0
Time to PSA progression [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Composite progression-free survival [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Based on RECIST, bone scan, and performance status
RECIST Response [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Based on RECIST v 1.1
Safety [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
Based on NCI CTCAE v. 4.03


Enrollment:	33
Study Start Date:	October 2008
Study Completion Date:	October 2013
Primary Completion Date:	October 2013 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: GEMOX GEMOX treatment	Drug: GEMOX Gemcitabine 1000 mg/m2 IV on day 1 every 2 weeks (fixed-dose rate 10 mg/m2/min) Oxaliplatin 100 mg/m2 IV on day 1 every 2 weeks Prednisolone 5 mg twice a day orally daily

Eligibility


Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Male
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Histologically or cytologically confirmed adenocarcinoma of the prostate
Clinical or radiologic evidence of metastatic disease
Documented disease progression during hormone therapy (ADT plus antiandrogen) and no response to ADT withdrawal
Docetaxel-refractory disease defined as disease progression documented either during treatment of within 60 days after the cessation of treatment with docetaxel
Prior exposure to estramustine or mitoxantrone is allowed
KPS ≥ 60
No prior radioisotope therapy
No prior radiotherapy 25% or more of the bone marrow
No peripheral neuropathy grade 2 or worse
Adequate organ and bone marrow function

Exclusion Criteria:

Other tumor type than adenocarcinoma
Presence or history of CNS metastasis
Other serious illness or medical conditions

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01487720

Locations


Korea, Republic of
Asan Medical Center
Seoul, Korea, Republic of, 138-736

Sponsors and Collaborators

Asan Medical Center

More Information

No publications provided


Responsible Party:	JLee, Associate Professor, Asan Medical Center
ClinicalTrials.gov Identifier:	NCT01487720 History of Changes
Other Study ID Numbers:	UOSG-AMC-0802
Study First Received:	December 6, 2011
Last Updated:	November 30, 2013
Health Authority:	Korea: Food and Drug Administration

Keywords provided by Asan Medical Center:


Castration-resistant prostate cancer Docetaxel-refractory status

Additional relevant MeSH terms:


Prostatic Neoplasms Genital Diseases, Male Genital Neoplasms, Male Neoplasms	Neoplasms by Site Prostatic Diseases Urogenital Neoplasms

ClinicalTrials.gov processed this record on March 03, 2015