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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2012-01466 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| MAYO-MC0453 | |||
| NCI-6651 | |||
| CDR0000433492 | |||
| MC0453 | Other Identifier | Mayo Clinic | |
| 6651 | Other Identifier | CTEP | |
| N01CM62205 | U.S. NIH Grant/Contract | View source |
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This phase II trial is studying how well 17-AAG works in treating patients with metastatic prostate cancer that did not respond to previous hormone therapy. Drugs used in chemotherapy, such as 17-AAG, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.
PRIMARY OBJECTIVES:
I. Determine the prostate-specific antigen (PSA) response in patients with hormone-refractory metastatic prostate cancer treated with 17-N-allylamino-17-demethoxygeldanamycin (17-AAG).
SECONDARY OBJECTIVES:
I. Determine the overall survival and disease-free survival rate in patients treated with this drug.
II. Determine the safety profile of this drug in these patients. III. Determine the duration of PSA response and PSA control in patients treated with this drug.
IV. Determine the partial and complete response rates in patients with measurable disease treated with this drug.
V. Correlate changes in expression levels of interleukin-6, maspin, and NF-kappaB in serum and tissue with cancer and treatment-related outcomes in patients treated with this drug.
OUTLINE: This is a multicenter study. Patients receive 17-N-allylamino-17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses of treatment beyond documentation of CR.
After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 16-28 patients will be accrued for this study within 20 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (tanespimycin) | Experimental | Patients receive 17-N-allylamino 17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients who achieve a complete response (CR) receive 2 additional courses of treatment beyond documentation of CR. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| tanespimycin | Drug | Given IV |
| |
| laboratory biomarker analysis |
| Measure | Description | Time Frame |
|---|---|---|
| PSA Response as Defined by the Recommendations of the Prostate-Specific Antigen Working Group | Normalization: PSA ≤4.0 ng/ml. This must be confirmed by a second PSA value measured when patient returns in 4-6 weeks. This qualifies as a CR response. > > 50% decline: A 50% decline in PSA value from baseline which must be confirmed by a second PSA value measured when patient returns in 4-6 weeks later. This qualifies as a PR response.> > Progression: A 25% or greater increase over baseline and an increase in the PSA level by at least 5 ng/mL, which is confirmed by a second value obtained approximately one week later. In addition, radiographic scans are required to confirm that a disease progression is by PSA only. | Up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Overall Responses | Confirmed response rate was defined using Response Evaluation Criteria In Solid Tumors (RECIST). A confirmed response is defined as a complete response (CR) or partial response (PR) observed on subsequent scans at least 4 weeks apart. Confirmed response rate was estimated by the number of successes divided by the total number of evaluable patients. Complete Response (CR) is defined as the disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in sum of longest diameter of target lesions. The proportion of confirmed responses will be estimated by the number of patients with confirmed responses divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner. |
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Inclusion Criteria:
Histologically confirmed adenocarcinoma of the prostate
Measurable or evaluable disease
Objective disease progression OR rising PSA despite receiving androgen deprivation therapy and undergoing antiandrogen withdrawal
Must be castrate (testosterone < 50 ng/mL)
Must have received ≥ 1 prior chemotherapy regimen for metastatic disease
No known brain metastases requiring active therapy
Performance status - ECOG 0-2
At least 12 weeks
Absolute neutrophil count ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 8.0 g/dL
Bilirubin ≤ 1.5 times upper limit of normal (ULN)
SGOT and/or SGPT ≤ 2.5 times ULN AND alkaline phosphatase normal
Alkaline phosphatase ≤ 4 times ULN AND SGOT and/or SGPT normal
Creatinine clearance ≥ 60 mL/min
Creatinine normal
QTc < 450 msec for male patients
LVEF > 40% by MUGA
EF normal by MUGA if prior anthracycline therapy
No congenital long QT syndrome
No left bundle branch block
Deep venous thrombosis or other clinically significant thromboembolic event within the past 6 months allowed provided patient is clinically stable on anticoagulation therapy
No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
No myocardial infarction within the past year
No cerebrovascular accident or transient ischemic attack within the past 6 months
No New York Heart Association class III or IV congestive heart failure
No poorly controlled angina
No uncontrolled dysrhythmia or dysrhythmias requiring medication
No active ischemic heart disease within the past 12 months
No other significant cardiac disease
Pulmonary embolus allowed within the past 6 months provided patient is clinically stable on anticoagulation therapy
Fertile patients must use effective contraception
Willing and able to provide blood samples
No serious allergy (i.e., hypotension, dyspnea, anaphylaxis, or edema) to eggs
No other concurrent malignancy or history of a curatively treated malignancy with a survival prognosis of < 5 years
No known HIV positivity
No active infection
No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study participation
At least 4 weeks since prior flutamide (6 weeks for bicalutamide or nilutamide)
At least 28 days since prior radiotherapy
No prior radiotherapy field that included the heart (e.g., mantle)
More than 6 months since prior coronary or peripheral artery bypass grafting
More than 28 days since prior investigational agents for prostate cancer
No concurrent agents that interact with cytochrome P450 3A4
No concurrent warfarin for anticoagulation
No concurrent medications that would prolong QTc
No other concurrent antineoplastic agents
Concurrent zoledronate for bone metastases or hypercalcemia allowed
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| Name | Affiliation | Role |
|---|---|---|
| Elisabeth Heath | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment (Tanespimycin) | Patients receive 300 mg/m^2 17-N-allylamino 17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. > Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Other |
Correlative studies |
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| Up to 3 years |
| Overall Survival | Overall survival time is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier. | From registration to death due to any cause, assessed up to 3 years |
| Disease-free Survival | Disease-free survival time is defined as the time from registration to documentation of disease progression. If a patient dies without a documentation of disease progression, the patient will be considered to have had progressed at the time of their death. In patients who have achieved a PSA response, we will assess the time to PSA progression. If the patient is declared to be a major treatment violation, the patient will be censored on the date the treatment violation was declared to have occurred. In the case of a patient starting treatment and then never returning for any evaluations, the patient will be censored for progression on day 1 post-registration. The distribution of disease-free survival time will be estimated using the method of Kaplan-Meier. | From registration to documentation of disease progression, assessed up to 3 years |
| Duration of PSA Response and PSA Control | The distribution of this response duration will be estimated using the method of Kaplan-Meier. In patients whose PSA has declined from baseline by at least 30 %, "duration of PSA response" will be defined as the time from PSA response to time of progression. If a patient goes on to alternate therapy, they will be censored at the date they end treatment on this study. "Duration of PSA Control" is defined as the time from the date of the first 30% decline in PSA until an inflection point is identified. Inflection point is defined as the time to first consistent PSA increase, the point at which PSA began what becomes a continuous increase > (retrospectively identified). The inflection point is the point at which disease control could assume to be lost. | From PSA response to time of progression, assessed up to 1 year |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment (Tanespimycin) | Patients receive 300 mg/m^2 17-N-allylamino 17-demethoxygeldanamycin (17-AAG) IV over 2-6 hours on days 1, 8, and 15. > Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | PSA Response as Defined by the Recommendations of the Prostate-Specific Antigen Working Group | Normalization: PSA ≤4.0 ng/ml. This must be confirmed by a second PSA value measured when patient returns in 4-6 weeks. This qualifies as a CR response. > > 50% decline: A 50% decline in PSA value from baseline which must be confirmed by a second PSA value measured when patient returns in 4-6 weeks later. This qualifies as a PR response.> > Progression: A 25% or greater increase over baseline and an increase in the PSA level by at least 5 ng/mL, which is confirmed by a second value obtained approximately one week later. In addition, radiographic scans are required to confirm that a disease progression is by PSA only. | All 15 eligible patients that started treatment were evaluated. | Posted | Number | participants | Up to 1 year |
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| Secondary | Proportion of Overall Responses | Confirmed response rate was defined using Response Evaluation Criteria In Solid Tumors (RECIST). A confirmed response is defined as a complete response (CR) or partial response (PR) observed on subsequent scans at least 4 weeks apart. Confirmed response rate was estimated by the number of successes divided by the total number of evaluable patients. Complete Response (CR) is defined as the disappearance of all target lesions. Partial Response (PR) is defined as a 30% decrease in sum of longest diameter of target lesions. The proportion of confirmed responses will be estimated by the number of patients with confirmed responses divided by the total number of evaluable patients. Ninety-five percent confidence intervals for the true success proportion will be calculated according to the approach of Duffy and Santner. | All 15 eligible patients that started treatment were evaluated. | Posted | Number | 95% Confidence Interval | percentage of responses | Up to 3 years |
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| ||||||||||||||||||||||||||
| Secondary | Overall Survival | Overall survival time is defined as the time from registration to death due to any cause. The distribution of survival time will be estimated using the method of Kaplan-Meier. | All 15 eligible patients that started treatment were evaluated. | Posted | Median | 95% Confidence Interval | months | From registration to death due to any cause, assessed up to 3 years |
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| Secondary | Disease-free Survival | Disease-free survival time is defined as the time from registration to documentation of disease progression. If a patient dies without a documentation of disease progression, the patient will be considered to have had progressed at the time of their death. In patients who have achieved a PSA response, we will assess the time to PSA progression. If the patient is declared to be a major treatment violation, the patient will be censored on the date the treatment violation was declared to have occurred. In the case of a patient starting treatment and then never returning for any evaluations, the patient will be censored for progression on day 1 post-registration. The distribution of disease-free survival time will be estimated using the method of Kaplan-Meier. | All 15 eligible patients that started treatment were evaluated. | Posted | Median | 95% Confidence Interval | months | From registration to documentation of disease progression, assessed up to 3 years |
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| Secondary | Duration of PSA Response and PSA Control | The distribution of this response duration will be estimated using the method of Kaplan-Meier. In patients whose PSA has declined from baseline by at least 30 %, "duration of PSA response" will be defined as the time from PSA response to time of progression. If a patient goes on to alternate therapy, they will be censored at the date they end treatment on this study. "Duration of PSA Control" is defined as the time from the date of the first 30% decline in PSA until an inflection point is identified. Inflection point is defined as the time to first consistent PSA increase, the point at which PSA began what becomes a continuous increase > (retrospectively identified). The inflection point is the point at which disease control could assume to be lost. | No participants with PSA response or PSA control. | Posted | From PSA response to time of progression, assessed up to 1 year |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Treatment (Tanespimycin) | Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. | 2 | 17 | 16 | 17 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Neutrophil count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Thrombosis | Vascular disorders | MedDRA 6 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hemoglobin decreased | Blood and lymphatic system disorders | MedDRA 6 | Systematic Assessment |
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| Premature ventricular contractions | Cardiac disorders | MedDRA 6 | Systematic Assessment |
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| Sinus arrhythmia | Cardiac disorders | MedDRA 6 | Systematic Assessment |
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| Sinus bradycardia | Cardiac disorders | MedDRA 6 | Systematic Assessment |
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| Supraventricular extrasystoles | Cardiac disorders | MedDRA 6 | Systematic Assessment |
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| Vision blurred | Eye disorders | MedDRA 6 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Mucositis oral | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA 6 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA 6 | Systematic Assessment |
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| Fever | General disorders | MedDRA 6 | Systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Skin infection | Infections and infestations | MedDRA 6 | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
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| Alkaline phosphatase increased | Investigations | MedDRA 6 | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | MedDRA 6 | Systematic Assessment |
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| Electrocardiogram QTc interval prolonged | Investigations | MedDRA 6 | Systematic Assessment |
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| Leukocyte count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Lymphocyte count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Neutrophil count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Platelet count decreased | Investigations | MedDRA 6 | Systematic Assessment |
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| Weight loss | Investigations | MedDRA 6 | Systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Blood glucose increased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Serum albumin decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Serum calcium decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Serum phosphate decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Serum potassium decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Serum sodium decreased | Metabolism and nutrition disorders | MedDRA 6 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Muscle weakness | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 6 | Systematic Assessment |
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| Tumor pain | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 6 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 6 | Systematic Assessment |
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| Peripheral motor neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
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| Peripheral sensory neuropathy | Nervous system disorders | MedDRA 6 | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA 6 | Systematic Assessment |
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| Hemorrhage urinary tract | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
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| Urinary frequency | Renal and urinary disorders | MedDRA 6 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 6 | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
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| Body odor | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
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| Skin hyperpigmentation | Skin and subcutaneous tissue disorders | MedDRA 6 | Systematic Assessment |
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| Flushing | Vascular disorders | MedDRA 6 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Elisabeth Iljas Heath, M.D. | Karmanos Cancer Institute at Wayne State University | heathe@karmanos.org |
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| C112765 | tanespimycin |
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