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Objectives to evaluate the activity of Erlotinib in prostate cancer patients who are hormone refractory and androgen independent and have not been exposed to chemotherapy.
This is a phase II open label single center study that evaluates the activity, efficacy, and toxicity of single agent Tarceva in chemotherapy-naive AIPC patients. Patients will receive single agent Tarceva at 150 mg daily without interruption until disease progression, unacceptable toxicity, or investigator's discretion. Eligible patients are those with documented prostate cancer (regardless of Gleason Score) who are considered hormone refractory as defined below. All patients must fail an anti-androgen withdrawal trial if they were already on such therapy. If patients were on LHRH analogues alone, they must fail the addition of an anti-androgen before being classified as hormone refractory. All patients must have adequate organ functions as specified below and have an ECOG performance status of 2 or less. It is hypothesized that 25 patients will be needed to adequately assess the activity of Tarceva in AIPC.
The activity of Tarceva in other malignancies has been demonstrated with dosed ranging from 100 to 150 mg daily. It is acceptable not to interrupt therapy unless toxicity occurs of disease progression is documented. Starting patients at 150 mg daily seems to be the most logical step, but dose reductions will be implemented based on side effects and adverse events.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tarceva | Experimental | Tarceva 150 mg QD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tarceva | Drug | 150mg QD |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall Clinical Benefit of Tarceva in CRPC. | Overall Clinical Benefit = percentage of partial responders (PR)+ the percentage of patients with stable disease (SD). Partial Response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum. Stable Disease (SD)is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease, using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0). | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival | One year survival rate. | during study |
| Time to Disease Progression | Patients were evaluated for response biochemically and radiographically at each response assessment. RECIST 1.0 criteria were used for radiographic response. PSA measurement at a central laboratory was used to assess biochemical response. Patients must have had a baseline PSA of 5 ng/ml to be evaluated for PSA response. PSA was measured every 8 weeks. For patients with measurable disease radiographically, PSA progression was not considered as having progressive disease. Refer to study publication for details. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chadi Nabhan, MD | Oncology Specialists, SC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oncology Specialists, SC | Park Ridge | Illinois | 60068 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19616281 | Derived | Nabhan C, Lestingi TM, Galvez A, Tolzien K, Kelby SK, Tsarwhas D, Newman S, Bitran JD. Erlotinib has moderate single-agent activity in chemotherapy-naive castration-resistant prostate cancer: final results of a phase II trial. Urology. 2009 Sep;74(3):665-71. doi: 10.1016/j.urology.2009.05.016. Epub 2009 Jul 17. |
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Patients must have had adquate bone marrow function and, Eastern Cooperative Oncology Group (ECOG) <3, and measurable disease.
Eligible patients were those who met the criteria of Castration Resistant Prostate Cancer (CRPC)who had not yet received chemotherapy.
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| ID | Title | Description |
|---|---|---|
| FG000 | Tarceva | Tarceva 150 mg orally every day |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Tarceva | Tarceva 150 mg QD |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Overall Clinical Benefit of Tarceva in CRPC. | Overall Clinical Benefit = percentage of partial responders (PR)+ the percentage of patients with stable disease (SD). Partial Response (PR) is defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum. Stable Disease (SD)is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease, using Response Evaluation Criteria in Solid Tumors Criteria (RECIST v1.0). | Posted | Number | percentage of pts w/clinical benefit | 5 years |
|
|
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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 | Tarceva | Tarceva 150 mg QD |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest Pain | Musculoskeletal and connective tissue disorders |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Low Creatinine Grade 3 & 4 | Renal and urinary disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sigrun Hallmeyer, MD (Director of Research); Chadi Nabhan, MD, FACP (PI) | Oncology Specialists, S.C. | 847-268-8200 | shallmeyer@oncmed.net |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000069347 | Erlotinib Hydrochloride |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| 25 months |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Participants |
|
|
| Secondary | Overall Survival | One year survival rate. | Posted | Number | % of partcipants alive at one year | during study |
|
|
|
| Secondary | Time to Disease Progression | Patients were evaluated for response biochemically and radiographically at each response assessment. RECIST 1.0 criteria were used for radiographic response. PSA measurement at a central laboratory was used to assess biochemical response. Patients must have had a baseline PSA of 5 ng/ml to be evaluated for PSA response. PSA was measured every 8 weeks. For patients with measurable disease radiographically, PSA progression was not considered as having progressive disease. Refer to study publication for details. | 29 participants enrolled. only 22 were evaluable, 4 withdrew consent, 2 had rapid PSA increase & 1 had cord compression | Posted | Median | Full Range | months | 25 months |
|
|
|
| 12 |
| 29 |
| 29 |
| 29 |
| Shortness of Breath | Respiratory, thoracic and mediastinal disorders |
|
| Hypoxia | Respiratory, thoracic and mediastinal disorders |
|
| Hematuria | Renal and urinary disorders |
|
| Gastro Intestinal Bleed | Gastrointestinal disorders |
|
| Renal Failure | Renal and urinary disorders |
|
| Congestive Heart Failure | Cardiac disorders |
|
| Weakness | General disorders |
|
| Involuntary Movement of Hands and Arms | Musculoskeletal and connective tissue disorders |
|
| Dehydration | General disorders |
|
| Pneumonia | Respiratory, thoracic and mediastinal disorders |
|
| Pulmonary Emboli | Respiratory, thoracic and mediastinal disorders |
|
| Diarrhea | Gastrointestinal disorders |
|
| Bowel Obstruction | Gastrointestinal disorders |
|
| Decompensation | General disorders |
|
| Spinal Cord Compression | Musculoskeletal and connective tissue disorders |
|
| Cellulitis | Infections and infestations |
|
| Alkaline Phosphatase High Grade 3 & 4 | Blood and lymphatic system disorders |
|
| Fatigue Grade 3 & 4 | General disorders |
|
| Pneumonia Grade 3 & 4 | Infections and infestations |
|
| Rash Grade 3 & 4 | General disorders |
|
| Diarrhea Grade 3 & 4 | Gastrointestinal disorders |
|
| Aspartate Aminotransferase Elevated Grade 1 - 4 | Blood and lymphatic system disorders |
|
| Anemia Grade 1 & 2 | Blood and lymphatic system disorders |
|
| Arthralgia Grade 1 & 2 | Nervous system disorders |
|
| Appetite decreased Grade 1 & 2 | Gastrointestinal disorders |
|
| Anxiety Grade 1 & 2 | Renal and urinary disorders |
|
| Alkaline Phosphatase Increased Grade 1 & 2 | Renal and urinary disorders |
|
| Bruises easily | Vascular disorders |
|
| Calcium Low Grade 1 & 2 | Gastrointestinal disorders |
|
| Constipation Grade 1 & 2 | Gastrointestinal disorders |
|
| Chest Pain Grade 1 & 2 | General disorders |
|
| Chills Grade 1 & 2 | General disorders |
|
| Cough Grade 1 & 2 | Respiratory, thoracic and mediastinal disorders |
|
| Dsynea on Exertion Grade 1 & 2 | Respiratory, thoracic and mediastinal disorders |
|
| Depression Grade 1 & 2 | Psychiatric disorders |
|
| Dehydration Grade 1 - 4 | Gastrointestinal disorders |
|
| Diarrhea Grade 1 & 2 | Gastrointestinal disorders |
|
| Edema Grade 1 & 2 | General disorders |
|
| Fatigue Grade 1 - 4 | General disorders |
|
| Fever Grade 1 & 2 | Infections and infestations |
|
| Fungal Infection Grade 1 & 2 | Infections and infestations |
|
| Gastroesophageal Reflux Disease Grade 1 & 2 | Gastrointestinal disorders |
|
| Hand Foot Syndrome Grade 1 - 4 | Skin and subcutaneous tissue disorders |
|
| Hematuria Grade 1 & 2 | General disorders |
|
| Hemoptesis Grade 1 & 2 | Respiratory, thoracic and mediastinal disorders |
|
| Headache Grade 1 & 2 | Nervous system disorders |
|
| Hot Flashes Grade 1 & 2 | General disorders |
|
| Hives Grade 1 & 2 | Skin and subcutaneous tissue disorders |
|
| Hyperglycemia Grade 1 - 4 | Gastrointestinal disorders |
|
| Infection Grade 1 & 2 | Infections and infestations |
|
| Insomnia Grade 1 & 2 | Psychiatric disorders |
|
| Itching Grade 1 & 2 | Skin and subcutaneous tissue disorders |
|
| Lymphopenia Grade 1 - 4 | Blood and lymphatic system disorders |
|
| Lightheadedness Grade 1 & 2 | Nervous system disorders |
|
| Libido decreased Grade 1 & 2 | General disorders |
|
| Mouth Sores Grade 1 & 2 | Gastrointestinal disorders |
|
| Mouth Dry Grade 1 & 2 | Gastrointestinal disorders |
|
| Nail changes Grade 1 & 2 | Skin and subcutaneous tissue disorders |
|
| Potassium Decreased Grade 1 & 2 | Blood and lymphatic system disorders |
|
| Potassium Increased Grade 1 & 2 | Blood and lymphatic system disorders |
|
| Protein Decreased Grade 1 & 2 | Gastrointestinal disorders |
|
| Renal Insufficiency Grade 1 - 4 | Renal and urinary disorders |
|
| Swallowing Difficulty Grade 1 & 2 | Gastrointestinal disorders |
|
| Sodium Decreased Grade 1 & 2 | Gastrointestinal disorders |
|
| Taste Change Grade 1 & 2 | Gastrointestinal disorders |
|
| Urinary Tract Infection Grade 1 & 2 | Infections and infestations |
|
| Wheezing Grade 1 & 2 | Respiratory, thoracic and mediastinal disorders |
|
| Blood Urea Nitrogen increased Grade 1 & 2 | Renal and urinary disorders |
|
| Creatinine Increased Grade 1 & 2 | Renal and urinary disorders |
|
| Eyes dry Grade 1 & 2 | General disorders |
|
| Eyes Watery Grade 1 & 2 | General disorders |
|
| Memory Loss Grade 1 & 2 | General disorders |
|
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| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |