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Eligible patients will be enrolled in one of 4 cohorts where each cohort will allow 3 patients to be on study. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. Once the pre-specified 400 mg by mouth two times a day (PO BID) dosing for both drugs is reached without toxicity, the study will close for accrual. If toxicity is noted prior to reaching the 400 mg PO BID dosing, then the dosing schedule that is deemed safest as per study design will be the one used for any future phase II study.
Gleevec and Sorafenib have modest efficacy in androgen-independent prostate cancer (AIPC) and the fact that both agents can be given orally with what appears to be tolerable side effects, we hypothesize that combining both agents may provide patients with another effective regimen in a disease where therapeutic options are limited. This study is designed to investigate the safety of combining Gleevec and Sorafenib as well as feasibility in AIPC patients who have failed one or more lines of systemic chemotherapy. Once safety is established, a follow-up phase II study will commence to investigate efficacy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental | Only 1 arm for the study - this arm gets both drugs, gleevec and sorafenib |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gleevec + Sorafenib | Drug | 400 mg Sorafenib every day (QD) 300mg Gleevec QD |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Experiencing Dose Limiting Toxicities (DLT's) | Eligible patients were enrolled in one of 4 cohorts, where each cohort allowed 3 evaluable patients to be on study, patients withdrawn from treatment for reasons other than toxicity were not considered evaluable. If one of the three evaluable patients experienced a dose limiting toxicity (DLT) the cohort was expanded to 6 evaluable patients. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. If 2 out of six evaluable patients experience a dose limiting toxicity this would show that the Maximum Tolerated Dose (MTD) was the dose from the prior cohort. | up to 20 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Clinical Benefit | Overall Clinical Benefit was measured as the sum of complete response (CR), partial response (PR), and stable disease (SD). | up to 20 weeks |
| Time to Disease Progression (TTP) |
Not provided
Inclusion Criteria:
Patients 18 years of age or older.
Histologically documented diagnosis of Prostate Cancer regardless of Gleason score.
Androgen-Independent Prostate Cancer
At least one measurable site of disease
Patients must have failed one or more lines of systemic chemotherapy, regardless of the chemotherapeutic agent used. There is NO limit to how many lines of chemotherapy a patient can receive
Patients receiving anti-coagulation treatment with an agent such as heparin may be allowed to participate. Patients on Warfarin are NOT allowed to participate.
Last chemotherapy exposure 4 weeks prior to study entry
Prior exposure to Sorafenib is allowed as long as last Sorafenib dose was 3 weeks or more from study entry
Prior exposure to Gleevec is an EXCLUSION
Progression after chemotherapy can be demonstrated radiographically (as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria) or biochemically with prostate-specific antigen (PSA) being elevated more than 25% than previous value as long as a repeat PSA confirms progression. (repeat PSA should be done within 3 weeks from the last one). Patients with bone-only disease are considered progressing if there are two more lesions on a new bone scan.
Performance status 0,1, 2 (ECOG)
Adequate end organ function, defined as the following:
Men of childbearing potential must agree to employ an effective barrier method of birth control prior to the study entry, throughout the duration of the study and for up to 3 months following discontinuation of study drug.
Written, voluntary informed consent.
Patients are allowed the following concurrent therapies:
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, S.C | Niles | Illinois | 60714 | United States | ||
| Oncology Specialists, S.C |
Patients enrolled failed previous chemotherapy.
17 patients were enrolled from our practice.
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| ID | Title | Description |
|---|---|---|
| FG000 | Imatinib + Sorafenib | Both drugs, Gleevec + Sorafenib are given to all patients on study. There are 4 potential cohorts. Each will enroll 3 evaluable (patients that complete 2 cycles of treatment) patients. If a Dose Limiting Toxicity is demonstrated in a cohort, an additional 3 evaluable patients can be enrolled in that cohort. Cohort 0 was 400mg Sorafenib every day (QD)and 300mg of Imatinib QD. Cohort 1 was 400mg Sorafenib two times a day and 300mg QD Imatinib. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cohort 0 |
|
| |||||||||||||||||||||
| Cohort 1 |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm 1 | Only 1 arm for the study - this arm gets both drugs, gleevec and sorafenib |
| 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 | Number of Patients Experiencing Dose Limiting Toxicities (DLT's) | Eligible patients were enrolled in one of 4 cohorts, where each cohort allowed 3 evaluable patients to be on study, patients withdrawn from treatment for reasons other than toxicity were not considered evaluable. If one of the three evaluable patients experienced a dose limiting toxicity (DLT) the cohort was expanded to 6 evaluable patients. Patients will receive both study drugs on escalated dosing schedule until the maximum of 400 mg PO BID is reached for both drugs or toxicity is established. If 2 out of six evaluable patients experience a dose limiting toxicity this would show that the Maximum Tolerated Dose (MTD) was the dose from the prior cohort. | Cohort 0: 6 evaluable patients were enrolled. Patients who withdrew for reasons other than toxicity were not considered evaluable for MTD. 1 out of 6 patients had a DLT, therefore Cohort 1 was started. Cohort 1: 2 DLTs were demonstrated from 5 evaluable patients. By definition the Maximum tolerated dose was the dosing schedule used in cohort 0. | Posted | Number | participants | up to 20 weeks |
|
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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 | Arm 1 | Only 1 arm for the study - this arm gets both drugs, gleevec and sorafenib |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Broken C2 verebrae | Musculoskeletal and connective tissue disorders |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sigrun Hallmeyer, MD Director of Research; Chadi Nabhan, MD FACP (PI) | Oncology Specialists, SC | 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 |
|---|---|
| D000068877 | Imatinib Mesylate |
| D000077157 | Sorafenib |
| ID | Term |
|---|---|
| D001549 | Benzamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D001565 | Benzoates |
| D000146 |
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Medium TTP is 2 months (range 1-5). 10 patients were evaluable for disease progression for these patients occurred between 1-5 months after starting the study. The TTP was calculated per protocol. For radiographic assessment Response Evaluation Criteria in Solid Tumors (RECIST) was used. Complete response = disappearance of all lesions. Partial response (PR)=30% or greater decrease in sum of longest diameter of measureable lesions SD. Lesions have no sufficient decrease for progressive disease and no sufficient increase to meet Progressive Disease (PD). PD more than 20% increase in sum of longest diameter of measurable lesions or 2 or more new bone mets. prostate-specific antigen (PSA) assessment for patients with measurable disease, PSA progression in the absence of measurable disease progression will not be considered progressive disease.
| up to 5 cycles, an average of 20 weeks, from the day of first treatment until the date of the last dose of study drug |
| Park Ridge |
| Illinois |
| 60068 |
| United States |
|
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG000 | Imatinib + Sorafenib Cohort 0 | 300mg every day (QD)Imatinib + 400mg every day (QD) Sorafenib, by mouth |
| OG001 | Imatinib + Sorafenib Cohort 1 | 300mg every day (QD) Imatinib + 400mg twice daily (BID)Sorafenib, by mouth |
|
|
| Secondary | Overall Clinical Benefit | Overall Clinical Benefit was measured as the sum of complete response (CR), partial response (PR), and stable disease (SD). | There were 17 patients enrolled. 10 were evaluable for assessment of overall clinical benefit. 7 were not evaluable due to having received <1 cycle of drug. | Posted | Number | percentage of evaluable participants | up to 20 weeks |
|
|
|
| Secondary | Time to Disease Progression (TTP) | Medium TTP is 2 months (range 1-5). 10 patients were evaluable for disease progression for these patients occurred between 1-5 months after starting the study. The TTP was calculated per protocol. For radiographic assessment Response Evaluation Criteria in Solid Tumors (RECIST) was used. Complete response = disappearance of all lesions. Partial response (PR)=30% or greater decrease in sum of longest diameter of measureable lesions SD. Lesions have no sufficient decrease for progressive disease and no sufficient increase to meet Progressive Disease (PD). PD more than 20% increase in sum of longest diameter of measurable lesions or 2 or more new bone mets. prostate-specific antigen (PSA) assessment for patients with measurable disease, PSA progression in the absence of measurable disease progression will not be considered progressive disease. | Posted | Median | Full Range | months | up to 5 cycles, an average of 20 weeks, from the day of first treatment until the date of the last dose of study drug |
|
|
|
| 6 |
| 17 |
| 17 |
| 17 |
| Pain | General disorders |
|
| Nausea | Gastrointestinal disorders |
|
| Vomiting | Gastrointestinal disorders |
|
| Urinary Tract Infection | Renal and urinary disorders |
|
| Chest pain | Cardiac disorders |
|
| Syncopal episode | Cardiac disorders |
|
| Dehydration | Gastrointestinal disorders |
|
| Diarrhea | Gastrointestinal disorders |
|
| Weakness | General disorders |
|
| Atrial Fibrillation | Cardiac disorders |
|
| Syndrome of Inappropriate Antiduretic Hormone | General disorders |
|
| Appetite decreased | Gastrointestinal disorders |
|
| Arthralgia | Musculoskeletal and connective tissue disorders |
|
| Albumin Low | Gastrointestinal disorders |
|
| Bruises easily | General disorders |
|
| Alopecia | General disorders |
|
| Anxiety | Psychiatric disorders |
|
| Atrial Fibrillation | Cardiac disorders |
|
| Alkaline Phosphatase | Hepatobiliary disorders |
|
| AST increased | Hepatobiliary disorders |
|
| Bilirubin increased | Renal and urinary disorders |
|
| Chest Pain | Cardiac disorders |
|
| Chloride Low | General disorders |
|
| Chills | General disorders |
|
| Constipation | Gastrointestinal disorders |
|
| Cough | Respiratory, thoracic and mediastinal disorders |
|
| Creatinine Increased | Renal and urinary disorders |
|
| Alt Increased | Hepatobiliary disorders |
|
| Eyes tearing | Eye disorders |
|
| Edema lower extremity | General disorders |
|
| Edema periorbital | General disorders |
|
| Edema ankle | General disorders |
|
| Ear sore | Ear and labyrinth disorders |
|
| Fatigue | General disorders |
|
| Foot pain | Musculoskeletal and connective tissue disorders |
|
| Fever | Infections and infestations |
|
| Fall | General disorders |
|
| Desquamation | Skin and subcutaneous tissue disorders |
|
| Diarrhea | Gastrointestinal disorders |
|
| Dehydration | Gastrointestinal disorders |
|
| Dyspnea on Excertion | Respiratory, thoracic and mediastinal disorders |
|
| Depression | Psychiatric disorders |
|
| Hypotension | Cardiac disorders |
|
| Hand Foot Syndrome | Skin and subcutaneous tissue disorders |
|
| Hypokalemia | Gastrointestinal disorders |
|
| Hypercalcemia | Gastrointestinal disorders |
|
| Hematuria | Renal and urinary disorders |
|
| Hypocalcemia | Gastrointestinal disorders |
|
| Hyperkalemia | Gastrointestinal disorders |
|
| Hyponatremia | Gastrointestinal disorders |
|
| Hot Flashes | General disorders |
|
| Hyperglycemia | Endocrine disorders |
|
| Insomnia | General disorders |
|
| Itching | Skin and subcutaneous tissue disorders |
|
| Infection | Infections and infestations |
|
| Leukopenia | Blood and lymphatic system disorders |
|
| Lymphopenia | Blood and lymphatic system disorders |
|
| Libido decreased | Reproductive system and breast disorders |
|
| Muscle Pain | Musculoskeletal and connective tissue disorders |
|
| Mouth Dry | Gastrointestinal disorders |
|
| Mucositis | Gastrointestinal disorders |
|
| Magnesium decreased | Gastrointestinal disorders |
|
| Neck Pain | Musculoskeletal and connective tissue disorders |
|
| Neuropathy | Musculoskeletal and connective tissue disorders |
|
| Neutropenia | Blood and lymphatic system disorders |
|
| Nail Changes | Skin and subcutaneous tissue disorders |
|
| Nausea | Gastrointestinal disorders |
|
| Oral candidiasis | Gastrointestinal disorders |
|
| Pancytopenia | Blood and lymphatic system disorders |
|
| Palmar erythema | Skin and subcutaneous tissue disorders |
|
| Pain | General disorders |
|
| Phosphorus High | Gastrointestinal disorders |
|
| Photo Sensitivity | Skin and subcutaneous tissue disorders |
|
| Total Protein Decreased | Gastrointestinal disorders |
|
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| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D010879 | Piperazines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011743 | Pyrimidines |
| D010671 | Phenylurea Compounds |
| D014508 | Urea |
| D009536 | Niacinamide |
| D009539 | Nicotinic Acids |
| D000147 | Acids, Heterocyclic |
| D011725 | Pyridines |