Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| OHSU-2656 | Other Identifier | OHSU IRB |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
RATIONALE: Drugs used in chemotherapy, such as paclitaxel poliglumex, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Estradiol may kill prostate cancer cells that no longer respond to hormone therapy. Giving paclitaxel poliglumex together with estradiol may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving paclitaxel poliglumex together with estradiol works in treating patients with stage IV prostate cancer.
OBJECTIVES:
Primary
Secondary
OUTLINE: This is a multicenter study.
Patients receive transdermal estradiol continuously (patches changed every 7 days) until the PSA level rises. Patients whose PSA increases above baseline or PSA decreases < 10% after 4 weeks of estradiol therapy or whose serum PSA reduction is < 50% after 12 weeks of estradiol therapy also receive paclitaxel poliglumex therapy. These patients receive paclitaxel poliglumex IV over 10-20 minutes on day 1. Treatment with paclitaxel poliglumex repeats every 28 days for up to 10 courses in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed every 6 months.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transdermal estradiol | Drug | Transdermal estradiol given 0.2mg/day for duration of study. | ||
| paclitaxel poliglumex | Drug | Paclitaxel poliglumex (PPX) is a macromolecular polymer-drug conjugate of paclitaxel. PPX was given every 28 days, at a dose of 150 mg/m2 |
| Measure | Description | Time Frame |
|---|---|---|
| Prostate Specific Antigen (PSA) Response Rate: Number of Subjects With Decreases in PSA of at Least 50% | PSA response rate is defined at the number of patients who experienced a PSA decline of equal to or greater than 50%, confirmed by a second measurement at least 4 weeks later. | While receiving study agents (on average, 3 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Measurable Disease Response Rate (Soft Tissue) | Measurable disease response rate by RECIST criteria. Response is defined as at least a 30% decrease in the sum of the longest diameter in measurable lesions (larger than 10mm at baseline). | While receiving study agents (on average, 3 months) |
| Time to Disease Progression |
Not provided
DISEASE CHARACTERISTICS:
Histologically confirmed adenocarcinoma of the prostate
Stage IV disease
Evidence of disease progression (by PSA and/or imaging studies) despite standard hormonal therapy and after exposure to docetaxel-containing chemotherapy, as evidenced by any of the following:
Measurable or evaluable disease progression, defined as the appearance of new lesion(s) or unequivocal increase in previously existing lesions or masses
Disease progression by PSA*, defined by 1 of the following:
Must have received prior therapy with at least two 3-weekly doses or six weekly doses of docetaxel
Serum testosterone < 50 ng/dL (unless surgically castrate)
No known or suspected brain metastases
PATIENT CHARACTERISTICS:
ECOG performance status 0-2
Life expectancy > 3 months
Absolute neutrophil count ≥ 1,500/mm³
Platelet count ≥ 100,000/mm³
Creatinine ≤ 1.5 times upper limit of normal (ULN)
Bilirubin ≤ 1.5 times ULN
AST and ALT ≤ 2.5 times ULN
No other active malignancy except adequately treated nonmelanoma skin cancer or other noninvasive or in situ neoplasm
No other significant active medical illness or infection that would preclude study compliance
No significant cardiovascular illness, including any of the following:
No significant peripheral neuropathy ≥ grade 2
PRIOR CONCURRENT THERAPY:
See Disease Characteristics
At least 6 weeks since prior antiandrogen therapy (4 weeks for flutamide)
More than 4 weeks since prior radiotherapy
More than 8 weeks since prior radiopharmaceutical therapy (strontium chloride Sr 89, samarium Sm 153 lexidronam pentasodium)
No prior paclitaxel
No other concurrent cytotoxic agents
No other concurrent chemotherapy or biologic response modifiers
No concurrent supplements known or suspected to contain supplemental estrogens
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Tomasz M. Beer, MD | OHSU Knight Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCSF Helen Diller Family Comprehensive Cancer Center | San Francisco | California | 94115 | United States | ||
Not provided
Twenty-one patients enrolled in the trial between March 2007 and May 2008 in the medical clinics at Oregon Health & Science University and the University of California at San Francisco.
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Transdermal Estradiol and Paclitaxel Poliglumex | All subjects enrolled were treated with transdermal estradiol 0.2 mg/24 hours for 4 weeks followed by the same dose of transdermal estradiol and paclitaxel poliglumex PPX 150 mg/m2 IV every 28 days. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Transdermal Estradiol and Paclitaxel Poliglumex | All subjects enrolled were treated with transdermal estradiol 0.2 mg/24 hours for 4 weeks followed by the same dose of transdermal estradiol and paclitaxel poliglumex PPX 150 mg/m2 IV every 28 days. |
| 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 | Prostate Specific Antigen (PSA) Response Rate: Number of Subjects With Decreases in PSA of at Least 50% | PSA response rate is defined at the number of patients who experienced a PSA decline of equal to or greater than 50%, confirmed by a second measurement at least 4 weeks later. | Posted | Number | Participants | While receiving study agents (on average, 3 months) |
|
|
While on study agents
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Transdermal Estradiol and Paclitaxel Poliglumex | All subjects enrolled were treated with transdermal estradiol 0.2 mg/24 hours for 4 weeks followed by the same dose of transdermal estradiol and paclitaxel poliglumex PPX 150 mg/m2 IV every 28 days. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Gastric Hemorrhage | Gastrointestinal disorders | CTCAE v. 3.0 | Subject admitted for gastric hemorrhage and thrombocytopenia. Event determined to be possibly related to study agents. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| hemoglobin decreased | Blood and lymphatic system disorders | CTCAE (3.0) |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Coordinator | Oregon Health & Science University Knight Cancer Institute | (503) 494-2897 | eilersk@ohsu.edu |
Not provided
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
Not provided
Not provided
| ID | Term |
|---|---|
| C509139 | paclitaxel poliglumex |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Time from Day 1 to Day of meeting criteria for PSA or Measurable Disease Progression |
| At time of progression by PSA or RECIST criteria |
| Time to Death | Defined as time from Day 1 of study regimen to Date of death from any cause. | Measured at Date of Death from any cause |
| Correlation of Levels of Serum Estradiol, Serum Cathepsin B, and Bone Turnover Markers With PSA Response | These correlative analyses were not completed. As there were no PSA responses, it was not possible to correlate serum estradiol, serum cathepsin B, or bone turnover markers with PSA response. | Measured after 4 cycles of combination therapy |
| OHSU Knight Cancer Institute |
| Portland |
| Oregon |
| 97239-3098 |
| United States |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Participants |
|
|
| Secondary | Measurable Disease Response Rate (Soft Tissue) | Measurable disease response rate by RECIST criteria. Response is defined as at least a 30% decrease in the sum of the longest diameter in measurable lesions (larger than 10mm at baseline). | Posted | Number | Participants | While receiving study agents (on average, 3 months) |
|
|
|
| Secondary | Time to Disease Progression | Time from Day 1 to Day of meeting criteria for PSA or Measurable Disease Progression | Posted | Median | 95% Confidence Interval | Days | At time of progression by PSA or RECIST criteria |
|
|
|
| Secondary | Time to Death | Defined as time from Day 1 of study regimen to Date of death from any cause. | Posted | Median | 95% Confidence Interval | Months | Measured at Date of Death from any cause |
|
|
|
| Secondary | Correlation of Levels of Serum Estradiol, Serum Cathepsin B, and Bone Turnover Markers With PSA Response | These correlative analyses were not completed. As there were no PSA responses, it was not possible to correlate serum estradiol, serum cathepsin B, or bone turnover markers with PSA response. | Posted | Measured after 4 cycles of combination therapy |
|
|
| 3 |
| 21 |
| 20 |
| 21 |
|
| Pneumonitis | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Subject admitted with lethargy, cough and elevated temperature. Chest X-ray demonstrated pneumonitis. Event determined to be possibly related to study agents. |
|
| Nausea and Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Subject admitted for intractable nausea and vomiting. Abdominal ultrasound was normal. Event deemed possibly related to study agents |
|
| Leukopenia | Blood and lymphatic system disorders | CTCAE (3.0) |
|
| Lymphopenia | Blood and lymphatic system disorders | CTCAE (3.0) |
|
| Thrombocytopenia | Blood and lymphatic system disorders | CTCAE (3.0) |
|
| Fatigue | General disorders | CTCAE (3.0) |
|
| Rash | Skin and subcutaneous tissue disorders | CTCAE (3.0) |
|
| Anorexia | Gastrointestinal disorders | CTCAE (3.0) |
|
| Constipation | Gastrointestinal disorders | CTCAE (3.0) |
|
| Diarrhea | Gastrointestinal disorders | CTCAE (3.0) |
|
| Nausea | Gastrointestinal disorders | CTCAE (3.0) |
|
| Vomiting | Gastrointestinal disorders | CTCAE (3.0) |
|
| Edema | Blood and lymphatic system disorders | CTCAE (3.0) |
|
| Alkaline Phosphatase increased | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Aspartate aminotransferase increased | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hyperbilirubinemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hyperglycemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hyperkalemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hypoalbuminemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hypocalcemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hypokalemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hyponatremia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Hypophosphatemia | Metabolism and nutrition disorders | CTCAE (3.0) |
|
| Peripheral Sensory Neuropathy | Nervous system disorders | CTCAE (3.0) |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) |
|
| Breast pain | Reproductive system and breast disorders | CTCAE (3.0) |
|
| Gynecomastia | Reproductive system and breast disorders | CTCAE (3.0) |
|
Not provided
| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |