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Pazopanib, Docetaxel, Prednisone Prostate

Information source: Duke University
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Prostate Cancer

Intervention: Pazopanib (Drug); Docetaxel (Drug); Pazopanib (Drug); Prednisone (Drug); Pegfilgrastim (Drug)

Phase: Phase 1

Status: Active, not recruiting

Sponsored by: Daniel George, MD

Official(s) and/or principal investigator(s):
Daniel J George, MD, Principal Investigator, Affiliation: Duke Cancer Institute

Summary

The primary purpose is to define the safety and tolerability of docetaxel/prednisone in combination with pazopanib (DPP) in men with metastatic Castration Resistant Prostate Cancer (mCRPC).

Clinical Details

Official title: Phase I Study of Docetaxel, Prednisone and Pazopanib in Men With Metastatic Castrate-Resistant Prostate Cancer (mCRPC) and Poor-Risk Factors

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Number and Percent of Participants with Adverse Events as a Measure of Safety and Tolerability; Number and Percent of participants who have disease progression

Secondary outcome:

Establish the maximum tolerated dose

Measurement of pazopanib and docetaxel drug levels in participants.

Relationship between genetic variants and drug levels (Cmax, Tmax, AUC, CL, Vd).

Establish the optimal dosing schedule

Detailed description: This Phase I study will consist of a dose escalation portion which includes a dose escalation phase of 10 dose levels: (1a) docetaxel 60 mg/m2, pazopanib 400 mg daily, prednisone 5 mg BID; (2a) docetaxel 75 mg/m2, pazopanib 400 mg daily, prednisone 5 mg BID; and (3a) docetaxel 75 mg/m2, pazopanib 600 mg daily, prednisone 5 mg BID; (4a) docetaxel 75mg/m2, pazopanib 800 mg daily, (5a) docetaxel 75mg/m2, pazopanib 1000mg daily, prednisone 5 mg; (1b) docetaxel 60 mg/m2, pazopanib 400 mg daily x 17 days, prednisone 5 mg BID; (2b) docetaxel 75 mg/m2, pazopanib 400 mg daily x 17 days, prednisone 5 mg BID; and (3b) docetaxel 75 mg/m2, pazopanib 600 mg daily x 17 days, prednisone 5 mg BID; (4b) docetaxel 75mg/m2, pazopanib 800 mg daily x 17 days, (5b) docetaxel 75mg/m2, pazopanib 1000mg daily x 17 days, prednisone 5 mg. If the investigators see > 1 dose limiting toxicity (DLT) at Dose level 3 then the investigators would investigate docetaxel 75 mg/m2, pazopanib 600 mg daily, prednisone 5 mg BID (Dose level 3a). If < 1 DLT are seen at Dose level 3 and Pharmacokinetic (PK) analysis is complete and acceptable, then the investigators will proceed to dose level 4) docetaxel 75 mg/m2, pazopanib 1000 mg daily, prednisone 5 mg BID. The investigators will dose escalate in a classic 3+3 design. The maximum tolerated dose (MTD) will be defined as the highest dose level that does not result in 2 or more dose limiting toxicities (DLTs). A dose expansion at the MTD of 10-15 patients (up to a total of 36 patients) will be accrued in order to further describe the safety profile.

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Male.

Criteria:

Inclusion Criteria:

- Histologically confirmed carcinoma of the prostate. Histologic evidence may be

confirmed through local or metastatic biopsy review. Non-adenocarcinomas are permitted.

- Radiographic evidence of metastatic disease; non-evaluable, bone only metastasis is

permitted.

- Evidence of disease progression despite castrate levels of testosterone (<50 ng/dl).

- At the time of screening, at least 2 weeks since prior palliative radiation therapy

and 4 weeks from major surgery, and resolution of all toxic effects of prior therapy to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE); version 4. 0 Grade < 1.

- Age >18 years

- Adequate laboratory parameters

- Eastern Cooperative Oncology Group (ECOG) performance status between 0 and 2

- Life expectancy greater than 3 months

- Written, signed and dated Institutional Review Board (IRB) approved informed consent

form. Exclusion Criteria:

- History of or active central nervous system metastases

- The use of immunologic, biologic, or hormonal therapies within 2 weeks of study

entry.

- Major surgery, open biopsy, traumatic injury within 4 weeks of the screening visit

- Subjects who have not recovered from prior biopsy, surgery, traumatic injury, and/or

radiation therapy.

- Previous treatment with docetaxel, including in the neo-adjuvant or adjuvant setting

- Presence of non-healing wound or ulcer

- Grade 3 or greater hemorrhage within the past month.

- Uncontrolled hypertension

- American Heart Association Class 2-4 heart disease or any history of congestive heart

failure with an ejection fraction <40%, recent cardiovascular event (within 12 months) including unstable angina, any exertional angina, myocardial infarction, exertional or rest claudication, or stroke/Cerebral Vascular Event/Transient Ischemic Attack. Patients with known moderate to severe documented carotid or peripheral vascular disease are excluded. Angioplasty or stenting of coronary or peripheral arteries are exclusionary if within the past 12 months.

- Anticoagulation with warfarin (therapeutic doses of warfarin for catheter patency are

permitted up to 2 mg/day). Low molecular weight heparin is permitted.

- Diabetes mellitus with glycosylated hemoglobin A1c (HbgA1c) > 8% despite therapy

- Subjects with active autoimmune disorder(s) being treated with systemic

immunosuppressive agents within 4 weeks prior to the screening visit.

- Active infection(s), active antimicrobial therapy or serious intercurrent illness.

- Does not agree to use medically acceptable contraceptive methods while on study and

for 3 months after the last dose of pazopanib.

- Any other major medical or psychiatric illness that, in the investigator's judgment,

will substantially increase the risk associated with the subject's participation in this study, including inability to absorb oral medications.

- Known hypersensitivity to any of the components in the docetaxel infusion or other

medical reasons for not being able to receive adequate premedication (for example, antihistamine or anti-inflammatory agents).

- CalculatedQT (QTc) interval on baseline EKG > 500milliseconds

- History or presence of nephrotic syndrome

Locations and Contacts

The University of Chicago, Chicago, Illinois 60637, United States

Duke Cancer Institute, Durham, North Carolina 27710, United States

Additional Information

Starting date: June 2011
Last updated: February 3, 2015

Page last updated: August 23, 2015

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