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Cabazitaxel With Radiation and Hormone Therapy for Prostate Cancer

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

Condition(s) targeted: Prostate Cancer

Intervention: Cabazitaxel (Drug); Intensity Modulated Radiation Therapy (IMRT) (Radiation); Anti-Androgen Therapy: Bicalutamide (Drug); Luteinizing Hormone-Releasing Hormone (LHRH) Agonist (Genetic)

Phase: Phase 1

Status: Recruiting

Sponsored by: Thomas Jefferson University

Official(s) and/or principal investigator(s):
Jianqing Lin, MD, Principal Investigator, Affiliation: Thomas Jefferson University

Overall contact:
Jianqing Lin, MD, Phone: 215-955-8874

Summary

This is a single-center, open-label, non-randomized Phase I study of weekly Cabazitaxel with concurrent intensity modulated radiation therapy (IMRT) (A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles.) and androgen deprivation therapy (Treatment to suppress or block the production or action of male hormones) in patients with locally advanced prostate cancer. It is hoped that by adding Cabazitaxel to the standard IMRT, greater local disease control can be achieved and eventually the cure rate can be increased. After this study, the maximally tolerated dose of Cabazitaxel that could be used in combination with radiation can be found. Men with locally advanced high risk prostate cancer represent a group of patients for whom cure is potentially achievable utilizing a multimodality approach. More aggressive treatment upfront with chemotherapy and ADT may improve the long term disease control. We hypothesize that Cabazitaxel may be added to radiation therapy safely, and we anticipate that this novel approach will improve disease control and eventually improve survival for locally advanced prostate cancer patients.

Clinical Details

Official title: Phase I Trial of Weekly Cabazitaxel With Concurrent Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy for the Treatment of Locally Advanced High Risk Adenocarcinoma of the Prostate

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

Primary outcome: Maximally Tolerated Dose (MTD) of Cabazitaxel and Intensity Modulated Radiation Therapy (IMRT)

Secondary outcome:

Acute and Late Non-Hematologic and Hematologic Toxicity Profile of Cabazitaxel and Intensity Modulated Radiation Therapy (IMRT) Combination

5-Year Biochemical Relapse Free Survival

Detailed description: Patients with locally advanced high Gleason grade prostate cancer often have local and metastatic disease progression. To improve on these outcomes, therapy needs to be directed at controlling the androgen sensitive and insensitive prostate cancer cells in the primary and metastatic sites. This therapeutic challenge has further prompted the use of combined modality approaches incorporating chemotherapy and hormonal therapy with radiation aimed at the intrinsically resistant cells and the micrometastatic disease that are both androgen sensitive and resistant. High likelihood of occult metastatic disease and existence of intrinsically castration resistant cells are the main rationales for early institution of androgen deprivation therapy (ADT) and chemotherapy in prostate cancer. The rationale for combining chemotherapeutic agents with ADT and radiotherapy in high risk prostate cancer patients is based on that chemotherapy can enhance radiotherapy and is also an effective therapy for metastatic castrate resistant disease. Prior studies with weekly docetaxel with ADT and intensity modulated radiation therapy (IMRT) were safe and feasible however cabazitaxel is more potent mitotic inhibitor which may further enhance the outcomes of patients with locally advanced prostate cancer. Men with locally advanced high risk prostate cancer represent a group of patients for whom cure is potentially achievable utilizing a multimodality approach. More aggressive treatment upfront with chemotherapy and ADT would improve the long term disease control. We hypothesize that Cabazitaxel may be added to radiation therapy safely, and we anticipate that this novel approach will improve disease control and eventually improve survival for locally advanced prostate cancer patients. The safety of the combination of Cabazitaxel with radiation will be established after this study. Potential efficacy will be determined in the future phase II/III trials. Hypofraction radiation treatment with shorter duration maybe possible if combined with chemotherapy modality.

Eligibility

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

Criteria:

Inclusion Criteria:

- Adenocarcinoma of the prostate with locally advanced prostate cancer without distant

metastatic with unfavorable risk features that are defined below:

- Gleason score ≥8

- Gleason score 7 and T3/T4 disease

- Gleason score 7 but PSA ≥20

- Karnofsky Performance Status >70,

- Age > 18

- Performance Status: ECOG ≤2

- Peripheral neuropathy: must be < grade 1

- Hematologic (minimal values):

- Absolute neutrophil count > 1,500/mm3

- Hemoglobin > 8. 0 g/dl

- Platelet count > 100,000/mm3

- Hepatic function

- Total bilirubin < Upper limit of normal (ULN)(except for Gilbert's disease)

- AST (SGOT) < 1. 5 x ULN

- ALT (SGPT) < 1. 5 x ULN

- Creatinine < 1. 5 x ULN

- Men of childbearing potential must be willing to consent to using effective

contraception while on treatment and for at least 3 months thereafter.

- No history of previous chemotherapy or pelvic irradiation

Exclusion Criteria:

- Patients with a history of severe hypersensitivity reaction to Cabazitaxel or other

drugs formulated with polysorbate 80.

- History of urological surgery or procedures predisposing to GU complications after

radiation (will be determined by radiation oncologist)

- History of diverticulitis, rectal bleeding or other lower GI diseases predisposing to

GI complications after radiation (will be determined by radiation oncologist)

- History of prior chemotherapy or pelvic irradiation,

- History of prior invasive malignant cancer(s) within the last 5 years except

adequately treated or controlled basal cell or squamous cell carcinoma of the skin

- Documented distant metastatic disease.

- Prior radical prostatectomy or cryosurgery for prostate cancer or bilateral

orchiectomy

Locations and Contacts

Jianqing Lin, MD, Phone: 215-955-8874

Thomas Jefferson University, Philadelphia, Pennsylvania 19107, United States; Recruiting
Jianqing Lin, MD, Phone: 215-955-8874
Clinical Research Management Office, Phone: 215-955-1661
Jianqing Lin, MD, Principal Investigator
William Kevin Kelly, DO, Sub-Investigator
Jean Hoffman-Censits, MD, Sub-Investigator
Adam Dicker, MD, PhD, Sub-Investigator
Wenyin Shi, MD, PhD, Sub-Investigator
Edouard Trabulsi, MD, Sub-Investigator
Ruth Birbe, MD, Sub-Investigator
Hushan Yang, PhD, Sub-Investigator
Robert Den, MD, Sub-Investigator
Mark Hurwitz, MD, Sub-Investigator
Additional Information

Kimmel Cancer Center at Thomas Jefferson University, an NCI-Designated Cancer Center

Thomas Jefferson University Hospitals

Starting date: September 2011
Last updated: April 24, 2015

Page last updated: August 23, 2015

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