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Ixabepilone Compared With Mitoxantrone and Prednisone in Treating Patients With Refractory Metastatic Prostate Cancer

Information source: National Cancer Institute (NCI)
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Adenocarcinoma of the Prostate; Recurrent Prostate Cancer; Stage IV Prostate Cancer

Intervention: ixabepilone (Drug); mitoxantrone hydrochloride (Drug); prednisone (Drug)

Phase: Phase 2

Status: Completed

Sponsored by: National Cancer Institute (NCI)

Official(s) and/or principal investigator(s):
Jonathan Rosenberg, Principal Investigator, Affiliation: University of California, San Francisco


This randomized phase II trial is studying ixabepilone to see how well it works compared to mitoxantrone and prednisone in treating patients with metastatic prostate cancer that has not responded to paclitaxel, docetaxel, or hormone therapy. Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. Some tumors become resistant to chemotherapy drugs. Ixabepilone may reduce resistance to the drugs and allow the tumor cells to be killed. It is not yet known which chemotherapy regimen is more effective in treating metastatic prostate cancer

Clinical Details

Official title: A Randomized Phase II Study Of BMS 247550 Or Mitoxantrone And Prednisone In Patients With Taxane Resistant Hormone Refractory Prostate Cancer

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Response to the randomized treatment as determined by > 50% PSA response as measured by RECIST criteria

Secondary outcome:

Frequency of any toxicity by grade

Response duration

Time to progressive disease

Frequency of response to third-line (crossover) therapy

Detailed description: PRIMARY OBJECTIVES: I. Determine the efficacy of ixabepilone (BMS-247550) vs mitoxantrone and prednisone, in terms of decline in prostate-specific antigen (PSA) levels, in patients with taxane-resistant, hormone-refractory metastatic prostate cancer. SECONDARY OBJECTIVES: I. Determine the safety of these regimens in these patients. II. Determine the objective response rate in patients with measurable disease who are treated with these regimens. III. Determine the clinical activity of each of these regimens after crossover in patients who experience disease progression on their originally assigned treatment arm and switch to the other treatment arm. OUTLINE: This is a randomized, crossover, multicenter study. Patients are stratified according to ECOG performance status (0 vs 1 or 2). Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive ixabepilone (BMS-247550) IV over 3 hours on day 1. ARM II: Patients receive mitoxantrone IV over 30 minutes on day 1 and oral prednisone twice daily on days 1-21. In both arms, courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients who progress while on treatment after at least 2 courses or discontinue treatment for any other reason may cross over to the other arm and receive treatment as above, beginning within 12 weeks of last study treatment on original arm. Patients are followed every 3 months.


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


Inclusion Criteria:

- Histologically confirmed adenocarcinoma of the prostate

- Metastatic disease (positive bone scan or measurable disease)

- Progressive hormone-refractory disease

- Based on 1 of the following:

- Transaxial imaging

- Rise in prostate-specific antigen (PSA)

- Radionuclide bone scan

- Must have undergone primary hormonal treatment (e. g., orchiectomy or

gonadotropin-releasing hormone analog with or without an antiandrogen) and demonstrated disease progression after antiandrogen discontinuation as defined below:

- Two consecutive rising PSA values, obtained at least 2 weeks apart, or

documented osseous or soft tissue progression

- For patients receiving flutamide, at least 1 PSA value must be obtained at

least 4 weeks after flutamide discontinuation

- For patients receiving bicalutamide or nilutamide, at least 1 PSA value

must be obtained at least 6 weeks after antiandrogen discontinuation

- Ineligible if sole manifestation of progression is an increase in

disease-related symptoms

- Meets 1 of the following criteria:

- Measurable disease and an elevated PSA

- Nonmeasurable disease and an elevated PSA, as follows:

- Positive bone scan

- PSA level at least 5 ng/mL, with increases on at least 2 successive

occasions at least 2 weeks apart

- New metastatic lesions by radionuclide bone scan

- Must have received at least 2 courses of paclitaxel- or docetaxel-based therapy, with

disease progression documented during therapy or no more than 60 days after cessation of therapy*

- Testosterone < 50 ng/dL

- No known active brain metastases

- Performance status - ECOG 0-2

- At least 12 weeks

- Granulocyte count ≥ 1,500/mm^3

- Platelet count ≥ 100,000/mm^3

- Bilirubin < 1. 5 times upper limit of normal (ULN)

- AST and ALT < 3 times ULN

- Creatinine ≤ 1. 5 times ULN

- Creatinine clearance > 40 mL/min

- Ejection fraction ≥ lower limit of normal by MUGA or echocardiogram

- No myocardial infarction within the past 6 months

- No significant cardiovascular disease

- No New York Heart Association class III or IV congestive heart failure

- No active angina pectoris

- Fertile patients must use effective contraception before, during, and for 3 months

after study therapy

- No prior hypersensitivity reaction to agents containing Cremophor®EL

- No serious infection

- No nonmalignant medical illnesses that are uncontrolled or whose control would be

jeopardized by complications of study therapy

- No psychiatric illness or social situation that would preclude study compliance

- No motor or sensory neuropathy grade 2 or greater

- No "currently active" second malignancy except nonmelanoma skin cancer

- Patients are not considered to have a "currently active" malignancy provided

they have completed therapy and are considered to have less than a 30% risk of relapse

- No concurrent prophylactic colony-stimulating factors for myelosuppression

- See Disease Characteristics

- No more than 1 prior chemotherapy regimen

- No prior mitoxantrone or epothilone

- No other concurrent chemotherapy

- See Disease Characteristics

- At least 4 weeks since prior antiandrogens (e. g., flutamide) (6 weeks for

bicalutamide or nilutamide)

- Patients must continue primary androgen deprivation therapy with luteinizing

hormone-releasing hormone agonist during study if prior orchiectomy was not performed

- At least 4 weeks since prior systemic (including oral) corticosteroids except

corticosteroids as part of first-line chemotherapy tapered off over 10-14 days prior to study entry

- At least 4 weeks since any prior hormonal therapy, including megestrol or finasteride

- No other concurrent systemic steroids

- At least 4 weeks since prior radiotherapy

- More than 8 weeks since prior radiopharmaceuticals (e. g., strontium chloride Sr 89 or

samarium Sm 153 lexidronam pentasodium)

- No concurrent radiotherapy

- See Disease Characteristics

- At least 4 weeks since prior herbal products known to decrease PSA levels (e. g., Saw

Palmetto or PC-SPES)

- More than 4 weeks since other prior antiprostate cancer therapy

- More than 4 weeks since prior systemic therapies for prostate cancer

- No other concurrent investigational agents

Locations and Contacts

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California 94143-0875, United States
Additional Information

Starting date: March 2003
Last updated: January 14, 2013

Page last updated: August 23, 2015

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