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Ixabepilone Compared With Mitoxantrone and Prednisone in Treating Patients With Refractory Metastatic Prostate Cancer
This study has been completed.
Sponsors and Collaborators: UCSF Helen Diller Family Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00058084
  Purpose

RATIONALE: 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.

PURPOSE: 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.


Condition Intervention Phase
Prostate Cancer
Drug: ixabepilone
Drug: mitoxantrone hydrochloride
Drug: prednisone
Phase II

MedlinePlus related topics: Cancer Prostate Cancer
Drug Information available for: Mitoxantrone hydrochloride Mitoxantrone Prednisone Ixabepilone
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Active Control
Official Title: A Randomized Phase II Study Of BMS 247550 Or Mitoxantrone And Prednisone In Patients With Taxane Resistant Hormone Refractory Prostate Cancer

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Response as measured by RECIST criteria [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Frequency of toxicity [ Designated as safety issue: Yes ]
  • Response duration [ Designated as safety issue: No ]
  • Time to progressive disease [ Designated as safety issue: No ]
  • Frequency of response to third-line (crossover) therapy [ Designated as safety issue: No ]

Study Start Date: March 2003
Primary Completion Date: September 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • 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

  • Determine the safety of these regimens in these patients.
  • Determine the objective response rate in patients with measurable disease who are treated with these regimens.
  • 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.

PROJECTED ACCRUAL: A total of 80 patients (40 per treatment arm) will be accrued for this study within 10 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • 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* NOTE: *For patients with PSA progression, confirmatory PSA must fall within 60 days after therapy cessation
  • Testosterone < 50 ng/dL
  • No known active brain metastases

PATIENT CHARACTERISTICS:

Age

  • Over 18

Performance status

  • ECOG 0-2

Life expectancy

  • At least 12 weeks

Hematopoietic

  • Granulocyte count ≥ 1,500/mm^3
  • Platelet count ≥ 100,000/mm^3

Hepatic

  • Bilirubin < 1.5 times upper limit of normal (ULN)
  • AST and ALT < 3 times ULN

Renal

  • Creatinine ≤ 1.5 times ULN OR
  • Creatinine clearance > 40 mL/min

Cardiovascular

  • 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

Other

  • 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

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No concurrent prophylactic colony-stimulating factors for myelosuppression

Chemotherapy

  • See Disease Characteristics
  • No more than 1 prior chemotherapy regimen
  • No prior mitoxantrone or epothilone
  • No other concurrent chemotherapy

Endocrine therapy

  • 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

Radiotherapy

  • 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

Surgery

  • See Disease Characteristics

Other

  • 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
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00058084

Locations
United States, California
Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center
Los Angeles, California, United States, 90048
UCSF Comprehensive Cancer Center
San Francisco, California, United States, 94115
Veterans Affairs Medical Center - San Francisco
San Francisco, California, United States, 94121
United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, United States, 02114
United States, Michigan
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, United States, 48109-0946
United States, New York
Memorial Sloan-Kettering Cancer Center
New York, New York, United States, 10021
United States, Wisconsin
University of Wisconsin Comprehensive Cancer Center
Madison, Wisconsin, United States, 53792-6164
Sponsors and Collaborators
UCSF Helen Diller Family Comprehensive Cancer Center
Investigators
Study Chair: Jonathan Rosenberg, MD UCSF Helen Diller Family Comprehensive Cancer Center
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Publications of Results:
Rosenberg JE, Weinberg VK, Kelly WK, Michaelson D, Hussain MH, Wilding G, Gross M, Hutcheon D, Small EJ. Activity of second-line chemotherapy in docetaxel-refractory hormone-refractory prostate cancer patients : randomized phase 2 study of ixabepilone or mitoxantrone and prednisone. Cancer. 2007 Jun 18; [Epub ahead of print]
Rosenberg JE, Weinberg VK, Kelly WK, et al.: Randomized phase II study of ixabepilone (Ix) or mitoxantrone and prednisone (MP) in patients with taxane resistant (TR) hormone refractory prostate cancer (HRPC). [Abstract] 2006 Prostate Cancer Symposium, February 24-26, 2006, San Francisco, CA. A-253, 2006.

Study ID Numbers: CDR0000285731, UCSF-02555, NCI-6046, UCSF-H6872-22147-01
Study First Received: April 7, 2003
Last Updated: September 9, 2008
ClinicalTrials.gov Identifier: NCT00058084  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the prostate
recurrent prostate cancer
stage IV prostate cancer

Study placed in the following topic categories:
Prednisone
Prostatic Diseases
Genital Neoplasms, Male
Epothilones
Urogenital Neoplasms
Mitoxantrone
Genital Diseases, Male
Adenocarcinoma
Taxane
Prostatic Neoplasms
Recurrence

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Mitosis Modulators
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Antimitotic Agents
Glucocorticoids
Hormones
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Sensory System Agents
Therapeutic Uses
Tubulin Modulators
Analgesics
Peripheral Nervous System Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on January 16, 2009