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Hormonal Ablation, Imatinib Mesylate and Docetaxel for Patients With Prostate Cancer
This study is ongoing, but not recruiting participants.
Sponsors and Collaborators: M.D. Anderson Cancer Center
Novartis Pharmaceuticals
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00500110
  Purpose

Primary Objective:

1. To evaluate the pathological complete response rate to neoadjuvant hormonal ablation, Imatinib and Docetaxel (HID) in high-risk localized prostate cancer.

Secondary Objectives:

  1. To describe the time to PSA-progression after neoadjuvant HID and radical prostatectomy in high-risk localized prostate cancer.
  2. To correlate pathological response with modulation of the Platelet-Derived Growth Factor Receptor (PDGFR) pathway.

Condition Intervention Phase
Prostate Cancer
Drug: Docetaxel
Drug: Imatinib Mesylate
Drug: Leuprolide
Drug: Goserelin Acetate
Phase II

MedlinePlus related topics: Cancer Prostate Cancer
Drug Information available for: Docetaxel Imatinib Imatinib mesylate Goserelin Leuprolide acetate Leuprolide
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Neoadjuvant Hormonal Ablation, Imatinib Mesylate and Docetaxel Followed by Radical Prostatectomy for High-Risk Localized Prostate Cancer

Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • To learn if treatment with hormones in combination with Gleevec (imatinib mesylate) and docetaxel can increase the chances that all of the tumor can be removed and help to decrease the chances of the cancer coming back. [ Time Frame: 6 Years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 45
Study Start Date: June 2003
Estimated Primary Completion Date: June 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Imatinib Mesylate + Docetaxel + Hormonal Ablation (Goserelin Acetate or Leuprolide)
Drug: Docetaxel
30 mg/m^2 IV Weekly Over 60 Minutes on Days 1, 8, 15, and 22. This will be followed by 2 weeks with no docetaxel.
Drug: Imatinib Mesylate
600 mg PO Daily x 42 Days.
Drug: Leuprolide
Hormone injections given every other month or every 3 months, as determined by the doctor.
Drug: Goserelin Acetate
Hormone injections given every other month or every 3 months, as determined by the doctor.

Detailed Description:

Docetaxel is a drug that was designed to help kill cancer cells. Imatinib mesylate is a drug designed to block cancer cells from growing and dividing. Hormonal treatment with Lupron (leuprolide) or Zoladex (goserelin acetate) is used to lower testosterone levels in the body because prostate cancer cells need testosterone to survive. All patients will have their prostate gland removed after treatment with these drugs.

Before treatment starts, you will be asked questions about your medical history and have a complete physical examination. You will have blood drawn (2 tablespoons) for routine blood tests. You will be asked questions about any medications you are currently taking and have taken in the past. You will have an electrocardiogram (ECG - a test that measures electrical activity of the heart). As part of your standard care for prostate cancer, you will also have a CT scan (or MRI scan) of the abdomen and pelvis along with a bone scan (x-rays of the bones) to see if the prostate cancer has moved to other parts of your body.

For this study, you will receive hormone injections to lower the levels of testosterone in the blood. You will also take imatinib mesylate capsules by mouth and receive treatment with docetaxel by vein to help kill the cancer cells before surgery.

You will receive hormone therapy with either leuprolide or goserelin acetate injections, whichever your doctor feels will give you the most benefit. The hormone injections will be given every other month or every 3 months. During treatment with the hormones, you will also take an anti-androgen drug called Casodex (bicalutamide) by mouth for up to 2 weeks. This drug is being used to help decrease the risks of developing side effects due to the hormone injections (this is the standard of care with hormone treatments). You will take imatinib mesylate capsules every day for 6 weeks starting with the hormone treatments. You will also receive treatment with docetaxel. Docetaxel injections are given by vein over 60 minutes once a week for 4 weeks in a row. This will be followed by 2 weeks with no docetaxel. This 6 week period is considered a course of treatment. You will have up to 3 courses of treatment (18 weeks) with docetaxel. After this treatment is complete, you will have prostate surgery within 4 weeks or when you have fully recovered from treatment.

During treatment, your general health will be monitored and you will have physical exams and blood tests (about 1-2 tablespoons) often to make sure that you are tolerating the treatment safely. If the disease gets worse or you experience intolerable side effects, you will be taken off the study and your doctor will discuss other treatment options with you.

Before surgery, you will be given a general anesthetic. An incision (cut) will be made in your abdomen (lower stomach area) and your prostate gland and lymph nodes in the pelvis will be removed. Before the procedure, the risks will be explained to you and you will need to sign a separate consent form.

After surgery, you will have check-up visits every 3 months for 1 year, then every 6 months for the rest of your life. At these visits, you will have a physical exam and around 1-2 tablespoons of blood collected for routine lab tests. If your doctor feels it is necessary, you may also have CT scans, bone scans, and/or x-rays. These tests are being done to check if the cancer has come back. If the cancer comes back, you will be removed from the study and your doctor will discuss treatment options with you.

This is an investigational study. The leuprolide or goserelin acetate injections, bicalutamide tablets, imatinib mesylate capsules, and docetaxel injections are all FDA approved and are commercially available. Up to 36 participants will take part in this study. All will be enrolled at UTMDACC.

  Eligibility

Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with adenocarcinoma of the prostate that in the opinion of the surgeon is resectable. Ductal adenocarcinoma of the prostate is included.
  • All patients must be regarded as low anesthetic risk for radical prostatectomy and confirm their intention to undergo radical prostatectomy at the end of the neoadjuvant therapy.
  • All patients must have at least one of the following high-risk features: clinical or pathological T3 disease, or cT2c or PSA>20ng/ml or Gleason 8-10 adenocarcinoma or clinical T2b and PSA>10ng/ml and Gleason 7 adenocarcinoma. The 1992 AJCC staging system will be followed.
  • Prior hormonal therapy up to 2 months is permitted; no concurrent ketoconazole is permitted.
  • Patients must have adequate bone marrow function defined as an absolute peripheral granulocyte count of >/= 1,500/mm3 and platelet count of >/= 100,000/mm3; adequate hepatic function defined with a total bilirubin of </= 1.5 mg/dl and AST/ALT </= 2X the upper limits of normal; adequate renal function defined as serum creatinine clearance >/= 40 cc/min (measured or calculated).
  • Patients must sign a written informed consent form prior to treatment. All patients must have a surgical and medical oncology consult prior to signing informed consent.

Exclusion Criteria:

  • Patients with small cell or sarcomatoid prostate cancers are not eligible.
  • Patients with clinical or radiological evidence of metastatic disease
  • Prior chemotherapy or experimental agents
  • Patients with severe intercurrent infection.
  • Patients with NYHA Class III/IV congestive heart failure, unstable angina or MI in the last 6 months.
  • Contraindications to corticosteroids.
  • Uncontrolled severe hypertension, uncontrolled diabetes mellitus, oxygen-dependent lung disease, chronic liver disease or HIV infection.
  • Second malignancies (excluding non-melanoma skin cancer) unless disease-free for 3 years.
  • Overt psychosis, mental disability or otherwise incompetent to give informed consent or history of non-compliance.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00500110

Locations
United States, Texas
U.T.M.D. Anderson Cancer Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
M.D. Anderson Cancer Center
Novartis Pharmaceuticals
Investigators
Principal Investigator: Paul Mathew, MD U.T.M.D. Anderson Cancer Center
  More Information

The University of Texas M.D.Anderson Cancer Center  This link exits the ClinicalTrials.gov site

Responsible Party: U.T.M.D. Anderson Cancer Center ( Paul Mathew, MD/Assistant Professor )
Study ID Numbers: ID03-0112
Study First Received: July 10, 2007
Last Updated: December 6, 2008
ClinicalTrials.gov Identifier: NCT00500110  
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
Prostate Cancer
Hormonal Ablation
Docetaxel
Imatinib Mesylate
STI571
Gleevec
Taxotere
Goserelin Acetate
Zoladex
Leuprolide
Lupron

Study placed in the following topic categories:
Imatinib
Docetaxel
Prostatic Diseases
Genital Neoplasms, Male
Leuprolide
Goserelin
Urogenital Neoplasms
Genital Diseases, Male
Prostatic Neoplasms

Additional relevant MeSH terms:
Antineoplastic Agents, Hormonal
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Enzyme Inhibitors
Reproductive Control Agents
Protein Kinase Inhibitors
Pharmacologic Actions
Neoplasms
Neoplasms by Site
Therapeutic Uses
Fertility Agents, Female
Fertility Agents

ClinicalTrials.gov processed this record on January 14, 2009