A Multi-institutional Translational Clinical Trial of Disulfiram in Men With Recurrent Prostate Cancer as Evident by a Rising PSA
The primary hypothesis of this study is that disulfiram is a DNA methyltransferase inhibitor
and may provide benefit for patients with prostate cancer by restoration of tumor suppressor
genes. Disulfiram is a potent DNA methyltransferase 1 (DNMT1) inhibitor in vitro in our
laboratory and it was recently found as one of the most potent inhibitors for PCa growth in
vitro by screening the Johns Hopkins Drug Library. Based on this data, extensive in vitro
and in vivo studies have been performed to explore its potential antitumor activities in
prostate PCa. Using both androgen sensitive and insensitive PCa cell lines, we have
confirmed that disulfiram can demethylate known highly methylated tumor suppressor genes
such as APC and RARß in PCa cell lines. Disulfiram inhibited PCa cell growth in vitro and in
vivo. In addition to these new findings, the antitumor activity of disulfiram and its other
possible mechanisms of action are well documented in literature. Disulfiram has been shown
to induce apoptosis in a number of cell lines including PCa. A variety of underlying
mechanisms of anticancer activity have been reported. Disulfiram has been shown to reduce
angiogenesis, inhibit DNA topoisomerases, inhibit nuclear factor κB, induce p21 and p53 with
G1/S cell cycle arrest, induce pro-apoptotic redox-related mitochondrial membrane
permeabilization, inactivate Cu/Zn superoxide dismutase by Cu2+ complexation, inhibit
Zn2+-dependent matrix metalloproteinases, and prevent tumor invasion or metastasis. The
disulfiram analogue pyrrolidine dithiocarbamate (PDTC) has been shown to inhibit proteasomal
activity in combination with copper in human breast and PCa cell lines. Also, disulfiram or
its metabolites permanently inactivate the human multidrug resistance P-glycoprotein or
reverses either MDR1- or MRP1-mediated drug efflux.
Interventional
Endpoint Classification: Bio-availability Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Dosage
To determine the dosage and duration of disulfiram for achieving its biological target effects as a DNMT1 inhibitor
1 year
No
Michael A Carducci, MD
Principal Investigator
Johns Hopkins University
United States: Food and Drug Administration
J0972
NCT01118741
May 2010
June 2012
Name | Location |
---|---|
Duke University | Durham, North Carolina 27710 |
Johns Hopkins Hospital | Baltimore, Maryland 21287 |
Thomas Jefferson Universith | Philadelphia, Pennsylvania 19107 |