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Phase I/II Study With Temsirolimus Versus no add-on in Patients With Castration Resistant Prostate Cancer (CRPC) Receiving First-line Docetaxel Chemotherapy


Phase 1/Phase 2
18 Years
N/A
Open (Enrolling)
Male
Prostatic Neoplasms

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Trial Information

Phase I/II Study With Temsirolimus Versus no add-on in Patients With Castration Resistant Prostate Cancer (CRPC) Receiving First-line Docetaxel Chemotherapy


The purpose of this Phase I study is to evaluate feasibility of dose levels DL1, DL2 and DL3
(which are combinations of Temsirolimus and Docetaxel) and defining a recommended dose (RD)
for the Phase II part using these dose levels in a dose escalating scheme.

Secondary objectives are the collection of safety data on the dose levels used in this part.

Inclusion Criteria


Inclusion Criteria Phase I Part:

- Adult males ≥18 years of age.

- Patients with CRPC defined as confirmed rise of PSA levels after orchiectomy or LHRH
agonist based therapy.

- Progressive disease, defined as PSA progression by confirmed rising PSA levels.

- PSA at time of study entry ≥2ng/ml within 1 week prior to treatment (according to
Scher 2008).

- Bone metastasis and/or lymph node and/or visceral organ metastases allowed.
Measurable and non measurable disease allowed.

- Performance status (PS) 0-1 ECOG.

- Signed written informed consent.

- White blood cell count (WBC) ≥4x10^9/L with neutrophils ≥1.5x10^9/L, platelet count
≥100x10^9/L, hemoglobin ≥9g/dL.

- Total bilirubin <=2 x upper limit of normal.

- AST and ALT <=2.5 x upper limit of normal, or <=5 x upper limit of normal in case of
liver metastases.

- Serum creatinine <=1.5 x upper limit of normal or creatinine clearance > 60 ml/min.

- Androgen ablation will have to be continued. Antiandrogens such as bicalutamide will
have to be discontinued at least 4 weeks prior to the start of study treatment.

Exclusion Criteria Phase I Part:

- Clinically symptomatic brain or meningeal metastasis.

- Receiving known strong CYP3A4 isoenzyme inhibitors and/or inducers.

- Any investigational drug within the 30 days before inclusion.

- Not recovered from prior biopsy, surgery, traumatic injury, and/or radiation therapy,
as judged by the investigator.

- Nonhealing wound or ulcer.

- Grade ≥ 3 hemorrhage within the past month.

- Any condition / concomitant disease not allowing chemotherapy with docetaxel,
prednisone and temsirolimus in the discretion of the treating physician, like: Renal
insufficiency requiring dialyses; congestive heart failure or uncontrolled angina
pectoris; prior myocardial infarction within 6 months of start of chemotherapy;
uncontrolled severe hypertension (failure of diastolic blood pressure to fall below
90 mm Hg despite the use of ≥ 3 anti-hypertensive drugs) or arrhythmias; instable
diabetes mellitus, ulceration from diabetes mellitus or other conditions not allowing
high dose corticosteroids; effusions in pericardium, pleura or abdomen symptomatic
and in need of being punctured.

- Known hypersensitivity to any of the components in the temsirolimus infusion or other
medical reasons for not being able to receive adequate premedication (antihistamine
agents).

- Legal incapacity or limited legal capacity

- Medical or psychological conditions that would not permit the patient to

- complete the study or sign informed consent.

Inclusion Criteria Phase II Part, Chemotherapy Period:

- Adult males ≥ 18 years of age.

- Patients with CRPC defined as confirmed rise of PSA levels after orchiectomy or LHRH
agonist based therapy

- Progressive disease, defined as PSA progression by confirmed rising PSA levels

- PSA at time of study entry ≥ 2ng/ml within 1 week prior to treatment (according to
Scher 2008).

- Bone metastasis and/or lymph node and/or visceral organ metastases allowed.
Measurable and non measurable disease allowed.

- Performance status (PS) 0-1 ECOG.

- Signed written informed consent.

- White blood cell count (WBC) ≥4x10^9/L with neutrophils ≥1.5x10^9/L, platelet count
≥100x10^9/L, hemoglobin ≥9g/dL.

- Total bilirubin <= 2 x upper limit of normal.

- AST and ALT <=2.5 x upper limit of normal, or <=5 x upper limit of normal in case of
liver metastases.

- Serum creatinine <=1.5 x upper limit of normal or creatinine clearance >60 ml/min.

- Androgen ablation will have to be continued. Antiandrogens such as bicalutamide will
have to be discontinued at least 4 weeks prior to the start of study treatment.

Exclusion Criteria Phase II Part, Chemotherapy Period:

- Prior Chemotherapy.

- Clinically symptomatic brain or meningeal metastasis.

- Receiving known strong CYP3A4 isoenzyme inhibitors and/or inducers.

- Any investigational drug within the 30 days before inclusion.

- Not recovered from prior biopsy, surgery, traumatic injury, and/or radiation therapy,
as judged by the investigator.

- Nonhealing wound or ulcer.

- Grade ≥ 3 hemorrhage within the past month.

- Any condition / concomitant disease not allowing chemotherapy with docetaxel,
prednisone and temsirolimus in the discretion of the treating physician, like: Renal
insufficiency requiring dialyses; congestive heart failure or uncontrolled angina
pectoris; prior myocardial infarction within 6 months of start of chemotherapy;
uncontrolled severe hypertension (failure of diastolic blood pressure to fall below
90 mm Hg despite the use of ≥ 3 anti-hypertensive drugs) or arrhythmias; instable
diabetes mellitus, ulceration from diabetes mellitus or other conditions not allowing
high dose corticosteroids; effusions in pericardium, pleura or abdomen symptomatic
and in need of being punctured.

- Known hypersensitivity to any of the components in the temsirolimus infusion or other
medical reasons for not being able to receive adequate premedication (antihistamine
agents).

- Legal incapacity or limited legal capacity.

- Medical or psychological conditions that would not permit the patient to complete the
study or sign informed consent.

Inclusion Criteria Phase II Part, Maintenance Period:

- Completed 8 cycles (up to 26 weeks) treatment in Arm A

- White blood cell count (WBC) ≥4x10^9/L with neutrophils ≥1.5x10^9/L, platelet count
≥100x10^9/L, hemoglobin ≥9g/dL.

- Total bilirubin <=2 x upper limit of normal.

- AST and ALT <=2.5 x upper limit of normal, or <=5 x upper limit of normal in case of
liver metastases.

- Serum creatinine <=1.5 x upper limit of normal or creatinine clearance >60 ml/min.

- General condition sufficient to allow therapy with temsirolimus.

- Signed Informed Consent.

Exclusion Criteria Phase II Part, Maintenance Period:

- Disease Progression in the first 8 cycles (up to 26 weeks).

Type of Study:

Interventional

Study Design:

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

Outcome Measure:

recommended dose

Outcome Description:

Phase I Part: Primary endpoint is the Recommended Dose (RD) for the Phase II Part chosen between the three DLs based on the dose escalation scheme.

Outcome Time Frame:

10 months

Safety Issue:

Yes

Principal Investigator

Rudolf Morant, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Tumor-und Brustzentrum ZeTuP, St. Gallen, Switzerland

Authority:

Germany: Federal Institute for Drugs and Medical Devices

Study ID:

C-II-007

NCT ID:

NCT01206036

Start Date:

July 2010

Completion Date:

June 2014

Related Keywords:

  • Prostatic Neoplasms
  • castration
  • prostate cancer
  • castration resistant prostate cancer
  • PSA
  • Docetaxel
  • Temsirolimus
  • disease progression free survival
  • DPFS
  • dose escalation
  • Neoplasms
  • Prostatic Neoplasms

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