A Randomized, Placebo-Controlled Phase IIb Clinical Trial of 2-Difluoromethylornithine (DFMO) Versus Bicalutamide (CASODEX) Alone and in Combination in Patients With Prostate Cancer in the Period Prior to Radical Prostatectomy or Brachytherapy: Modulation of Tissue and Molecular Biomarkers in Human Prostate Tissue Serum
bicalutamide
+ eflornithine
+ oral eflornithine placebo
Enfermedades Urogenitales+6
+ Enfermedades Genitales
+ Enfermedades Genitales Masculinas
Estudio de Tratamiento
Resumen
Fecha de inicio: 1 de noviembre de 2001
Fecha en la que se inscribió al primer participante.OBJECTIVES: * Compare levels of polyamine spermine, polyamine putrescine, and spermidine in patients with localized prostate cancer undergoing brachytherapy or radical prostatectomy and treated with neoadjuvant eflornithine and bicalutamide vs eflornithine alone vs bicalutamide alone vs no neoadjuvant therapy. * Compare the expression of surrogate biomarkers (i.e., serum prostate-specific antigen, tissue levels of proliferating cell nuclear antigen, Ki67, and TGF-alpha, apoptosis assays \[ICH-PARP and TUNEL\], and cytomorphometric indices) in patients treated with these regimens. * Compare the toxicity of these regimens in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled study. Patients are stratified according to Gleason score (< 7 vs ≥ 7). Patients are randomized to 1 of 4 treatment arms. * Arm I: Patients receive oral eflornithine and oral bicalutamide once daily. * Arm II: Patients receive oral eflornithine and oral bicalutamide placebo once daily. * Arm III: Patients receive oral eflornithine placebo and oral bicalutamide once daily. * Arm IV: Patients receive oral eflornithine placebo and oral bicalutamide placebo once daily. In all arms, treatment continues for 28 days in the absence of unacceptable toxicity. Patients then undergo either prostatectomy or brachytherapy, as determined by the patient, on day 29. Patients are followed at 4 weeks. PROJECTED ACCRUAL: A total of 44 patients (11 per treatment arm) will be accrued for this study within 11 months.
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 34 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Tratamiento
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Hombre
Sexo biológico de los participantes elegibles para inscribirse.A partir de 18 años
Rango de edades de los participantes que pueden unirse al estudio.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
DISEASE CHARACTERISTICS: * Histologically confirmed prostate cancer * Localized disease * Paraffin blocks from diagnostic biopsies available * Planning to undergo brachytherapy or prostatectomy PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-3 Life expectancy * Not specified Hematopoietic * Hemoglobin ≥ 10.0 g/dL * WBC ≥ 3,500/mm\^3 * Platelet count ≥ 125,000/mm\^3 Hepatic * Bilirubin ≤ 2.0 mg/dL * SGOT and SGPT ≤ 2 times normal * No history of liver disease (e.g., hepatitis, cirrhosis, or jaundice) Renal * Creatinine ≤ 2.0 mg/dL Cardiovascular * No symptomatic coronary artery disease * No uncontrolled hypertension * No acute myocardial infarction within the past year Other * Fertile patients must use effective contraception * No more than 10 decibels baseline hearing loss at any frequency by full bilateral audiometry within the past month * No hypersensitivity to eflornithine or bicalutamide * No other prior or active malignancy except nonmelanoma skin cancer or other cancer curatively treated at least 5 years ago with no evidence of recurrent or residual disease * No concurrent acute or chronic medical or psychiatric condition that would preclude study participation PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent immunotherapy Chemotherapy * No other concurrent chemotherapy Endocrine therapy * More than 1 year since prior antiandrogen, luteinizing hormone-releasing hormone (LHRH) agonist, bicalutamide, finasteride, or diethylstilbestrol * No other concurrent antiandrogen, LHRH agonist, finasteride, or diethylstilbestrol Radiotherapy * See Disease Characteristics * No other concurrent radiotherapy Surgery * See Disease Characteristics
Plan de Estudio
Conoce todos los tratamientos administrados en este estudio, su descripción detallada y en qué consisten.4 grupos de intervención están designados en este estudio
0% de probabilidad de ser asignado al grupo placebo
Grupos de Tratamiento
Grupo I
ExperimentalGrupo II
ExperimentalGrupo III
ExperimentalGrupo IV
ExperimentalObjetivos del Estudio
Objetivos Primarios
Centros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene una ubicación
University of Alabama at Birmingham Comprehensive Cancer Center
Birmingham, United StatesVer ubicación