An Open-Label Study Of Exploratory Pharmacogenomics And Pharmacologic Effects Of Neoadjuvant Oral CCI-779 In Newly Diagnosed Prostate Cancer Patients Undergoing Radical Prostatectomy Who Have A High Risk Of Relapse
Collecte de données
Maladies génito-urinaires+7
+ Maladies Génitales
+ Maladies génitales masculines
Étude thérapeutique
Résumé
Date de début de l'étude : 1 août 2003
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Primary * Determine the effects of oral CCI-779 on changes in the phosphorylation state of proteins in the mammalian target of rapamycin (mTOR) signaling pathway in the tumor tissue of patients with newly diagnosed prostate cancer undergoing radical prostatectomy. * Determine the effects of this drug on changes in p70S6 kinase activity, phosphorylation state of mTOR pathway proteins, and on global and targeted gene expression patterns in the peripheral blood mononuclear cells (PBMCs) of these patients. Secondary * Determine the effects of this drug on global and targeted gene expression patterns in these patients. * Identify pharmacodynamic/pharmacogenomic surrogate markers of this drug in both tumor tissue and PBMCs and determine if blood may be used as a surrogate tissue source for biomarkers of drug activity in the tumor in these patients. * Determine, preliminarily, the potential antitumor effects of this drug in these patients. * Determine the pharmacokinetics of this drug in these patients. * Correlate phosphatase and tensin homolog (PTEN) gene status with the pharmacodynamic/pharmacogenomic effects of this drug in these patients. * Determine the effects of this drug on changes in protein expression patterns in the plasma of these patients. OUTLINE: This is a randomized, open-label, multicenter study. Patients are randomized to 1 of 3 treatment arms. Patients randomized to arm III are stratified according to tumor expression of phosphatase and tensin homolog (PTEN) gene mutations (negative vs positive). * Arm I: Patients receive oral CCI-779 once daily for a total of 8 weeks. * Arm II: Patients receive a higher dose of CCI-779 as in arm I. * Arm III: Patients receive a higher dose (higher than arm II) of CCI-779 as in arm I. Approximately 24-48 hours after the last dose of CCI-779, patients in all arms undergo radical prostatectomy. Patients are followed on day 7-10 and then at 4 weeks after study completion. PROJECTED ACCRUAL: A total of 40 patients (5 each for arms I and II and 30 for arm III) will be accrued for this study.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.15 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Homme
Le sexe biologique des participants éligibles à s'inscrire.À partir de 18 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: * Histologically confirmed adenocarcinoma of the prostate * Diagnosis based on a minimum of 6 core biopsy samples * Clinically confirmed organ-confined disease * Candidate for radical prostatectomy * No evidence of metastatic disease by CT scan and bone scan * High risk of relapse based on either of the following criteria: * Any one of the following: * Stage T2C or higher * Gleason score greater than 7 * Prostate-specific antigen (PSA) greater than 20 ng/mL OR * Any two of the following: * Gleason score at least 7 * PSA 10-20 ng/mL * Greater than 50% of total biopsy cores with cancer involvement PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * Not specified Hematopoietic * No active bleeding * Absolute neutrophil count at least 1,500/mm\^3 * Platelet count at least 100,000/mm\^3 * Hemoglobin at least 10 g/dL Hepatic * No acute or chronic hepatitis B * Hepatitis B surface antigen negative * No acute or chronic hepatitis C * No antibodies to hepatitis C * Bilirubin no greater than 1.5 times upper limit of normal (ULN) * AST and ALT no greater than 2 times ULN Renal * No ongoing urinary tract infection necessitating rapid or emergent surgical resection * Creatinine no greater than 1.5 times ULN Cardiovascular * No unstable angina * No myocardial infarction within the past 6 months * No life-threatening ventricular arrhythmia requiring ongoing maintenance therapy Pulmonary * No known pulmonary hypertension * No pneumonitis Other * Fertile patients must use effective contraception during and for 12 weeks after study participation * HIV negative * No other severe immunocompromised states * No active infection requiring antibiotic therapy * No serious concurrent illness * No other major illness that would substantially increase the risk associated with study participation * No other malignancy within the past 5 years except basal cell or squamous cell skin cancer PRIOR CONCURRENT THERAPY: Biologic therapy * No concurrent immunotherapy Chemotherapy * No prior chemotherapy * No other concurrent chemotherapy Endocrine therapy * More than 3 weeks since prior IV corticosteroids * No concurrent systemic corticosteroids * No prior or concurrent hormonal therapy for underlying malignancy Radiotherapy * No prior or concurrent radiotherapy Surgery * More than 3 months since prior major surgery Other * More than 1 month since prior experimental drugs * More than 3 weeks since prior immunosuppressive agents * No concurrent immunosuppressive therapies * No other concurrent investigational agents * No concurrent enzyme-inducing anticonvulsants (e.g., phenobarbital, phenytoin, or carbamazepine) * No concurrent ketoconazole, diltiazem, rifampin, terfenadine, cisapride, astemizole, pimozide, or Hypericum perforatum (St. John's wort) * No concurrent grapefruit or grapefruit juice
Plan de l'étude
Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.Objectifs de l'étude
Objectifs principaux
Objectifs secondaires
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 1 site