Randomized Phase II Trial of Docetaxel (Taxotere) and Oblimersen (Antisense Oligonucleotide Directed to BCL-2) Versus Taxotere Alone in Patients With Hormone-Refractory Prostate Cancer

Date de début de l'étude : 1 avril 2004

DISEASE CHARACTERISTICS: * Histologically confirmed adenocarcinoma of the prostate * Hormone-refractory disease * Disease progression after prior hormonal therapy with luteinizing hormone-releasing hormone (LH-RH) analogues or orchiectomy and antiandrogens (given together or consecutively) * Prostate-specific antigen (PSA) progression documented by at least 2 increases in PSA values over previous PSA reference value * Must demonstrate continued PSA elevation for at least 6 weeks after discontinuation of antiandrogen therapy * PSA ≥ 5 ng/mL (Hybritech or equivalent) within the past week * Testosterone ≤ 0.5 ng/mL\* NOTE: \*Patients with medical castration with LH-RH analogue must continue with LH-RH analogue throughout the study * No evidence of painful and/or destructive bone metastases requiring concurrent radiotherapy, bisphosphonates, or bone-seeking radionuclides * Other bone metastases allowed * No clinical evidence of brain metastases PATIENT CHARACTERISTICS: Age * 18 and over Performance status * WHO 0-2 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * WBC ≥ 3,500/mm\^3 * Hemoglobin ≥ 10 g/dL Hepatic * AST and ALT ≤ 1.5 times upper limit of normal (ULN) * Bilirubin ≤ ULN * PTT and PT ≤ 1.5 times ULN OR * INR ≤ 1.3 Renal * Creatinine ≤ 1.5 times ULN OR * Creatinine clearance ≥ 50 mL/min Cardiovascular * No unstable angina * No uncontrolled hypertension * No deep venous thrombosis within the past 6 months * No cerebrovascular accident, transient ischemic attack, or myocardial infarction within the past 6 months Pulmonary * No pulmonary embolism * No history of interstitial pneumonitis * No history of pulmonary fibrosis Other * Adequate venous access * HIV negative * No active infection * No pre-existing neuropathy * No hypersensitivity to phosphorothioates * No hypersensitivity to oligonucleotides or any other component of the oblimersen formulation or to drugs formulated with polysorbate * No psychological, familial, sociological, or geographical condition that would preclude study compliance * No other malignancy within the past 5 years except adequately treated superficial urothelial or skin cancer PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Prior estramustine allowed * No other prior chemotherapy * No concurrent estramustine Endocrine therapy * See Disease Characteristics * At least 6 weeks since prior flutamide, bicalutamide, or nilutamide * More than 6 weeks since prior hormonal manipulation with PC-SPES * Concurrent LH-RH agonist allowed * No concurrent antiandrogens Radiotherapy * See Disease Characteristics * No prior radiotherapy involving \> 25% of marrow-producing area * No prior bone-seeking radionuclides * No concurrent radiotherapy (including palliative therapy for painful bone metastases) * No concurrent bone-seeking radionuclides Surgery * See Disease Characteristics Other * Prior bisphosphonates allowed * No concurrent anticoagulation except for low-dose warfarin (1 mg/day) * No concurrent regular (daily) intake of opioid analgesics * No other concurrent experimental drugs or anticancer drugs * No concurrent bisphosphonates