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Eflornithine in Treating Patients At High Risk of Developing Prostate Cancer

Randomized Placebo-Controlled, Double-Blind Phase IIb Chemoprevention Trial of Difluoromethylornithine in Brothers and First Cousin Males of Familial Prostate Cancer Probands

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00006101
Enrollment
76
Registered
2003-01-27
Start date
1998-10-31
Completion date
2012-12-31
Last updated
2018-05-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Prostate Cancer

Keywords

stage I prostate cancer

Brief summary

RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the development of cancer. The use of eflornithine (DMFO) may be an effective way to prevent the development of prostate cancer. PURPOSE: Randomized phase II trial to determine the effectiveness of eflornithine in preventing prostate cancer in patients who are at high risk of developing the disease.

Detailed description

OBJECTIVES: * Compare the levels of polyamines (putrescine, spermidine, and spermine) and progression-related genes in the prostate tissue of patients at high genetic risk for prostate cancer treated with eflornithine (DFMO) vs placebo. * Determine the side effects of DFMO and compare them with the biological effect on the prostate gland in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled study. Patients are stratified according to age (35 to 60 vs 61 to 70) and presence of localized cancer (yes vs no). All patients receive oral placebo daily for 4 weeks. Patients who are compliant and take the placebo 5-7 days each week are randomized to one of two arms. * Arm I: Patients receive oral placebo daily. * Arm II: Patients receive high-dose oral eflornithine (DFMO) daily. Treatment continues for 1 year in the absence of unacceptable toxicity. PROJECTED ACCRUAL: A total of 100 patients (50 per arm) will be accrued for this study within 3 years.

Interventions

Take 500mg of DFMO per day for 12 months

DRUGPlacebo

Take placebo per day for 12 months

Sponsors

National Cancer Institute (NCI)
CollaboratorNIH
Thomas E. Ahlering
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
MALE
Age
35 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

Criteria for Eligibility 1. Men between the ages of 35 and 70 with family history of prostate cancer, i.e., prostate cancer diagnosed in two first degree relatives before the age of 70 years. (First degree relatives include a brother, father, and son.) There will be occasions in which a second or even third degree relative will be eligible. Additional information regarding these criteria is provided below and in Attachment 1.) * Two or more affected relatives of which at least 1 is a first degree relative or * At least two affected relatives, both of which are at least a second degree relative or * One first degree relative diagnosed with prostate cancer at age 55 or less. 2. No history of invasive cancer within 5 years (though non-melanoma skin or papillary bladder cancer will not be reason to exclude a patient); no prior history of prostate cancer, no severe metabolic disorders or other life-threatening acute or chronic disease; no additional x-ray or chemotherapy anticipated. * Men found to have localized prostate cancer (Gleason score ≤7) as part of the screening for the current trial, and opt for watchful waiting as their standard of care treatment for their condition, will be eligible to sign an additional consent form to continue with the randomization and on-study activities of this trial. On-study activities for these individuals will not differ from the on-study activities for the other men enrolled in this trial. 3. Must not require a medically mandated special diet which precludes compliance with study requirements 4. Not requiring regular use of anticoagulants on a regular basis. Prior use of chemoprevention agent(s) (such as Proscar) is allowed as long as the subject has been off the agent(s) for at least 3 months. Not currently participating in another prostate prevention trial. 5. Absence of history of current documented or symptomatic gastric or duodenal ulcer within 12 months prior to study entry, or of significant kidney or liver disease. No chronic anemia (hematocrit \< 35 volume %), leukopenia (WEB \<4,000) with normal differential, or thrombocytopenia (platelets \<100,000) and with serum creatinine \<1.5 mg/dl, serum bilirubin \<2.0 mg/dl, and serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic pyruvic transaminase (SGPT) \<2× normal. Urinalysis should have \<1+ protein, 0-3 casts, 0-5 white blood cell count (WBC) and red blood cell count (RBC). 6. Absence of any condition that predisposes to difficulties with hearing, wound healing or repair. 7. Must meet Southwest Oncology Group performance status criteria of 0-1 (0 = fully active, able to carry on all predisease activities without restriction \[Karnofsky scale 90-100\]; 1 = restricted in physically strenuous activity, but ambulatory and able to carry out work of a light or sedentary nature, i.e., light housework or office work \[Karnofsky scale 70-80\]. 8. Subjects must be willing and able to keep required visits for study procedures and to complete study questionnaires. 9. Patient must not have had radiation therapy in the pelvic area.

Design outcomes

Primary

MeasureTime frameDescription
Change in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsBaseline and 12 monthsDifference refers to absolute difference of 12 months to baseline and % relative difference refers to the ratio of the absolute difference divided by the baseline times 100.

Countries

United States

Participant flow

Participants by arm

ArmCount
Eflornithine
500mg/d for 12 months eflornithine: Take 500mg of DFMO per day for 12 months
38
Placebo
placebo for 12 months Placebo: Take placebo per day for 12 months
38
Total76

Baseline characteristics

CharacteristicEflornithinePlaceboTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
4 Participants5 Participants9 Participants
Age, Categorical
Between 18 and 65 years
34 Participants33 Participants67 Participants
Region of Enrollment
United States
38 participants38 participants76 participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants
Sex: Female, Male
Male
38 Participants38 Participants76 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 380 / 38
other
Total, other adverse events
20 / 3818 / 38
serious
Total, serious adverse events
4 / 381 / 38

Outcome results

Primary

Change in Total PSA, Percent Free PSA, and Prostate Volume at 12 Months

Difference refers to absolute difference of 12 months to baseline and % relative difference refers to the ratio of the absolute difference divided by the baseline times 100.

Time frame: Baseline and 12 months

Population: The results reported include all men with both an entrance and exit biopsy, regardless of cancer status.

ArmMeasureGroupValue (MEAN)Dispersion
EflornithineChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsTotal PSA-0.75 Relative % differenceStandard Deviation 26.29
EflornithineChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsPercent Free PSA10.21 Relative % differenceStandard Deviation 44.39
EflornithineChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsProstate Volume0.94 Relative % differenceStandard Deviation 17.58
PlaceboChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsTotal PSA1.55 Relative % differenceStandard Deviation 38.29
PlaceboChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsPercent Free PSA4.89 Relative % differenceStandard Deviation 40.14
PlaceboChange in Total PSA, Percent Free PSA, and Prostate Volume at 12 MonthsProstate Volume11.14 Relative % differenceStandard Deviation 19.44

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026