Prostate Cancer
Conditions
Keywords
recurrent prostate cancer
Brief summary
RATIONALE: Calcitriol may help prostate cancer cells become more like normal cells, and to grow and spread more slowly. Dexamethasone may help calcitriol work better by making tumor cells more sensitive to the drug. Giving calcitriol together with dexamethasone may be an effective treatment for prostate cancer that did not respond to hormone therapy . PURPOSE: This phase II trial is studying how well giving calcitriol together with dexamethasone works in treating patients with prostate cancer that did not respond to hormone therapy.
Detailed description
OBJECTIVES: * To investigate the response rate in patients with androgen-independent prostate cancer treated with calcitriol and dexamethasone. * To evaluate the toxicity of high-dose calcitriol and dexamethasone in these patients. OUTLINE: Patients receive oral dexamethasone once on days 1 and 2 and calcitriol IV over 1 hour on day 2. Treatment repeats weekly in the absence of disease progression or unacceptable toxicity. Blood samples are collected at baseline and on days 2 and 3 to assess VDR and CYP24 expression in peripheral blood mononuclear cells.
Interventions
IV
Oral
Correlative Study
Correlative Study
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * History of androgen-independent prostate cancer * Evidence of rising PSA level (with or without new lesion by radiograph or physical examination), defined as follows: * PSA level \> 5 ng/mL and clearly rising on 2 measurements taken ≥ 2 weeks apart after androgen deprivation therapy (i.e., orchiectomy or luteinizing hormone-releasing hormone \[LHRH\] analogue) and antiandrogen withdrawal, if appropriate * PSA rising before and on the first value taken at 4 or 6 weeks after antiandrogen cessation is considered disease progression * Measurable or evaluable disease as defined by any of the following: * Measurable or evaluable tumor masses by radiograph or physical examination * Evaluable PSA * Concurrent LHRH analogue or diethylstilbestrol (DES) for testicular androgen suppression required if no prior bilateral orchiectomy * Patients receiving other monotherapy for testicular androgen suppression must switch to a LHRH analogue or DES ≥ 14 days prior to study entry PATIENT CHARACTERISTICS: * ECOG 0-2 * Life expectancy ≥ 12 weeks * ANC ≥ 1,000/mm³ * Platelet count ≥ 75,000/mm³ * Hemoglobin \> 8.9 g/dL (transfusion or erythropoietin support allowed) * Serum creatinine ≤ 1.8 mg/dL * AST ≤ 4 times upper limit of normal (ULN) * Total bilirubin ≤ 2.0 mg/dL * Serum corrected calcium \< ULN * No history of nephrolithiasis within the past 5 years * No unstable, uncontrolled peptic ulcer disease, congestive heart failure, glaucoma, HIV, or diabetes PRIOR CONCURRENT THERAPY: * At least 28 days since prior androgen deprivation therapy (≥ 42 days for bicalutamide) * A 28-day washout period is not required for patients who have previously progressed despite antiandrogen withdrawal and who have resumed antiandrogens without reduction of PSA * At least 14 days since prior radiotherapy * At least 28 days since prior strontium 89 * At least 28 days since prior chemotherapy and/or investigational agents * No concurrent medications or supplements that contain additional calcium (e.g., Tums) * No concurrent radiotherapy for pain control or any other indication * Concurrent bisphosphonates allowed provided dose/regimen is stable
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response (Complete or Partial Response) | 1 year | Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Corrected Serum Calcium Expression | 1 year | Number of patients with corrected serum calcium levels between 11 mg/dL and 12 mg/dL detected on 1 or more occasions. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Dexamethasone and Calcitriol Patients receive oral dexamethasone once on days 1 and 2 and calcitriol IV over 1 hour on day 2. Treatment repeats weekly.
calcitriol: IV
dexamethasone: Oral
protein expression analysis: Correlative Study
laboratory biomarker analysis: Correlative Study | 18 |
| Total | 18 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Disease Progression | 16 |
| Overall Study | Withdrawal by Subject | 2 |
Baseline characteristics
| Characteristic | Dexamethasone and Calcitriol |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 11 Participants |
| Age, Categorical Between 18 and 65 years | 7 Participants |
| Age, Continuous | 68.2 years STANDARD_DEVIATION 11.8 |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 18 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 18 / 18 |
| serious Total, serious adverse events | 4 / 18 |
Outcome results
Objective Response (Complete or Partial Response)
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
Time frame: 1 year
Population: All treated and eligible patients
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dexamethasone and Calcitriol | Objective Response (Complete or Partial Response) | 0 percentage of participants |
Corrected Serum Calcium Expression
Number of patients with corrected serum calcium levels between 11 mg/dL and 12 mg/dL detected on 1 or more occasions.
Time frame: 1 year
Population: All treated and eligible patients
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Dexamethasone and Calcitriol | Corrected Serum Calcium Expression | 6 Participants |