Prostate Cancer, Prostatic Adenocarcinoma
Conditions
Keywords
prostate, Degarelix, injections, radical prostatectomy, 11-182
Brief summary
Degarelix is an approved drug that is used to treat prostate cancer by lowering testosterone levels in the body. Degarelix is commonly given with radiation for prostate cancer, but less frequently with surgery since there has been no proven benefit with this approach. The investigators do not expect the patient to benefit directly from treatment with degarelix since their prostate will be removed shortly after the drug is given. Instead, the investigators hope to learn about how degarelix and other treatment that lowers your testosterone effects prostate cancer cells and use this information to develop better treatments in the future.
Interventions
DRUGdegarelix injection
Treatment will consist of a single 240 mg injection of degarelix 4 ± 1 day before radical prostatectomy, depending on treatment arm.
DRUGandrogen deprivation therapy
Sponsors
Memorial Sloan Kettering Cancer Center
Ferring Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologic confirmation of prostatic adenocarcinoma by MSKCC inclusive of the following: * 3 or more positive biopsy cores or equivalent tumor specimen as confirmed by pathologist * At least 2 cores containing ≥3 mm of tissue with carcinoma or equivalent tumor specimen as confirmed by pathologist * A primary tumor Gleason score ≥ 7 * Adequate primary biopsy tissue or equivalent tumor specimen as confirmed by pathologist available for protocol required analysis (i.e. bladder or TURP specimen) * Planning to have or have had a radical prostatectomy (RP) at MSKCC * Candidates may have a history of deep vein thrombosis, pulmonary embolism, and/or cerebrovascular accident, or require concomitant systemic anticoagulation, if otherwise deemed to be suitable for RP * Karnofsky performance status \>70% (Appendix A) * Sexually active fertile subjects, and their partners, must agree to use medically accepted methods of contraception (eg, barrier methods, including male condom, female condom, or diaphragm with spermicidal gel) during the course of the study and for 3 months after the dose of study drug(s) for Cohorts 1 , 2 and 4, and for 3 months after the surgery for Cohort 3 * For cohorts 1,2 and 4 only:, non-castrate testosterone level (\>100 ng/dL) * For cohort 3 only:, 1-6 months of androgen deprivation therapy (gonadotropin hormone releasing analogs with or without an anti-androgen) prior to prostatectomy with a castrate testosterone level of \<50 ng/dL within 1 month prior to prostatectomy.
Exclusion criteria
* Histologic variants in the primary tumor (histologic variants other than adenocarcinoma) * Current or prior chemotherapy * The use of the 5-alpha-reductase inhibitor dutasteride must be discontinued within 4 weeks of degarelix injection for Cohort 1, 2 and 4, and within 4 weeks of surgery for Cohort 3. * Saw palmetto administered with the intent to treat the patient's malignancy within 1 week of degarelix injection for Cohorts 1, 2 and 4, and for within 1 week of surgery for Cohort 3 * Current or prior radiation therapy to the prostate * Active infection or intercurrent illness * Concomitant therapy with any other experimental drug * For cohorts 1, 2 and 4 only:, current or prior hormonal therapy (e.g., gonadotropin hormone releasing analogs, megestrol acetate, or antiandrogens) are exclusionary
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percent Change in Prostate Cancer Cell Proliferation (Ki-67 Levels) | Baseline and up to 2 years | The primary endpoint is the change in the rate of proliferation (Ki-67), as evaluated by IHC in anatomically matched tumor foci from the pre-treatment diagnostic biopsy and the RP specimen. The levels in pre-treatment biopsy serve as the baseline. Ki-67 is a widely accepted nuclear marker for cell proliferation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Median Percentage of Cells From Biopsy and Surgery That Are Positive For Ki-67 | up to 2 years | The secondary endpoint is PTEN status by IHC in the diagnostic biopsy and RP specimens. PTEN status will be determined by an IHC method that has been validated using control prostate cell lines and tissues at MSKCC. The PTEN status will be reported in binary fashion as "retained" (diffuse moderate immunoreactivity retained in benign glands as well as adenocarcinoma on 100X magnification) or "null" (complete loss of nuclear and cytoplasmic immunoreactivity in tumor cells while expression is retained in surrounding stroma. |
| Record Participant Biomarker Results and Correlates of Response | Up to 14+/- days | through expression profiling of prostate cancer after three time intervals of androgen deprivation therapy and correlate with PTEN and ERG status, proliferation rate, apoptotic rate, and histologic response |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORDana Rathkopf, MD
Memorial Sloan Kettering Cancer Center
Participant flow
Pre-assignment details
3 participants withdrew consent and were not treated
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 76 years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 34 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 31 Participants |
| Region of Enrollment United States | 3 Participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 17 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 2 / 17 | 0 / 17 | 1 / 3 | 0 / 1 |
| other Total, other adverse events | 13 / 17 | 17 / 17 | 1 / 3 | 0 / 1 |
| serious Total, serious adverse events | 7 / 17 | 5 / 17 | 0 / 3 | 0 / 1 |
Outcome results
None listed