Prostate Cancer
Conditions
Brief summary
10 patients will be enrolled in the initial cohort and will receive two infusions of unlabeled huJ591 on days 1 and 14. 89Zr-J591 will be administered on day 21 (+ 1 day) and a positron emission tomography-computed tomography (PET/CT) will be performed week later on day 28 + 1 (visit 4). Approximately 2 to 3 weeks after the 2nd dose of J591, the patient will undergo radical prostatectomy with or without lymph node dissection (day 31 + 4 days). The final visit for the study will include a postoperative visit two weeks following surgery.
Detailed description
This is an open-label, single center pilot study to evaluate the efficacy of huJ591 to trigger antibody-dependent cellular cytotoxicity (ADCC) response manifested by a peri-tumoral inflammatory response with or without apoptosis of prostate cancer cells in patients diagnosed with either high or intermediate-risk prostate cancer. To participate the patients will be required to meet all eligibility criteria. Patients may not participate in other clinical trials while undergoing therapeutic treatment. The initial screening period (up to 28 days prior to start of treatment under this clinical trial) consists of visit to confirm eligibility, discuss the risks / benefits of participating in the trial and radical prostatectomy (with or without lymph node dissection), and obtain patient prostate biopsy samples for anti-prostate specific membrane antigen (PSMA) expression review. An enrolled subject's participation in the study entails approximately 6 to 7 weeks of therapy along with the additional 2 weeks time involved in recovery from a radical prostatectomy. Adverse events will be collected throughout the entirety of the study. The total duration of the patient being in the study can be around 9 to 11 weeks. Medical information/Survival information will be collected from the routine followup visits (standard of care) for up to 3 years after the surgery.
Interventions
DRUGhuJ591
Antibody is derived from a hybridoma originally produced in the Weill Medical College Laboratory of Urological Oncology. Treatment with 100 mg of HuJ591 will be administered as an intravenous infusion at a concentration of 5 mg/mL and rate of \<5 mg/minute.
DRUG89Zr-J591
Drug product is manufactured by the radiochemistry staff of Citigroup Biomedical Imaging Center (CBIC) research core facility. Radiolabeling of DFO-huJ591 with 89Zr is achieved by the addition of 89Zr-oxalate to the DFO-huJ591 in ammonium acetate buffer.
Sponsors
Weill Medical College of Cornell University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adult male \> 18 years of age 2. Histologically confirmed diagnosis of prostate cancer 3. Intermediate or high risk prostate cancer defined by: * High risk (any one of the following): 1. Gleason grade \> 8 2. Gleason grade 4+3 with more than 3 cores involved with \> 20% of volume involved 3. Any Gleason with PSA above 20 ng/mL 4. Gleasone \> 4+3 and tumor stage clinical T3 or above * Intermediate risk prostate cancer defined as: 1. Gleason grade = 7 2. Any Gleason with PSA between 10 and 20 ng/mL 4. Eastern Cooperative Oncology Group (ECOG) Performance status of 0-1 5. Ability to understand and willingness to sign a written informed consent document 6. Prostate biopsy with + PSMA expression in tumor cells by immunohistochemistry
Exclusion criteria
1. Serum creatinine \> 3x upper limit of normal (ULN) 2. Bilirubin (total) \> 1.5 x ULN; subjects with Gilbert's syndrome will be allowed if direct bilirubin is within institutional normal limits 3. Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT or SGOT) \> 2.5x ULN 4. Other severe acute or chronic medical condition or laboratory abnormality that may increase the risk associated with study participation 5. On any other new anticancer therapy between screening and prostatectomy 6. Frank metastasis identified during clinical staging 7. Patient ineligible for radical prostatectomy for any other reason
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Induction of inflammatory and/or apoptotic response of prostate cancer cells by reviewing H&E stained slides from pre treatment biopsy and comparing to the post-treatment radical prostatectomy pathology using the Peri-tumoral inflammation 4-point scoring | Change from baseline in Peri-tumoral inflammation 4-point scoring at Day 31 post prostatectomy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to biochemical (PSA) and/or radiographic recurrence will be followed by drawing PSA samples and performing radiographic scans. | From date of first treatment until the date of first documented progression or date of death, whichever came first, assessed up to 36 months | PSA values will be monitored at screening, then at months 3, 6, 9, 12, 18, 24, and 36 after Day 1 of treatment. Radiographic scans will be performed at screening and at months 6, 12, 18, 24, 30, and 36. |
| Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | Adverse events will be monitored on Days 1, 14, 21, 28, 31, and 45 | — |
Countries
United States
Outcome results
None listed