Photodynamic Therapy With Lutetium Texaphyrin in Treating Patients With Locally Recurrent Prostate Cancer
A Phase I Trial of Photodynamic Therapy With Lutetium Texaphyrin in Patients With Locally Recurrent Prostate Carcinoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Determine the dose limiting toxicities and maximum tolerated dose of photodynamic therapy (PDT) using 730 nm light and lutetium texaphyrin in patients with locally recurrent prostate adenocarcinoma who have failed previous definitive radiotherapy.
SECONDARY OBJECTIVES:
I. Measure lutetium texaphyrin levels in needle biopsies of the prostate before and after PDT using an HPLC and tissue fluorescence assay and calculate the percent change in lutetium texaphyrin after treatment.
II. Measure lutetium texaphyrin fluorescence in situ in the prostate before and after PDT using optical methods and correlate these results with the direct tissue measurements made in the biopsies of these patients.
III. Determine clinical outcome including clinical response, progression free survival, time to complete response, time to biochemical relapse, time to local progression, time to distant failure, overall survival, and disease specific survival in these patients treated with this regimen.
OUTLINE: This is a dose-escalation study of lutetium texaphyrin and light fluence.
Patients receive lutetium texaphyrin IV over 10-15 minutes 3-24 hours before photodynamic therapy (PDT). Optical fibers attached to a laser are inserted through a catheter into the prostate. The laser delivers 730 nm light to the prostate until the specified fluence is delivered. Patients undergo biopsy of the prostate and bladder before and after PDT. Cohorts of 3-6 patients receive escalating doses of lutetium texaphyrin and light fluence until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose limiting toxicity.
Patients are followed at 2 weeks, 1 month, 2 months, 3 months, then every 3 months until 2 years, then every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A minimum of 24 patients will be accrued for this study within 3 years.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Abramson Cancer Center of the University of Pennsylvania
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Histologically proven locally recurrent prostate adenocarcinoma previously treated with definitive radiotherapy
- No T3 or T4 primary tumors
- No evidence of regional or distant metastases by MRI or bone scan
- No pathologic demonstration of malignancy in pelvic or abdominal lymph nodes
- Prostate gland volume no greater than 50 mL by MRI or ultrasound
- PSA no greater than 20 ng/mL
- Performance status - ECOG 0-2
- WBC at least 2,000/mm^3
- Platelet count at least 100,000/mm^3
- No severe liver disease (e.g., cirrhosis or grade III-IV elevations in liver function studies)
- Bilirubin no greater than 1.5 mg/dL
- Creatinine normal
- Creatinine clearance at least 60 mL/min
- Medical suitability for implantation
- Fertile patients must use effective contraception during and for 6 months after study participation
- No history of grade III or IV genitourinary or gastrointestinal toxicity
- No known G6PD deficiency
- No porphyria
- At least 4 weeks since prior gene therapy
- At least 4 weeks since prior immunotherapy
- At least 4 weeks since prior combination chemotherapy
- No concurrent chemotherapy
- At least 4 weeks since prior hormonal therapy
- No concurrent hormonal therapy
- No prior cryosurgery for prostate cancer
- No other concurrent medication for prostate cancer
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Treatment (motexafin lutetium, PDT)
Patients receive lutetium texaphyrin IV over 10-15 minutes 3-24 hours before photodynamic therapy (PDT).
Optical fibers attached to a laser are inserted through a catheter into the prostate.
The laser delivers 730 nm light to the prostate until the specified fluence is delivered.
Patients undergo biopsy of the prostate and bladder before and after PDT.
Cohorts of 3-6 patients receive escalating doses of lutetium texaphyrin and light fluence until the maximum tolerated dose (MTD) is determined.
The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose limiting toxicity.
|
Given IV
Other Names:
Undergo photodynamic therapy
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Dose-limiting toxicity (DLT) defined as grade III non-hematologic toxicity or grade IV hematologic toxicity as assessed by the Cancer Therapy Evaluation Program Common Toxicity Criteria (CTC) version 2.0
Time Frame: 24 hours
|
24 hours
|
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MTD based on the incidence of DLT as assessed by the Cancer Therapy Evaluation Program CTC version 2.0
Time Frame: 24 hours
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24 hours
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent change in lutetium texaphyrin levels in needle biopsies by high pressure liquid chromatography (HPLC) and tissue fluorescence assay
Time Frame: From pre-PDT to post-PDT
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Scattergrams and error bar plots of lutetium texaphyrin concentration by lutetium texaphyrin dose level and possibly by light fluence (for a fixed lutetium texaphyrin dose = 2) will be constructed to investigate possible dose-concentration relationships.
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From pre-PDT to post-PDT
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Lutetium texaphyrin levels in situ
Time Frame: At pre- and post-PDT
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Descriptive statistics (mean, median, standard deviation, range and coefficient of variation) will be used to characterize the distribution of lutetium texaphyrin concentrations within each dose level.
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At pre- and post-PDT
|
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Clinical response rate defined as no evidence of disease (NED)
Time Frame: Up to 5 years
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The 95% confidence interval will be calculated for the rate of NED.
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Up to 5 years
|
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Progression-free survival (PFS)
Time Frame: From the date of accession to the date of documentation of clinical progression or until the date of death from any cause, assessed up to 5 years
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Estimated by the method of Kaplan and Meier.
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From the date of accession to the date of documentation of clinical progression or until the date of death from any cause, assessed up to 5 years
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Time to complete response
Time Frame: Up to 5 years
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Up to 5 years
|
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Time to biochemical relapse
Time Frame: Up to 5 years
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Up to 5 years
|
|
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Time to local progression as determined by clinical exam
Time Frame: From the date of accession to the date of documented local progression, assessed up to 5 years
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Estimated by the method of Kaplan and Meier.
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From the date of accession to the date of documented local progression, assessed up to 5 years
|
|
Time to distant failure
Time Frame: From the date of accession to the date of documented metastatic disease, assessed up to 5 years
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From the date of accession to the date of documented metastatic disease, assessed up to 5 years
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|
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Overall survival
Time Frame: From the date of accession to the date of death, assessed up to 5 years
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From the date of accession to the date of death, assessed up to 5 years
|
|
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Disease specific survival
Time Frame: Up to 5 years
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Up to 5 years
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NCI-2012-02323
- UPCC 6899
- CDR0000067672 (Registry Identifier: PDQ (Physician Data Query))
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