A Study of Epirubicin With Estramustine Phosphate and Celecoxib for the Treatment of Prostate Cancer

A Phase II Trial of Epirubicin With Estramustine Phosphate and Celecoxib for the Treatment of Hormone Resistant Prostate Cancer (HRPC)

The purpose of this clinical trial is to find out the effect of epirubicin with estramustine phosphate and celecoxib on PSA and objective response in patients with hormone resistant prostate cancer as well as evaluating the toxicity, quality of life of this combination. Celecoxib is an FDA approved drug to treat arthritis. Epirubicin, alone or with estramustine phosphate has been used in the treatment of hormone resistant prostate cancer. These drugs have demonstrated evidences of tumor blood vessel suppression and combination of these three drugs could possibly arrest further tumor growth or even make the tumor decrease in size.

Study Overview

• Status: Unknown
• Conditions: Prostate Cancer
• Intervention / Treatment: Drug: Epirubicin; Drug: Celecoxib; Drug: Estramustine Phosphate

• Study Type: Interventional
• Enrollment: 28
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Basil Kasimis, MD; Phone Number: 1544 973-676-1000; Email: basil.kasimis@med.va.gov

Study Locations

• United States
  • New Jersey
    • East Orange, New Jersey, United States, 07018
      • Recruiting
      • Department Of Veterans Affairs NJ Health Care System
      • Contact: Basil Kasimis, MD; Phone Number: 1544 973-676-1000; Email: basil.kasimis@med.va.gov
      • Sub-Investigator: Victor Chang, MD
      • Sub-Investigator: Shanthi Srinivas, MD
      • Sub-Investigator: Fengming Zhong, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Patient must have histologically proven adenocarcinoma of the prostate gland.
• Patient must have evidence of progressive metastatic disease (e.g., bone, pelvic mass, lymph node, liver or lung metastases) within 6 weeks prior to participation in the study.
• Patients must not have an elevated PSA level as the only evidence of disease. While castrated, the patients should have rising PSA on two consecutive measurements at least 1 week apart. The confirmatory PSA must be obtained within 1 week prior to study registration and should be >10ng/ml.
• Patients with bone metastases only (i.e., lacking soft-tissue disease) must have a PSA level of > 10 ng/ml. Patients with soft tissue metastases and /or visceral disease must have either measurable disease or a PSA level of > 10 ng/ml.
• Radiological evidence of hydronephrosis will not by itself constitute evidence of metastatic disease.
• Patients must have had prior treatment with bilateral orchiectomy or other primary hormonal therapy (e.g., estrogen therapy, LHRH analog + flutamide, etc.) with evidence of treatment failure.

NOTE: Patients who have not undergone bilateral orchiectomy must continue LHRH agonist therapy (e.g., depot leuprolide or goserelin) while receiving this protocol therapy.

• For patients previously treated with flutamide (Eulexin), nilutamide (Nilandron), or bicalutamide (Casodex): Patients must have discontinued flutamide or nilutamide < 4 weeks and for bicalutamide 6 weeks prior to registration.
• Patients should not have prior exposure to anthracyclines or estramustine phosphate.
• Patients must not have had prior radiotherapy < 4 weeks prior to this protocol treatment.
• Patients must not have previously received Strontium 89, Samarium 153, or other radioisotope therapies.
• Patients must have recovered from all toxicities due to prior treatment for prostate cancer prior to receiving this protocol treatment.
• Patients must have adequate bone marrow function: (WBC > 4000/ mm3, granulocytes > 2000/ mm3, platelet count > 100,000/mm3, and Hemoglobin > 8.0 g/dl < 4 weeks prior to participate in this study.
• Patients must have the following chemistry values < 4 weeks prior to participate in this study:
• Bilirubin < 1.5 mg/dl
• Transaminases (SGOT and/or SGPT) < 5 x institutional upper limit of normal (ULN)
• Creatinine < 2.0 mg/d. or creatinine clearance > 50 ml/min
• Alkaline phosphatase £ 5 x ULN
• Patients must have no active angina pectoris, or known heart disease of New York Heart Association Class III-IV. Patients must not have a history of myocardial infarction < 6 months prior to the study participation.
• Patients with a history of prior malignancy are eligible provided they were treated with curative intent and have been free of disease for the time period considered appropriate for the specific cancer.
• No serious concurrent medical illness or active infection should be present which would jeopardize the ability of the patient to receive the chemotherapy outlined in this protocol with reasonable safety.
• Sexually active patients must use an accepted and effective method of contraception while receiving protocol treatment.
• Patients must have a Karnofsky Performance Scale (KPS) score over 50. (Equaling ECOG Performance Scale of 0, 1, or 2).
• Age > 18 years.
• Patient must have failed the Taxotere treatment.

Exclusion Criteria:

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Determine the effect of epirubicin with estramustine phosphate and celecoxib on PSA and objective response in patients with HRPC

Secondary Outcome Measures

Outcome Measure
Evaluate the toxicity of the combination of epirubicin with estramustine phosphate and celecoxib in patients with stage D3 prostate cancer.
Determine the effects of this regimen on quality of life.
Determine the survival of the patients treated with the proposed regimen.

Collaborators and Investigators

• Sponsor: Department of Veterans Affairs, New Jersey
• Collaborators: Pfizer
• Investigators: Principal Investigator: Basil Kasimis, MD, Department Of Veterans Affairs NJ Health Care System

Publications and helpful links

General Publications

• Zhong F, Kasimis B, Hwang S, Cogswell J, Chang V, Morales E, Gonzalez M, Boholli I, Ohanian M, Blumenfrucht M: Second Line Treatment of Hormone Resistant Prostate Cancer (HRPC). A Phase II Trial of Epirubicin (E), Estramustine Phosphate (EP) and Celecoxib © Proc Am Soc Clin Oncol, Vol 24 #4754, 2005.

Study record dates

Study Major Dates

• Study Start: July 1, 2002
• Study Completion: June 1, 2006

Study Registration Dates

• First Submitted: September 20, 2005
• First Submitted That Met QC Criteria: September 20, 2005
• First Posted (Estimate): September 22, 2005

Study Record Updates

• Last Update Posted (Estimate): September 22, 2005
• Last Update Submitted That Met QC Criteria: September 20, 2005
• Last Verified: September 1, 2005

More Information

Terms related to this study

• Keywords: Celecoxib; Epirubicin; Hormone Refractory Prostate Cancer; Estramustine Phosphate
• Additional Relevant MeSH Terms: Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Genital Neoplasms, Male; Prostatic Diseases; Prostatic Neoplasms; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Peripheral Nervous System Agents; Enzyme Inhibitors; Analgesics; Sensory System Agents; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; Antirheumatic Agents; Cyclooxygenase Inhibitors; Antineoplastic Agents; Antineoplastic Agents, Hormonal; Antineoplastic Agents, Alkylating; Alkylating Agents; Topoisomerase II Inhibitors; Topoisomerase Inhibitors; Antibiotics, Antineoplastic; Cyclooxygenase 2 Inhibitors; Epirubicin; Celecoxib; Estramustine
• Other Study ID Numbers: K-EPIRU-0030-280-US