- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00309894
Ketoconazole, Hydrocortisone, and GM-CSF in Treating Patients With Progressive Prostate Cancer After Hormone Therapy
Phase II Trial to Assess the Activity of Ketoconazole Plus GM-CSF in Patients With Prostate Cancer Progressive After Androgen Deprivation
RATIONALE: Androgens can cause the growth of prostate cancer cells. Drugs, such as ketoconazole, may stop the adrenal glands from making androgens. GM-CSF may help ketoconazole work better by making tumor cells more sensitive to the drug. Giving ketoconazole together with hydrocortisone and GM-CSF may be an effective treatment for prostate cancer.
PURPOSE: This phase II trial is studying how well giving ketoconazole together with hydrocortisone and GM-CSF works in treating patients with progressive prostate cancer after hormone therapy.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- Evaluate the effect of ketoconazole, hydrocortisone, and sargramostim (GM-CSF) on time to clinical progression in patients with prostate cancer that has progressed on primary hormonal therapy.
Secondary
- Evaluate the objective response frequency in patients treated with this regimen.
- Investigate the safety of this regimen.
OUTLINE: This is an open-label, nonrandomized study.
Patients receive oral ketoconazole three times daily and oral hydrocortisone twice daily on days 1-28 and sargramostim (GM-CSF) subcutaneously on days 15-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
PROJECTED ACCRUAL: A total of 48 patients will be accrued for this study.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
California
-
San Francisco, California, United States, 94115
- UCSF Comprehensive Cancer Center
-
San Francisco, California, United States, 94121
- Veterans Affairs Medical Center - San Francisco
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
- Histologically confirmed adenocarcinoma of the prostate
Progressive disease after androgen deprivation AND meets 1 of the following criteria:
Measurable disease
- Measurable lesions ≥ 10 mm with spiral CT
- Up to 5 lesions per organ and 10 lesions total should be identified as target lesions
No measurable disease
Patients with prostate-specific antigen (PSA)-only disease must have an elevated PSA
- PSA evidence for progressive disease consists of a PSA level of ≥ 5 ng/mL that has risen on ≥ 2 successive occasions, ≥ 2 weeks apart
- Patients with a positive bone scan must also have an elevated PSA
Patients who received prior antiandrogen as a part of primary androgen ablation therapy must demonstrate disease progression after discontinuation of the antiandrogen
Disease progression after antiandrogen withdrawal is defined as 2 consecutive rising PSA values obtained ≥ 2 weeks apart, or documented osseous or soft tissue progression
- Patients receiving flutamide must have had ≥ 1 of the PSA values obtained ≥ 4 weeks after flutamide discontinuation
- Patients receiving bicalutamide or nilutamide must have had ≥ 1 of the PSA values obtained ≥ 6 weeks after antiandrogen discontinuation
- Testosterone < 50 ng/dL
- PSA ≥ 5 ng/mL
PATIENT CHARACTERISTICS:
- Karnofsky performance status 60-100%
- No serious intercurrent infections or nonmalignant uncontrolled medical illnesses
- No psychiatric illnesses OR social situations that would limit compliance
- No active or uncontrolled autoimmune disease
- ALT and AST normal
- Bilirubin normal
- Absolute neutrophil count ≥ 1,500/mm³
- Platelet count ≥ 100,000/mm³
- Creatinine ≤ 1.5 times upper limit or normal (ULN)
- Hemoglobin ≥ 8 g/dL
No other currently active malignancy except for nonmelanoma skin cancer
- No currently active malignancy defined as therapy completed with ≤ 30% risk of relapse
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Patients must continue primary androgen deprivation therapy with a luteinizing-hormone releasing-hormone (LHRH) analogue if they have not undergone orchiectomy
No prior systemic chemotherapy for prostate cancer
- All other systemic chemotherapy must have been completed ≥ 2 years prior to study
- No other concurrent chemotherapy, immunotherapy, or radiotherapy
- Major surgery or radiation therapy completed ≥ 4 weeks prior to study
- No other concurrent corticosteroids, including routine use antiemetics
- No prior ketoconazole, aminoglutethimide, or corticosteroids for treatment of progressive prostate cancer
- No prior immunotherapy (e.g., vaccines or sargramostim GM-CSF)
- Patients receiving any other hormonal therapy (e.g., megestrol, finasteride, herbal product known to decrease PSA levels [e.g., saw palmetto or PC-SPES], or any systemic corticosteroid) must discontinue the agent ≥ 4 weeks prior to enrollment and progressive disease must be documented after discontinuation
No initiation of bisphosphonate therapy within 1 month prior to starting study therapy
- Patients on stable doses that show tumor progression are allowed to continue bisphosphonate
No concurrent supplements or complementary medicines/botanicals, except any combination of the following:
- Conventional multivitamin supplements
- Selenium
- Lycopene
- Soy supplements
- Vitamin E
- At least 8 weeks since prior radiopharmaceuticals (strontium chloride Sr 89, samarium Sm 153 lexidronam pentasodium)
- No other concurrent investigational or commercial anticancer agents or therapies
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Time to progression
|
Secondary Outcome Measures
Outcome Measure |
---|
Response rate as measured by prostate-specific antigen and objective parameters
|
Frequency of grades 3-4 toxicity
|
Pattern of immune response as measured by immunohistochemistry
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Charles Ryan, MD, University of California, San Francisco
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
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
- Anti-Infective Agents
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Immunologic Factors
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 Enzyme Inhibitors
- Hormone Antagonists
- Antifungal Agents
- Steroid Synthesis Inhibitors
- 14-alpha Demethylase Inhibitors
- Ketoconazole
- Sargramostim
- Hydrocortisone
- Hydrocortisone 17-butyrate 21-propionate
- Hydrocortisone acetate
- Hydrocortisone hemisuccinate
Other Study ID Numbers
- 035516
- UCSF-H45860-23833-02
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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