- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00672594
Study of Sunitinib Malate in Patients With Newly Diagnosed Prostate Cancer Prior to Prostatectomy
July 31, 2014 updated by: Duke University
Investigator-Initiated Pilot Study of Sunitinib Malate in Patients With Newly Diagnosed Prostate Cancer Prior to Prostatectomy
The purpose of this study is to look at blood and tissue samples for changes following the use of Sunitinib malate.
Additionally, we would like to find out if the drug, Sunitinib malate, is safe and works in men with prostate cancer.
Sunitinib malate , also known as Sutent, is approved by the U.S. Food and Drug Administration (FDA), for treatment of tumors of intestines and kidney but it is being tested in research studies for use in men with prostate cancer.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Eligible patients will be treated with 50 mg once daily for four weeks followed by one to two weeks off treatment prior to undergoing radical prostatectomy.
Patients with palpable disease (cT2-3) and patients with 3 or more positive prostatic biopsies from one lobe may undergo an additional study of IFP monitoring before treatment and during week 4 of study treatment.
Safety and tolerability of Sunitinib malate therapy at this dose and schedule in this patient population will be assessed.
Extensive correlative science evaluations, including assessment of physiologic, cellular, molecular and genetic changes during treatment with Sunitinib malate, will be performed
Study Type
Interventional
Enrollment (Actual)
30
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Texas
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Houston, Texas, United States, 77030
- MD Anderson, University of Texas
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
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:
- Histologic evidence of adenocarcinoma of the prostate deemed candidates for curative RRP
- Intermediate or high risk, clinically localized disease
- Adequate organ function
- Patients must be surgically sterile or must agree to use effective contraception during the period of therapy
- Select imaging to rule out metastasis will be done as clinically indicated
- Signed and date informed consent document
Exclusion Criteria:
- Prior treatment for prostate cancer
- Major surgery or radiation therapy within 4 weeks of starting the study treatment
- NCI CTCAE grade 3 hemorrhage within 4 weeks of starting therapy
- History of or known metastatic prostate cancer
- Any of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
- Ongoing cardiac dysrhythmias of NCI CTCAE grade 2 or greater
- QTc interval > 500 msec on baseline EKG
- Hypertension that cannot be controlled by medications (>150/100 mm Hg despite optimal medical therapy).
- Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication
- Known active infection
- Concurrent treatment on another clinical trial. Supportive care trials or non-treatment trials, e.g. QOL, are allowed.
- Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results, and in the judgment of the investigator would make the subject inappropriate for entry into this study.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Sunitinib Malate
Sunitinib Malate 50mg capsule by mouth once daily for 4 weeks
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Sunitinib Malate 50mg capsule by mouth once daily for 4 weeks
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Apoptotic Indices Before and After Treatment
Time Frame: Baseline and 4 weeks
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Pathologic changes will be described using immuno-histochemical techniques (assessment of apoptotic/proliferative indices and microvessel density (MVD)) using paraffin-embedded samples and freshly cut slides from the block which are deparaffinized and rehydrated through graded alcohol, where applicable.
Antigen retrieval will be accomplished by microwaving in citrate buffer from 5 to 7 minutes for the Ki-67 and MVD analysis.
Mean difference in %apoptosis (measured as %TUNEL positive cells per high powered field) between pre and post treatment will be reported.
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Baseline and 4 weeks
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Change in Proliferation Indices Before and After Treatment
Time Frame: Baseline and 4 weeks
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Pathologic changes will be described using immuno-histochemical techniques (assessment of apoptotic/proliferative indices and microvessel density (MVD)) using paraffin-embedded samples and freshly cut slides from the block which are deparaffinized and rehydrated through graded alcohol, where applicable.
Antigen retrieval will be accomplished by microwaving in citrate buffer from 5 to 7 minutes for the Ki-67 and MVD analysis.
Mean difference in %proliferation (Ki67 positive nuclei out of total nuclei) between pre and post treatment will be reported.
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Baseline and 4 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Patients Experiencing Grade ≥4 Hematologic or Grade ≥3 Non-hematologic Toxicity
Time Frame: 4 years
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Adverse events were collected using Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 and were converted to version 4.0 for the purposes of ClinicalTrials.gov
reporting.
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4 years
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Change in Pathologic (Microvessel Density).
Time Frame: Baseline and 4 weeks
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Pathologic changes will be described using immuno-histochemical techniques (assessment of microvessel density (MVD)) using paraffin-embedded samples and freshly cut slides from the block which are deparaffinized and rehydrated through graded alcohol, where applicable.
Antigen retrieval will be accomplished by microwaving in citrate buffer from 5 to 7 minutes for the MVD analysis.
Results are reported as the difference in pre and post MVD.
Units for MVD are number of CD31 cells per high powered field.
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Baseline and 4 weeks
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Change in Systemic Parameters Before and After Sunitinib Malate Treatment.
Time Frame: Baseline and 4 weeks
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We evaluated candidate biomarkers of this pathway to predict for pharmacodynamic response to Sunitinib malate.
In addition, a 7 ml plasma sample was collected at baseline and again at 4 weeks on all patients to assess possible biomarkers of response.
Reported is the mean percent change in plasma concentration for each marker between 4 weeks and baseline.
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Baseline and 4 weeks
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Protein Levels and Activation Status of PDGFR in Prostate Cancer Tissue.
Time Frame: 4 years
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We will perform immunohistochemistry staining on snap frozen specimens for endothelial and pericyte cell staining as previously described (42).
Frozen prostate tumor biopsies are sectioned at 6μm thickness and fixed with acetone for 10 minutes.
Endogenous peroxidase activity is quenched with 3% hydrogen peroxide for 15 min and then blocked with 5% normal serum.
The slides are incubated with the primary antibody (1;100) overnight at 4 C°, and washed with PBS.
Negative controls will be included by omission of the primary antibody.
Biotinylated donkey antimouse antibody (1:1000, v/v) will be applied for 30 min at room temperature, followed by application of ABC kit (Vector Lab, Inc., Burlingame, USA).
Slides are again washed in PBS and the color is developed by 5 min incubation with diaminobenzidine (DAB) solution.
Slides are then counterstained with hematoxylin.
Mean protein levels are presented.
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4 years
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Difference in Gene Expression Patterns Using Microarray Analysis
Time Frame: 4 years
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Microarray data of 21 specimens from men enrolled who have undergone a prostatectomy and study treatment were compared to data from 21 prostatectomy only specimens.
We used previously developed genomic signatures to measure the deregulation of oncogenic pathways built using Bayesian Probit models for 'metagene' factors from a singular value decomposition of top differentially expressed genes.
A Monte Carlo Markov Chain was used to generate the predicted probabilities of pathway activity in normalized samples.
We predicted the activity of these pathways, leading to the generation of probability measures that have previously reflected the state of pathway activity.
These probability scores are interpreted as gene expression values to describe pathway activity patterns.
A probability near 0 indicates a low chance of pathway activity; a probability near 1 indicates a higher likelihood of activity.
Differences (treatment - control) in mean probability for each pathway are reported.
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4 years
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Interstitial Fluid Pressure (IFP)
Time Frame: 4 years
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Measure Interstitial fluid pressure (IFP) pre-treatment and during treatment to indirectly measure the effect of Sunitinib malate on transcapillary transport and correlate with other biologic evidence of treatment effect.Eligible patients who sign consent will undergo a baseline transrectal ultrasound (TRUS)-guided measurement of tumor IFP.
Participants will then begin treatment with daily oral Sunitinib malate with biweekly monitoring for response and toxicity.
After 4 weeks of therapy, patients undergo a repeat TRUS and tumor IFP measurement.
Following a 1 to 2 week wash out period, patients undergo prostatectomy with pathologic tissue collection.
This will be performed as a means to evaluate whether Sunitinib malate has the ability to decrease tumor IFP, and whether this correlates with other tr
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4 years
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Daniel J George, MD, Duke University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
July 1, 2006
Primary Completion (Actual)
September 1, 2012
Study Completion (Actual)
September 1, 2013
Study Registration Dates
First Submitted
May 4, 2008
First Submitted That Met QC Criteria
May 4, 2008
First Posted (Estimate)
May 6, 2008
Study Record Updates
Last Update Posted (Estimate)
August 4, 2014
Last Update Submitted That Met QC Criteria
July 31, 2014
Last Verified
May 1, 2014
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
- Enzyme Inhibitors
- Antineoplastic Agents
- Angiogenesis Inhibitors
- Angiogenesis Modulating Agents
- Growth Substances
- Growth Inhibitors
- Protein Kinase Inhibitors
- Sunitinib
Other Study ID Numbers
- Pro00007396
- DUMC-8725 (Other Identifier: Duke legacy protocol number)
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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