SB939 in Treating Patients With Recurrent or Metastatic Prostate Cancer

A Phase II Study of SB939 in Patients With Recurrent or Metastatic Castration Resistant Prostate Cancer

RATIONALE: SB939 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

PURPOSE: This phase II trial is studying how well SB939 works in treating patients with recurrent or metastatic prostate cancer.

Study Overview

• Status: Completed
• Conditions: Prostate Cancer
• Intervention / Treatment: Drug: HDAC inhibitor SB939

Detailed Description

OBJECTIVES:

Primary

• To determine the efficacy, as measured by PSA response and progression-free survival, of HDAC inhibitor SB939 in patients with recurrent or metastatic castration-resistant prostate cancer.

Secondary

• To determine the objective response and response duration in patients with measurable disease at baseline.
• To determine the tolerability and toxicity of this drug in these patients.
• To determine the number of circulating tumor cells at baseline and after 6 weeks (and 12 weeks if patient is still on study treatment).
• To explore potential molecular factors predictive of response by assessment of archival prostate tumor tissue.
• To explore ERG and PTEN expression on circulating tumor cells as a potential prognostic and predictive marker for response to this drug.
• To determine time to PSA and time to objective progression in these patients.

OUTLINE: This is a multicenter study.

Patients receive oral HDAC Inhibitor SB939 once daily on days 1, 3, 5, 8, 10, 12, 15, 17, and 19. Treatment repeats every 4 weeks for up to 12 courses in the absence of disease progression or unacceptable toxicity.

Blood samples are collected periodically for correlative studies. Blood samples and Archival tumor tissue are analyzed for TMPRSS2-ERG fusion and PTEN deletion status by FISH; TMPRSS2-ERG fusion by RT-PCR; and for the number of circulating tumor cells.

After completion of study therapy, patients are followed up at 4 weeks and then every 3 months thereafter.

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Phase 2

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Calgary, Alberta, Canada, T2N 4N2
      • Tom Baker Cancer Centre
    • Edmonton, Alberta, Canada, T6G 1Z2
      • Cross Cancer Institute
  • British Columbia
    • Kelowna, British Columbia, Canada, V1Y 5L3
      • BCCA - Cancer Centre for the Southern Interior
    • Vancouver, British Columbia, Canada, V5Z 4E6
      • BCCA - Vancouver Cancer Centre
  • Nova Scotia
    • Halifax, Nova Scotia, Canada, B3H 1V7
      • QEII Health Sciences Center
  • Ontario
    • London, Ontario, Canada, N6A 4L6
      • London Regional Cancer Program
    • Toronto, Ontario, Canada, M5G 2M9
      • Univ. Health Network-Princess Margaret Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 120 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the prostate
• Presence of clinically and/or radiologically documented disease (target or non-target)

• Metastatic or locally recurrent disease for which no curative therapy exists AND for which systemic chemotherapy is indicated due to progression, meeting the following criteria:

  • At least two rises in PSA over a reference value OR the development of new metastatic lesions with a stable or rising PSA

    • First rising PSA must be taken at least 1 week after the reference value
    • Third or subsequent PSA must show further increase confirming progression within 2 weeks prior to study enrollment
    • PSA progression must be documented after discontinuation of peripheral antiandrogens (4 weeks for flutamide and 6 weeks for bicalutamide/nilutamide) for patients with documented evidence of progression while receiving peripheral antiandrogens

• Medically or surgically castrated by androgen ablation

  • Castrate level of testosterone (< 1.7 nmol/L) must be present for patients undergoing medical androgen ablation

• Received prior hormone therapy

  • Must have hormone-refractory disease
  • Therapy with luteinizing hormone-releasing hormone (LHRH) agonist must continue for patients already receiving this treatment at the time of enrollment
  • Patients who discontinued LHRH agonist must restart therapy (if not surgically castrated) and the castrate level of testosterone must be present
• PSA ≥ 5 ng/mL
• Primary or metastatic tumor tissue available
• No documented CNS metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• Life expectancy ≥ 12 weeks
• Absolute granulocyte count ≥ 1.5 x 10^9/L
• Platelet count ≥ 100 x 10^9/L
• AST and ALT ≤ 2.5 times upper limit of normal (ULN)
• Bilirubin normal
• Serum creatinine normal
• Potassium normal
• Calcium normal
• Fertile patients must use effective contraception
• QTc ≤ 450 msec
• LVEF ≥ 50% by Echo or MUGA scan
• Troponin I or T ≤ ULN
• Able to take oral medication
• No preexisting uncontrolled cardiac condition
• No prior myocardial infarction
• No history of other malignancies, except adequately treated nonmelanoma skin cancer or other solid tumors curatively treated with no evidence of disease for ≥ 5 years
• No gastrointestinal abnormalities (e.g., bowel obstruction or previous gastric resection) that would lead to inadequate absorption of HDAC Inhibitor SB939
• No known HIV positivity or hepatitis B or C infections

• No chronic medical condition or comorbidity that may increase the risks associated with study participation/study drug administration or may interfere with the interpretation of study results, including any of the following:

  • Pulmonary disease
  • Active infection
  • Psychiatric condition
  • Laboratory abnormality

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• At least 4 weeks since prior antiandrogens (6 weeks for bicalutamide)

• At least 4 weeks since prior external-beam radiotherapy

  • Exceptions may be made for low-dose, non-myelosuppressive radiotherapy
• At least 28 days since other prior investigational therapy or anticancer therapy
• At least 14 days since prior major surgery and wound healing has occurred
• No more than 1 prior chemotherapy regimen allowed and recovered from significant toxicity
• No prior strontium
• No prior HDAC inhibitors
• No current agents (dysrhythmic drugs) with a known risk of Torsades de Pointes
• No other concurrent cytotoxic therapy or radiotherapy
• No other concurrent investigational therapy

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

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SB939; SB939 given orally every other day 3 times a week (i.e. Monday /Wednesday /Friday, or Tuesday /Thursday / Saturday) for 3 consecutive weeks followed by one week off-dosing. A treatment cycle is 4 weeks (28 days).	Drug: HDAC inhibitor SB939; SB939 given orally every other day 3 times a week (i.e. Monday /Wednesday /Friday, or Tuesday /Thursday / Saturday) for 3 consecutive weeks followed by one week off-dosing. A treatment cycle is 4 weeks (28 days).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PSA response	Each patient will have PSA response calculated. Required at the end of every cycle.	each cycle
Progression-free survival	Used as an indicator of efficacy, patients with PSA response will have length of progression free survival calculated.	end of study

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective response rate	Patients with measurable disease will have objective response evaluated.	every other cycle
Duration of response	Patients with objective response will have duration of response calculated as will be followed until progression/relapse	every other cycle
Safety	Toxicity and tolerability will be evaluated	each cycle
Change in circulating tumor cells during study compared to baseline	Patients will have on study samples compared to baseline to look for chance in number of CTC.	each cycle
Comparison of TMPRSS2-ERG fusion and PTEN deletion in circulating tumor cells	samples will be taken and analyzed each cycle with a comparison made at end of study.	each cycle
Comparison of two systems for counting circulating tumor cells	Two different systems will be used to count CTC. Results will be compared at the end of the study for accuracy.	end of study

Collaborators and Investigators

• Sponsor: NCIC Clinical Trials Group
• Collaborators: S*BIO
• Investigators: Study Chair: Kim N. Chi, MD, British Columbia Cancer Agency; Study Chair: Bernhard Eigl, MD, FRCPC, Tom Baker Cancer Centre - Calgary

Publications and helpful links

General Publications

• Eigl BJ, North S, Murray N, Heng DYC, Winquist E, Powers J, Walsh WR, Eisenhauer E, Squire J, Cox M, Chi KN. A Phase II Study of SB939 in Patients with Recurrent or Metastatic Castration Resistant Prostate Cancer (CRPC). AACR Mol Cancer Tehr 10[11 Suppl; abstr A211]. 2011
• Eigl BJ, North S, Murray N, Heng DYC, Winquist E, Powers J, Walsh WR, Eisenhauer E, Squire J, Cox M, Chi KN. A Phase II Study of SB939 in Patients with Recurrent or Metastatic Castration Resistant Prostate Cancer (CRPC). Canadian Cacner Research Conference. 2011.
• Eigl BJ, North S, Winquist E, Finch D, Wood L, Sridhar SS, Powers J, Good J, Sharma M, Squire JA, Bazov J, Jamaspishvili T, Cox ME, Bradbury PA, Eisenhauer EA, Chi KN. A phase II study of the HDAC inhibitor SB939 in patients with castration resistant prostate cancer: NCIC clinical trials group study IND195. Invest New Drugs. 2015 Aug;33(4):969-76. doi: 10.1007/s10637-015-0252-4. Epub 2015 May 19.

Study record dates

Study Major Dates

• Study Start (Actual): June 28, 2010
• Primary Completion (Actual): January 5, 2015
• Study Completion (Actual): February 13, 2015

Study Registration Dates

• First Submitted: February 24, 2010
• First Submitted That Met QC Criteria: February 24, 2010
• First Posted (Estimated): February 25, 2010

Study Record Updates

• Last Update Posted (Actual): August 4, 2023
• Last Update Submitted That Met QC Criteria: August 3, 2023
• Last Verified: April 1, 2020

More Information

Terms related to this study

• Keywords: stage III prostate cancer; stage IV prostate cancer; recurrent prostate cancer; adenocarcinoma of the prostate; hormone-resistant prostate cancer
• Additional Relevant MeSH Terms: Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Genital Neoplasms, Male; Prostatic Diseases; Urogenital Diseases; Male Urogenital Diseases; Genital Diseases, Male; Genital Diseases; Prostatic Neoplasms; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Histone Deacetylase Inhibitors
• Other Study ID Numbers: I195; CAN-NCIC-IND195 (Registry Identifier: NCI US PDQ); CDR0000666241 (Other Identifier: PDQ)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No