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- Klinische proef NCT00859781
177Lu radioactief gemerkt monoklonaal antilichaam HuJ591 (177Lu-J591) en ketoconazol bij patiënten met prostaatkanker
Een gerandomiseerde fase 2-studie van 177Lu radioactief gelabeld monoklonaal antilichaam HuJ591 (177Lu-J591) en ketoconazol bij patiënten met risicovolle gecastreerde biochemisch recidiverende prostaatkanker na lokale therapie
The purpose of this study is to test the effectiveness of the experimental drug, 177Lu-J591 in combination with ketoconazole and hydrocortisone against prostate cancer.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This research is being done because the standard treatments for prostate cancer that has returned (PSA is elevated) after surgery and/or radiation and progressed on initial hormonal therapy are not curative. Existing treatments, such as the ketoconazole used as part of this study may decrease PSA temporarily, but unfortunately the cancer continues to grow. This experimental drug is designed to seek out all of the prostate cancer cells and to deliver a lethal dose of radiation to the areas of cancer, but not to normal areas. Some of the normal organs (liver, kidney and bone marrow) do receive some radiation dose that is within the acceptable limits.
The experimental drug in this study includes an antibody (abbreviated: mAb) called "J591". It is a protein molecule which can bind to a specific site on a prostate cancer cell. A very energetic radioactive (an unstable atom) metal called 177Lutetium (abbreviated: 177Lu) is attached to the J591 antibody. The fully assembled drug is called "177Lu-J591". The study will assess the potential of the energy given off by the radioactive compound to kill cancer cell. This study may also involve the use of 111Indium (abbreviated 111In). This is also an energetic radioactive particle, but does not generally give off enough energy to kill cancer cells, but allows researchers to take pictures. This radioactive particle is also attached to the J591 antibody (called 111In-J591) and will serve as a placebo (treatment with no active medicine).
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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California
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Los Angeles, California, Verenigde Staten, 90048
- Cedars Sinai
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Los Angeles, California, Verenigde Staten, 90089
- USC/Norris Comprehensive cancer center
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District of Columbia
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Washington D.C., District of Columbia, Verenigde Staten, 20007
- Georgetown University Medical Center
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Indiana
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Indianapolis, Indiana, Verenigde Staten, 46202
- Indiana University Melvin and Bren Simon Cancer Center
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Iowa
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Iowa City, Iowa, Verenigde Staten, 52242
- University of Iowa Hospitals and Clinics
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Kansas
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Westwood, Kansas, Verenigde Staten, 66205
- The University of Kansas Cancer Center
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68130
- XCancer Omaha
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New York
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New York, New York, Verenigde Staten, 10021
- Weill Cornell Medical College
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Pennsylvania
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Pittsburgh, Pennsylvania, Verenigde Staten, 15232
- UPMC Hillman Cancer Center
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Utah
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Salt Lake City, Utah, Verenigde Staten, 84108
- University of Utah
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
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Histologically or cytologically confirmed adenocarcinoma of the prostate previously treated with surgery and/or radiotherapy.
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Biochemical progression (rising PSA) after medical or surgical castration
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High risk of systemic progression defined as:
- Rising PSA as defined above and either:
- Absolute PSA > 20 ng/mL AND/OR
- PSA doubling time < 8 months
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No evidence of local recurrence or distant metastases
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Age >18 years.
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Serum testosterone < 50 ng/ml
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Patients capable of fathering children must agree to use an effective method of contraception for the duration of the trial.
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Subjects on bisphosphonate therapy must be on a stable dose and must have started therapy > 4 weeks prior to protocol therapy.
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Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
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Use of red blood cell or platelet transfusions within 4 weeks of treatment
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Use of hematopoietic growth factors within 4 weeks of treatment
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Prior cytotoxic chemotherapy and/or radiation therapy within 4 weeks of treatment
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Prior radiation therapy encompassing >25% of skeleton (see Appendix C)
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Prior treatment with 89Strontium or 153Samarium containing compounds (e.g. Metastron®, Quadramet®)
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Platelet count <150,000/mm3 or known primary qualitative platelet disorder
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Absolute neutrophil count (ANC) <2,000/mm3
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Hematocrit <30 percent and Hemoglobin < 10 g/dL
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Abnormal coagulation profile (PT or INR, PTT > 1.3x ULN) unless on therapeutic anticoagulation - see concomitant meds section
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Serum creatinine >2.5 mg/dL
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AST (SGOT) >2x ULN
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Bilirubin (total) >1.5x ULN; subjects with Gilbert's syndrome will be allowed if direct bilirubin is within institutional normal limits
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Active serious infection
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Active angina pectoris or NY Heart Association Class III-IV
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ECOG Performance Status > 2
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Life expectancy <12 months
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History of deep vein thrombosis and/or pulmonary embolus within 1 month of study entry
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Other serious illness(es) involving the cardiac, respiratory, CNS, renal, hepatic or hematological organ systems which might preclude completion of this study or interfere with determination of causality of any adverse effects experienced in this study
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Prior investigational therapy (medications or devices) within 4 weeks of treatment. Furthermore, other investigational therapy is not permitted during the treatment phase.
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Prior use of ketoconazole for the purposes of prostate cancer therapy for greater than 1 month
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Known history of HIV. The effects of J591 are unknown in this population. Furthermore, ketoconazole has many well-described drug-drug interactions which could affect antiviral therapy. If necessary, this population will be studied separately.
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Currently active other malignancy other than non-melanoma skin cancer. Patients are considered not to have "currently active" malignancy if they have completed any necessary therapy and are considered by their physician to be at less than 30% risk of relapse.
- Known history of known myelodysplastic syndrome
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Adrenal hormone inhibitors (other than ketoconazole) within 4 weeks prior to study enrollment
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Finasteride (Propecia® or Proscar®) or dutasteride (Avodart®) within 4 weeks of enrollment
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Patients on corticosteroids prior to enrollment must have either discontinued and shown biochemical progression or have biochemical progression on a stable dose
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 1. 177Lu-J591 + Ketoconazole
Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 177Lu-J591 Infusion, continue ketoconazole and hydrocortisone |
177Lu-J591 70 mCi/m2 on day 29 (+/- 2 days) of treatment
Andere namen:
Ketoconazole at a dose of 400 mg (two 200 mg tabs) to be taken orally (preferably on an empty stomach) three times per day (total daily dose of 1200 mg)
Andere namen:
Hydrocortisone at a dose of 20 mg orally each morning, 10 mg orally each evening (total daily dose of 30 mg)
Andere namen:
|
|
Placebo-vergelijker: 2. 111In-J591 + Ketoconazole
Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 111In-J591 (placebo) Infusion, continue ketoconazole and hydrocortisone |
Ketoconazole at a dose of 400 mg (two 200 mg tabs) to be taken orally (preferably on an empty stomach) three times per day (total daily dose of 1200 mg)
Andere namen:
Hydrocortisone at a dose of 20 mg orally each morning, 10 mg orally each evening (total daily dose of 30 mg)
Andere namen:
111In-J591 at a dose of 5 mCi on day 29 (+/- 2 days) of treatment
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Proportion of Participants Free of Radiographically Evident Metastases From Baseline to 18 Months After Study Drug Administration
Tijdsspanne: Baseline and 18 months after study drug administration
|
Subjects will perform a CT and/or MRI scan of the abdomen and pelvis, chest x-ray or CT scan of the chest and bone scan to determine the proportion of participants free of radiographically evident metastases from baseline to 18 months after study drug administration. |
Baseline and 18 months after study drug administration
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in PSA Response Rate
Tijdsspanne: Collected at screening, V2, V3, V5, V9 then every 4 weeks till PSA progression or end of study at approximately 100 months
|
PSA response will be determined by comparing the PSA levels after therapy to the baseline and pre-treatment PSA via blood specimens |
Collected at screening, V2, V3, V5, V9 then every 4 weeks till PSA progression or end of study at approximately 100 months
|
Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Scott T Tagawa, M.D., Weill Medical College of Cornell University
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Geschat)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Genitale ziekten
- Genitale neoplasmata, mannelijk
- Urogenitale neoplasmata
- Neoplasmata per site
- Neoplasmata
- Genitale ziekten, man
- Prostaat Ziekten
- Mannelijke urogenitale ziekten
- Prostaatneoplasmata
- Hormonen
- Hormonen, hormoonvervangers en hormoonantagonisten
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Polycyclische verbindingen
- Zwangere
- Steroïden
- Verbindingen met gefuseerde ring
- Zwangeringen
- Zwangeres
- 11-hydroxycorticosteroïden
- Hydroxycorticosteroïden
- Bijnierschorshormonen
- 17-hydroxycorticosteroïden
- Piperazines
- Hydrocortison
- Ketoconazol
- J591 monoklonale antistof
Andere studie-ID-nummers
- 0810010067
- J591+Ketoconazole (Andere identificatie: Weill Cornell Medicine)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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