Prostate Adenocarcinoma Clinical Trial
Official title:
Neoadjuvant Androgen Depletion in Combination With Vorinostat Followed by Radical Prostatectomy for Localized Prostate Cancer: Total Androgen-Receptor Gene Expression Targeted Therapy (TARGET)
This phase II trial studies how well androgen deprivation therapy and vorinostat followed by radical prostatectomy works in treating patients with prostate cancer that has not spread to other parts of the body. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as bicalutamide, goserelin acetate, and leuprolide acetate, may lessen the amount of androgens made by the body. Vorinostat may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving androgen deprivation therapy and vorinostat before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
PRIMARY OBJECTIVES:
I. To determine the rate of pathologic complete response in patients with localized prostate
cancer treated with androgen depletion therapy (ADT) and oral vorinostat administered for a
minimum of 6 weeks and maximum of 8 weeks before radical prostatectomy.
SECONDARY OBJECTIVES:
I. To determine and evaluate pre- and post-treatment levels of prostate-specific antigen
(PSA), testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and
dehydroepiandrosterone-dulfate (DHEA-S) in blood.
II. To determine and evaluate pre- and post-treatment levels of testosterone,
androstenedione, androstenediol, DHT, DHEA, and DHEA-S in prostate.
III. To determine and evaluate gene and protein expression analysis including androgen
receptor (AR) target genes, PSA and TMPRSS2 (transmembrane protease, serine 2), in
pre-treatment biopsy and post-treatment radical prostatectomy.
IV. To determine and evaluate exploratory gene microarray analysis. V. To determine and
evaluate the safety and tolerability of ADT in combination with vorinostat (SAHA) as assessed
by physical examinations, adverse events, and laboratory assessments.
OUTLINE:
Patients receive bicalutamide orally (PO) once daily (QD) for 1 month and leuprolide acetate
intramuscularly (IM) or goserelin acetate subcutaneously (SC) once a month until surgery.
Patients also receive vorinostat PO QD beginning on the first day of androgen depletion
therapy and continuing for up to 8 weeks or until the day of surgery. Patients then undergo
an open or laparoscopic radical prostatectomy. Patients with positive surgical margins
undergo immediate adjuvant external beam radiotherapy to the prostatic fossa, based on the
judgment of the treating physician.
After completion of study treatment, patients are followed every 3 months for up to 1 year.
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