Prostate Cancer Clinical Trial
Official title:
Phase I Study of Weekly Intravenous PS-341 (Bortezomib) Plus Mitoxantrone in Patients With Advanced Androgen-Independent Prostate Cancer (AI-PCa)
Primary Objective:
-Establish the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of weekly
mitoxantrone in combination with weekly PS-341 in patients with advanced AI-PCa.
Secondary objectives:
- Evaluate the effect of bortezomib and mitoxantrone in combination on PSA levels among
patients with baseline PSA levels >/=5 ng/mL who are treated near the maximum tolerated
dose.
- Monitor the effect of escalating doses of bortezomib combined with mitoxantrone on
selected parameters of clinical benefit (i.e. performance status, tumor-related
symptoms, measurable disease response).
Mitoxantrone is used to treat bone pain in advanced prostate cancer and inhibits many
proteins that the cancer cells need to multiply.
Bortezomib is a member of a new class of drugs that possess powerful and broad-spectrum
anti-tumor activity and inhibit many proteins that the cancer cells need to survive and
multiply.
Pre-study testing will include brief physical examination, vital signs (weight, height,
temperature, pulse, respiratory and blood pressure), chest x-ray, EKG (test to measure the
electrical activity of the heart), echocardiogram, blood test, urine tests, and depending on
the stage of the disease, a CT scan and/or bone scan.
During treatment, the participants will receive one dose of Mitoxantrone combined with one
dose of Bortezomib every week for 4 weeks in a row followed by 2 weeks of rest; this is
called a course. If side effects are not too severe, Mitoxantrone and Bortezomib will be
infused rapidly into a vein while participants will be receiving normal saline ("salt in
water solution") at a rate of 100ml/hour. They will receive the salt solution the entire time
they are in the treatment area.
Participants will have their vital signs (temperature, pulse, breathing, blood pressure)
taken before and one hour after treatment. All side effects during course one will be
reviewed and, if no serious side effects took place, the participant may have additional
courses. A pill may be given by mouth every day to decrease the risk of clot formation or a
pill for diarrhea, nausea, and/or vomiting if the doctor believes that participants may need
it.
Also during treatment, participants will have a complete physical examination by a physician
or their designated representative (such as a nurse or physician assistant) each week of
treatment. Bone Scan and/or CT Scan will be done if necessary. Participants will have blood
tests done every week during study. A special blood test, called the 20S proteosome, will be
done weekly during Cycles 1 and 2 to evaluate the activity of the drugs. Blood will be
collected before you receive treatment and then at 1-2 hours afterward. About 2 teaspoons of
blood will be collected each time for this. Bone scan, chest x-ray and/or CT scans will be
repeated during the study every other course.
Participants will be taken off study if the disease gets worse or intolerable side effects
occur. Side effects that are thought to be related to the study drug are renal failure
resulting in death, and a grade 3 rash requiring treatment with steroids that recurred with
subsequent treatments.
The maximum amount of time that participants can remain on the study is 8 courses of
treatment. Long term follow-up of participants will include a phone call every 6 months.
This is an investigational study. Bortezomib has been approved by the FDA for investigational
use only. Mitoxantrone has been approved by the FDA for treatment of symptoms in advanced
prostate cancer. Only Mitoxantrone is commercially available. About 42 participants will take
part in this study. All will be enrolled at M.D. Anderson .
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