Prostate Cancer Clinical Trial
Official title:
A Phase II Study of BAY 43-9006 (Sorafenib) in Metastatic, Androgen-Independent Prostate Cancer
BAY 43-9006 (Sorafenib) is an experimental cancer drug produced by Bayer Health Care
Corporation. It represents a new class of anticancer agents known as bi-aryl ureas. This
study will investigate its effect on prostate cancer and its side effects. Researchers expect
to enroll a maximum of 46 men with prostate cancer for this study. The duration of the study
will depend on its results.
Before beginning to take the drug, patients will be admitted to the hospital for 2 days, have
a medical examination and give blood samples, and have a tumor or bone marrow biopsy. On the
first day of the study, patients will begin taking the drug as 2 tablets twice daily, morning
and evening. Blood will be taken throughout the day to determine the drug's level in the
bloodstream.
Patients will be discharged from the hospital on the second day, and will continue to take
the drug twice daily until instructed to stop. During each of the first 4 weeks, patients
will be required to have their blood pressure checked. At the end of the first 4 weeks,
patients will have a physical examination and blood tests, as well as a second tumor or bone
marrow biopsy.
After the first 4 weeks, patients will continue with their drug regimen. At the end of each
4-week cycle, patients will have a physical examination and blood tests. Patients will also
have x-Rays, computed tomography (CT) scans, and/or magnetic resonance imaging (MRIs) at
every other 4-week examination or as required. Patients will be asked to keep a diary
recording the time and amount of their medication for this study.
BAY 43-9006 (Sorafenib) is a potent inhibitor of wild-type and mutant b-Raf and c-Raf kinase
isoforms in vitro. In addition, this agent also inhibits p38, c-kit, vascular endothelial
growth factor receptor 2 (VEGFR-2) and platelet-derived growth factor receptor beta
(PDGFR-beta) affecting tumor growth as well as possibly promoting apoptosis by events
downstream of c-Raf. At this time, over 500 patients have been treated with this drug with
tolerable side effects.
The primary objective of this study is to determine if BAY 43-9006 (Sorafenib) is associated
with a 50% 4 month probability of progression free survival in patients with metastatic
androgen independent prostate cancer (AIPC) as determined by clinical, radiographic, and
prostatic specific antigen (PSA) criteria.
The secondary objective of this study will be demonstration of biologic effect by the drug in
the patient and on the tumor (when possible). Correlative studies will be conducted on
serially obtained tissue biopsies, bone marrow biopsies, and white blood cell collections.
These laboratory correlates will include elucidation of activation of components of the
Raf-extracellular-signal regulated kinase (ERK)-methyl ethyl ketone (MEK) and angiogenesis
pathways using protein microarray technologies developed by the National Cancer Institute
(NCI)/Food and Drug Administration (FDA) clinical proteomics program.
Per Amendment D, a secondary objective of this study will also be to determine the time to
progression measured by clinical and radiographic criteria. The 22 patients treated on the
first stage of this protocol will be retrospectively evaluated with respect to this secondary
endpoint possible. Please refer to the statistics section for further details.
The combination of correlated clinical and laboratory endpoints with emphasis on molecular
signaling will provide new information on the anti-tumor effects helping to characterize its
role in the treatment of androgen independent prostate cancer (AIPC).
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