Prostate Cancer Clinical Trial
Official title:
A Phase II Study of OGX-011 Given Prior to Radical Prostatectomy in Patients With Localized Prostate Cancer
The purpose of this trial is to assess the effects of combined therapy with androgen ablation and OGX-011 (an antisense to clusterin) given prior to radical prostatectomy on pathologic complete response rates in men with localized prostate cancer and high risk features.
Clusterin as an anti-apoptotic cytoprotective chaperone protein upregulated in an adaptive
cell survival manner that confers resistance to various cell death triggers, including
hormone-, radiation-, and chemotherapy. In pre-clinical models, inhibition of clusterin
expression using the second generation antisense OGX-011 can enhance cell death following
treatment with androgen ablation, radiotherapy, and chemotherapy. In phase I clinical
trials, OGX-011 has been well tolerated and a biologically effective dose has been
identified in humans.
Study Design
This is an open-label, non-blinded, phase II clinical, tissue pharmacokinetic and
pharmacodynamic study of weekly OGX-011 and neoadjuvant hormone therapy prior to radical
prostatectomy in patients with localized prostate carcinoma and high-risk features.
Study Objectives
Primary Objectives
- To assess the effects of combined neoadjuvant hormone therapy (NHT) and OGX-011 prior
to radical prostatectomy on pathologic complete response rates in men with high risk
localized prostate cancer.
Secondary Objectives
- To quantify changes in clusterin expression in residual prostate cancer after treatment
with NHT and OGX-011.
- To measure levels of full length OGX-011 in prostate tissues after 3 months of NHT.
- To assess the safety and tolerability toxicity of 3 months of OGX-011 and NHT prior to
radical prostatectomy.
- To measure evidence of OGX-011's effect on clusterin expression in patient peripheral
blood mononuclear cells (PBMNC).
- To measure evidence of OGX-011's effect on patient clusterin serum levels.
- To assess the effects of combined NHT and OGX-011 on time to PSA nadir.
- To determine PSA recurrence rates after combined NHT and OGX-011.
Key Eligibility Criteria
1. Histologically confirmed adenocarcinoma of the prostate, previously untreated
2. Potential candidate for radical prostatectomy
3. Any one of the following criteria (minimum of 2 positive biopsies):
- Clinical stage T3
- Serum PSA > 10 ng/ml
- Gleason score 7-10
- Gleason score 6 and > 3 positive biopsies
4. ECOG performance status 0-1
5. WBC ≥ 3.0 x 10^9/L
6. Hemoglobin ≥ 100 g/L
7. Platelets ≥ 100 x 10^9/L
8. PTT, INR, AST, ALT, creatinine, total bilirubin within normal limits
Treatment Plan
Approximately 45 newly diagnosed, previously untreated patients with clinically localized,
high-risk prostate carcinoma will be entered into this trial. These patients will receive
neoadjuvant hormone therapy (buserelin 9.9 mg subcutaneously x 1 injection with flutamide
250 mg orally T.I.D. for the first 4 weeks only) for 12 weeks in combination with OGX-011 (a
2'MOE phosphorothioate clusterin antisense oligonucleotide) weekly on a 4 week cycle for 3
courses. For week one, cycle one only, OGX-011 will be given on Days 1, 3 and 5. OGX-011 is
given at a dose of 640 mg by intravenous infusion over 2 hours. Radical prostatectomy will
take place within 14 days of the last dose of OGX-011.
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