Prostate Cancer Clinical Trial
Official title:
A Phase II Study of AZD2171 in Metastatic Androgen Independent Prostate Cancer
Background:
- AZD2171 (Cediranib) is an experimental drug that inhibits formation of new blood
vessels.
- Tumors need new blood vessels to grow. Preventing the growth of new blood vessels with
AZD2171 may inhibit tumor growth.
Objectives:
-To determine the effectiveness and side effects of AZD2171 in patients with prostate cancer
that has metastasized (spread beyond the primary site).
Eligibility:
- Males 18 years of age and older with androgen-independent prostate cancer that has
metastasized.
- Patients must have received prior treatment with docetaxel.
Design:
Patients take one AZD2171 by mouth every day in 28-day treatment cycles and undergo the
following procedures:
- 1- to 2-day hospitalization at the start of the study for biopsies and blood
measurements to determine the level of AZD2171 in the bloodstream. Blood is drawn
immediately before the first dose, and 0.25 hr, 0.5 hr, 1 hr, 2 hr, 4 hr, 6 hr, 8 hr, 12
hr, 24 hr, and 48 hours after the dose is taken.
- Blood tests before starting treatment and then monthly to determine the level of
vascular endothelial growth factor receptor ( VEGFR), a protein involved in blood vessel
formation.
- Magnetic resonance imaging (MRI) scans once a month to evaluate blood flow.
- Tumor biopsies (optional) both before and after the second and sixth treatment cycles.
- Clinic visits every 4 weeks, including various routine and research blood tests, urine
test and electrocardiogram.
- Computed tomography (CT) scan of the chest, abdomen, and pelvis every 8 weeks
- Bone scan every 8 weeks
Patients record all doses of AZD2171 taken or missed in a pill diary. They record their blood
pressure at least once daily in a blood pressure diary.
Treatment may continue as long as the patient tolerates the AZD2171 and the cancer does not
worsen.
Background:
- AZD2171 (Cediranib) is an oral potent inhibitor of receptor tyrosine kinases which
impact vascular endothelial growth factor-A (VEGF).
- VEGF appears important in blood vessel formation and disease progression in prostate
cancer.
- No known effective therapy in patients with progressive androgen-independent prostate
cancer after treatment with docetaxel.
Objectives:
- Primary objective of this study is to determine if AZD2171 is associated with a 30% 6
month probability of progression free survival in patients with metastatic androgen
independent prostate cancer (AIPC) as determined by clinical and radiographic criteria.
- 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 and white blood cell collections.
- Laboratory correlates will include elucidation of activation of components of the VEGFR2
and angiogenesis pathways and evaluation of endothelial cell adhesion molecules
(released by damaged cells) using enzyme-linked immunosorbent assay (ELISA),
pharmacogenetic analysis of kinase insert domain receptor (KDR) variants and single
nucleotide polymorphisms, and pharmacokinetic characterization of AZD2171 activity.
Eligibility:
- Metastatic progressive androgen-independent prostate cancer.
- Prior treatment with docetaxel.
- May not have corrected QT interval (QTc ) greater than 470 msec or greater than 1+
proteinuria on 2 consecutive dipsticks no less than 1 week apart.
Design:
- Phase II trial with a two stage design. 12 patients enrolled in first cohort, if 2 or
more are progression free at 6 months than enroll up to 35 evaluable patients. The
ceiling will be set at 37 to allow for inevaluable patients.
- Starting dose 20 mg QD (every day) for all patients.
- Once two stage design is complete then prednisone 10 mg once per day will be given in
combination with AZD2171. The total number of patients will be 23 for this portion of
the protocol.
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