Prostate Cancer Clinical Trial
Official title:
Predicting Response to Platinum Chemotherapy in Metastatic Castration Resistant Prostate Ca(mCRPC)Using a Genomic Signature for "BRCAness": A Phase II Prospective Open Label Clinical Trial of Satraplatin in Men With mCRPC Who Have Progressed on Docetaxel
The purpose of the study is to test genes for BRCAness(BRCA[BReast CAncer] gene) Studying these genes could help predict which patients would benefit from treatment with satraplatin, a medication being used for subjects who have failed prior chemotherapy. All subjects will have a biopsy of metastatic lesions to measure BRCAness (a gene signature). This gene signature may be able to predict response to satraplatin and a tool will be developed to be able to screen patients likely to benefit from satraplatin. Subjects will all receive Satraplatin days 1-5 and Prednisone 5 mg twice daily every 35 days. Response rates will be evaluated every 2 cycles or approximately every 9 weeks. Patients will be considered responders if they have measurable disease meeting criteria for partial or complete response. PSA will be measured day one of each treatment cycle. Each treatment cycle is 35 days.
We will be developing a genomic based signature of "BRCAness" based on literature of genomic
signatures from women with breast cancer and germline BRCA mutations.The "BRCAness" breast
cancer signature will differentiate germline BRCA 1/2 breast cancers from standard
estrogen-receptor (+) breast cancers. We will obtain a library of genomic signatures Recently
these techniques have been used to develop a transcriptional "signature" for androgen
receptor (AR) activity in men with CRPC(Castration Resistant Prostate Cancer). The
investigator will apply the "BRCAness" breast cancer signature to pathological prostate
cancer specimens to determine the percentage of patients in the overall prostate cancer
population that express this signature, as well as the clinical and histological phenotype of
this population.
This novel prostate cancer "BRCAness" signature will be developed over a period of 4-6
months. This "BRCAness" signature has not previously been evaluated in prostate cancer
patients and would be expected, based on known characteristics of BRCA mutant breast and
ovarian cancers, to be more platinum-responsive. Relevant clinical data, including histology,
grade, stage, size of residual tumor, recurrence, and survival, will be obtained from
outpatient and inpatient charts to perform subsequent correlative studies.
All patients enrolled in the phase II clinical trial with satraplatin will have pre-treatment
biopsies of metastatic sites. All of the specimens will be frozen, batched and stored as
previously described. We anticipate that all patients will be enrolled 16 months from when
the trial opens. When the last patient is enrolled in the trial and all of the metastatic
biopsies have been collected, they will be shipped in bulk on dry ice to laboratory for
RNA(ribonucleic acid) isolation, RNA quality assessment and processing, microarray
hybridization, microarray data quality assessment, and "BRCAness" prostate cancer signature
application. Frozen biopsies will be processed for microarray analysis using laser capture
microdissection and RNA amplification using adaptations of previously published methods. The
application of the prostate cancer BRCAness signature will take place over two months.
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