Hormone Refractory Prostate Cancer Clinical Trial
Official title:
Exploratory Study of Molecular Phenotype Changes and Personalized Treatment for Patients With Castration Resistant Prostate Cancer
To explore the molecular phenotypic changes and personalized treatment in castration-resistant prostate cancer.
This is a multi-center study to explore the molecular phenotypic changes in
castration-resistant prostate cancer by histopathological,immunohistochemical and molecular
analysis of cancer related genes in castration-resistant prostate cancer.After patient
eligibility is determined, tumor tissue will be acquired from archival or transurethral
resection or from re-biopsy specimens from patients with recurrence, visceral metastasis,
bone metastases. According to the molecular phenotypic changes, personalized treatment were
performed.
Participants will be screened with a full medical history and physical examination, blood
and urine tests, and tumor imaging studies. The tumor specimens at diagnosis of prostate
cancer should be needed for all the participants.
After assessing for the prostate specific antigen (PSA) level and the tumor molecular
phenotypic features,participants will be separated into different treatment groups:
1. Participants with "AR dependent" CRPC (generally with high PSA level and/or high AR
expression) and with druggable gene mutations will receive Docetaxel/prednisone+Target
drugs.
2. Participants with "AR dependent" CRPC (generally with high PSA level and/or high AR
expression) and without druggable gene mutations will receive Docetaxel/ Prednisone.
3. Participants with "AR independent" CRPC (generally without AR expression and/or rapid
progression with low PSA level) and with druggable gene mutations will receive
Cisplatin/Etoposide+Target drugs.
4. Participants with "AR independent" CRPC (generally without AR expression and/or rapid
progression with low PSA level) and without druggable gene mutations will receive
Cisplatin/Etoposide.
Participants with druggable gene mutations will receive the corresponding molecular targeted
drugs.
Participants with epidermal growth factor receptor (EGFR) gene mutation will receive a drug
called Gefitinib, which inhibits a protein called EGFR that is thought to be a key factor in
the development and progression of some cancers.
Participants with B-type Raf kinase (BRAF) gene mutations will receive a drug called
Vemurafenib, which inhibits a protein called mitogen-activated or extracellular
signal-regulated protein kinase kinase (MEK) that is thought to be a key factor in the
development and progression of some cancers.
Participants with v-akt murine thymoma viral oncogene homologue 1 (AKT1) gene mutations will
receive a drug called Celecoxib, which inhibits a protein called v-akt murine thymoma viral
oncogene homologue (AKT) that is thought to be a key factor in the development and
progression of some cancers.
Participants who have erythroblastic leukemia viral oncogene homolog 2 (ERBB2) gene mutation
will receive a drug called lapatinib, which inhibits some proteins that are thought to be
key factors in the development and progression of some cancers.
Participants with PDGFRA gene mutations will receive a drug called sunitinib, which inhibits
some proteins that are thought to be key factors in the development and progression of some
cancers.
Participants with PIK3CA gene mutations will receive a drug called Everolimus, which
inhibits a protein called AKT that is thought to be a key factor in the development and
progression of some cancers.
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Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label
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