Prostate Cancer Clinical Trial
Official title:
Randomized Phase II Study of Two Different Doses of RAD-001 (Everolimus) as Neo-Adjuvant Therapy in Patients With Localized Prostate Cancer
RATIONALE: Everolimus may stop the growth of tumor cells by blocking some of the enzymes
needed for cell growth. Giving everolimus before surgery may make the tumor smaller and
reduce the amount of normal tissue that needs to be removed.
PURPOSE: This randomized phase II trial is studying the side effects and how well everolimus
works in treating patients with newly diagnosed localized prostate cancer.
OBJECTIVES:
Primary
- To determine the clinical effects of everolimus, in terms of pathologic response (i.e.,
histologic P0, margin status, or capsular penetration) and surgical outcome, in patients
with newly diagnosed localized prostate cancer treated with two different doses of
everolimus prior to radical prostatectomy.
- To evaluate the safety and tolerability of this drug in these patients.
Secondary
- To determine the effect of this drug on prostate-specific antigen (PSA) levels in these
patients.
- To determine the effect of this drug on levels of expression of PTEN, Akt, phospho-mTOR
(i.e., Se2448), phospho-p70 S6 kinase (i.e., Thre389), phospho-Smad3 (i.e., Ser433/435),
phospho-Smads 1/5 (i.e., Ser463/465), AR, and TUNEL in these patients.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive low-dose oral everolimus once daily for up to 8 weeks in the
absence of unacceptable toxicity.
- Arm II: Patients receive high-dose oral everolimus once daily for up to 8 weeks in the
absence of unacceptable toxicity.
Within 7 days after the last dose of everolimus, all patients undergo radical prostatectomy
with bilateral pelvic lymphadenectomy.
Tumor biopsy specimens acquired prior to treatment and prostate tumor tissue acquired at the
time of radical prostatectomy are evaluated for biomarker correlative studies. Tissue samples
are assessed by immunohistochemistry (IHC) and tissue microarray analysis for expression of
cellular and molecular biomarkers (i.e., p-S6, p-4E-BP1, and p-Akt) that correlate with
response. Prostatectomy specimens are also assessed by pathologic analysis for
histopathologic response (i.e., pathologic stage, Gleason score, margin status, and tumor
size).
After completion of study therapy, patients are followed at 6 weeks.
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