Prostate Cancer Clinical Trial
Official title:
A Phase I Neoadjuvant Study of In-situ REIC/Dkk-3 Therapy Followed By Prostatectomy in Patients With High Risk Localized Prostate Cancer
This is a phase I neoadjuvant gene therapy followed by prostatectomy, open-label, dose-escalation trial for prostate cancer patients with high risk of local recurrence after radical prostatectomy. Patients entered into this trial will have Prostate Cancer of Clinical stage T1c, T2 or T3 with a Gleason Score of between 7 (4+3) and 10 at the time of enrollment. Patients will receive three 1 mL injections (3 mL total volume) of Ad-REIC/Dkk-3 into the prostate prior to undergoing a radical prostatectomy. Three patients will be treated at each dose level unless a dose-limiting toxicity (DLT) is observed or MFD (defined as 1 x 10e12 vp/treatment) is achieved with expansion for up to 6 more patients at the MTD or MFD.
This is a phase I neoadjuvant gene therapy followed by prostatectomy, open-label,
dose-escalation trial for prostate cancer patients with high risk of local recurrence after
radical prostatectomy. Patients entered into this trial will have Prostate Cancer of
Clinical stage T1c, T2 or T3 with a Gleason Score of between 7 (4+3) and 10 at the time of
enrollment.
Patients will receive three 1 mL injections (3 mL total volume) of Ad-REIC/Dkk-3 into the
prostate under transrectal ultrasound-guidance (TRUS) and, patients will undergo a radical
prostatectomy four weeks after the injection.
Patients will receive treatment at one of three dose levels in a sequential dose-escalating
design.
Three patients will be treated at each dose level unless a dose-limiting toxicity (DLT) is
observed or MFD (defined as 1 x 10e12 vp/treatment) is achieved. Enrollment will proceed to
the next dose level if 0 of 3 patients experiences a DLT; if one of the first 3 patients
experiences a DLT, three additional patients will be enrolled until a second patient
experiences a DLT (which defines the toxic dose) or until six total patients have been
treated at that dose level, whichever comes first. If a second DLT is not experienced within
that cohort, dose escalation may continue.
Additional patients will be enrolled a minimum of 14 days after treatment of the first
patient in the cohort (sentinel patient).
If 2 DLTs are observed within a cohort, enrollment into the cohort will cease and the dose
level immediately preceding that dose will be determined to be the MTD. If 2 non-lethal DLTs
are observed in Cohort 1, a lower dose cohort (Cohort -1) may be initiated.
Once the MTD is defined, an additional 3-6 patients may be enrolled at that dose level to
further evaluate safety of the MTD.
Patients will undergo a scheduled radical prostatectomy approximately 4 weeks after the
Ad-REIC/Dkk-3 injection. The prostate tissue removed will be retained and for those patients
treated at the MTD, assessed for REIC expression and evidence of apoptosis by TUNEL
staining.
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Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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