Prostate Adenocarcinoma Clinical Trial
Official title:
Phase I/II Trial of Anti-IGF-IR Monoclonal Antibody IMC-A12 Plus mTOR Inhibitor Temsirolimus (CCI-779) in Metastatic Castration-Resistant Prostate Cancer (CRPC)
This phase I/II trial is studying the side effects of giving cixutumumab together with temsirolimus and to see how well it works in treating patients with metastatic prostate cancer. Monoclonal antibodies, such as cixutumumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving cixutumumab together with temsirolimus may kill more tumor cells.
PRIMARY OBJECTIVES:
I. To confirm the safety and tolerability of IMC-A12 (cixutumumab) and temsirolimus using the
recommended phase II dose level for advanced solid tumors in chemo-naive patients with
metastatic castration-resistant prostate cancer and a rising prostate-specific antigen (PSA).
(Phase I) II. To confirm the safety and tolerability of IMC-A12 and temsirolimus given on an
every three weeks dosing schedule. (Phase I Extension) II. To determine the tumor response
rate and/or composite time to progression (cTTP) for chemotherapy-naive patients with
castration-resistant prostate cancer (CRPC) receiving the combination of IMC-A12 and CCI-779
(temsirolimus). (Phase II)
SECONDARY OBJECTIVES:
I. To determine the maximal percent decrease in PSA from baseline. II. To determine the
change in PSA doubling time (PSADT). III. To determine the time to PSA progression and
6-month progression-free survival (PFS).
IV. To determine the rate of adverse events.
EXPLORATORY OBJECTIVES:
I. To evaluate changes in circulating tumor cell (CTC) numbers with time. II. To evaluate
IGF1R and androgen receptor (AR) in CTCs and correlate with response.
III. To evaluate profiling CTCs at the molecular level by polymerase chain reaction (PCR) for
prostate cancer-specific genes.
IV. To explore the association between clinical outcomes, administration of therapy, and
serial fludeoxyglucose F 18 (FDG)-positron emission tomography (PET) imaging.
V. To correlate fluorine F 18 FMDHT (18-FDHT)-PET imaging findings with outcome measures of
response.
VI. To perform tumor biopsies and evaluate biomarkers that may correlate with active feedback
and tumor response to therapy, including anti-insulin receptor substrate 1 (IRS-1),
anti-IRS-2, phosphorylated (p) protein kinase B (Akt)(S473), p-ribosomal protein S6 kinase
(70/S6K), anti-phospho-AKT1 substrate 1 (proline-rich) (PRAS 40), and phosphatase and tensin
homolog gene (PTEN) status.
OUTLINE: This is a multicenter study.
Patients receive cixutumumab intravenously (IV) over 60-70 minutes and temsirolimus IV over
30 minutes on days 1, 8, 15, and 22. Courses repeat every 28 days in the absence of disease
progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at 4 weeks.
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