A Phase I Study of 1,25 Dihydroxy-Vitamin D3 (Calcitriol) in Patients With Prostate Cancer
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed prior localized adenocarcinoma of the prostate that has
undergone definitive radiation or surgery and demonstrates progression biochemically
with all of the following:
- Baseline PSA at least 4 ng/mL
- At least a 50% increase in PSA over at least 3 determinations taken at more than
2 week intervals
- No radiographically evident disease
- Neoadjuvant hormonal therapy prior to radical prostatectomy or radiotherapy
allowed
- Treatment in an intermittent approach allowed if off therapy for at least 12
weeks OR
- Histologically confirmed androgen-independent adenocarcinoma of the prostate with all
of the following:
- Progression on primary hormonal treatment (e.g., orchiectomy, estrogen therapy,
gonadotropin-releasing hormone analog with or without an antiandrogen) with
either new osseous lesions in bone, a greater than 25% increase in
bidimensionally measurable tumor mass, or rising PSA values (rising PSA on any 3
determinations taken at at least weekly intervals, to greater than 50% above
baseline PSA) despite castrate levels of testosterone (no greater than 30 ng/mL)
- If receiving antiandrogen as part of primary hormonal therapy, must meet
criteria above for progression after discontinuation of antiandrogen
- No change in hormonal therapy (including prednisone or dexamethasone) within the
past 2 weeks
- If no prior surgical orchiectomy, must continue on medical therapies to maintain
castrate levels of testosterone
- Prior chemotherapy, palliative radiotherapy, or radioisotope treatment allowed
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- Karnofsky 70-100%
Life expectancy:
- At least 3 months
Hematopoietic:
- WBC at least 3,500/mm^3
- Platelet count at least 100,000/mm^3
Hepatic:
- Bilirubin less than 2.0 mg/dL OR
- SGOT less than 3 times upper limit of normal
Renal:
- Creatinine less than 1.5 mg/dL OR
- Creatinine clearance at least 60 mL/min
- No history of nephrolithiasis
- Must have 2 functioning kidneys
Cardiovascular:
- No New York Heart Association class III or IV heart disease
Pulmonary:
- No severe debilitating pulmonary disease
Metabolic:
- No pre-existing endocrine or metabolic disorders that impact calcium regulatory axis
including hypercalcemia (ionized serum calcium greater than 5.3 mg/dL or total
calcium greater than 10.5 mg/dL) or hypercalciuria (greater than 300 mg urinary
calcium/24 hours)
Other:
- No active secondary malignancy except nonmelanoma skin cancer
- Must maintain low calcium diet (less than 800 mg calcium daily)
- No uncontrolled serious active infection
- No history of malabsorption disorders
- No history of inflammatory bowel disease
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- See Disease Characteristics
- At least 4 weeks since prior chemotherapy and recovered
- No concurrent chemotherapy
Endocrine therapy:
- See Disease Characteristics
- Recovered from prior endocrine therapy
Radiotherapy:
- See Disease Characteristics
- At least 4 weeks since prior radiotherapy and recovered
- No concurrent radiotherapy to sole measurable lesion
Surgery:
- See Disease Characteristics
- Recovered from prior surgery
- No concurrent surgery to sole measurable lesion
Other:
- No other concurrent cholecalciferol