Randomized Phase II Study of Two Different Doses of RAD-001 (Everolimus) as Neo-Adjuvant Therapy in Patients With 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.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Proportion of patients who are P0 (i.e., no clinically detectable tumor in the pathologic specimen) at surgery
Specimens are fixed in formalin for 24 hours.Specimens are the cut at 3 mm intervals perpendicular to the rectal surface and the sections are examined grossly and microscopically on routine Hematoxylin and Eosin stain (H&E) (pathologic complete response or P0) will be defined as responders.
After 8 weeks of therapy at the time of prostatectomy
No
Jorge A. Garcia, MD
Principal Investigator
Case Comprehensive Cancer Center
United States: Food and Drug Administration
CASE21806
NCT00526591
September 2007
Name | Location |
---|---|
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center | Cleveland, Ohio 44195 |