Description:
The purpose of this study is to test the effectiveness of the experimental drug, 177Lu-J591 in combination with ketoconazole and hydrocortisone against prostate cancer.
The purpose of this study is to test the effectiveness of the experimental drug, 177Lu-J591 in combination with ketoconazole and hydrocortisone against prostate cancer.
Recruiting
Phase 2
Drug | Synonyms | Arms |
---|---|---|
177Lu-J591 | J591 | 1. 177Lu-J591+Ketoconzole |
Ketoconazole | Nizoral | 1. 177Lu-J591+Ketoconzole |
Hydrocortisone | Cortef | 1. 177Lu-J591+Ketoconzole |
111In-J591 | J591 | 2. 111In-J591 + ketoconazole |
This research is being done because the standard treatments for prostate cancer that has returned (PSA is elevated) after surgery and/or radiation and progressed on initial hormonal therapy are not curative. Existing treatments, such as the ketoconazole used as part of this study may decrease PSA temporarily, but unfortunately the cancer continues to grow. This experimental drug is designed to seek out all of the prostate cancer cells and to deliver a lethal dose of radiation to the areas of cancer, but not to normal areas. Some of the normal organs (liver, kidney and bone marrow) do receive some radiation dose that is within the acceptable limits. The experimental drug in this study includes an antibody (abbreviated: mAb) called "J591". It is a protein molecule which can bind to a specific site on a prostate cancer cell. A very energetic radioactive (an unstable atom) metal called 177Lutetium (abbreviated: 177Lu) is attached to the J591 antibody. The fully assembled drug is called "177Lu-J591". The study will assess the potential of the energy given off by the radioactive compound to kill cancer cell. This study may also involve the use of 111Indium (abbreviated 111In). This is also an energetic radioactive particle, but does not generally give off enough energy to kill cancer cells, but allows researchers to take pictures. This radioactive particle is also attached to the J591 antibody (called 111In-J591) and will serve as a placebo (treatment with no active medicine).
Name | Type | Description | Interventions |
---|---|---|---|
1. 177Lu-J591+Ketoconzole | Experimental | Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 177Lu-J591 Infusion, continue ketoconazole and hydrocortisone |
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2. 111In-J591 + ketoconazole | Placebo Comparator | Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 111In-J591 (placebo) Infusion, continue ketoconazole and hydrocortisone |
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Inclusion Criteria: - Histologically or cytologically confirmed adenocarcinoma of the prostate previously treated with surgery and/or radiotherapy. - Biochemical progression (rising PSA) after medical or surgical castration - High risk of systemic progression defined as: 1. Rising PSA as defined above and either: 2. Absolute PSA > 20 ng/mL AND/OR 3. PSA doubling time < 8 months - No evidence of local recurrence or distant metastases - Age >18 years. - Serum testosterone < 50 ng/ml - Patients capable of fathering children must agree to use an effective method of contraception for the duration of the trial. - Subjects on bisphosphonate therapy must be on a stable dose and must have started therapy > 4 weeks prior to protocol therapy. - Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: - Use of red blood cell or platelet transfusions within 4 weeks of treatment - Use of hematopoietic growth factors within 4 weeks of treatment - Prior cytotoxic chemotherapy and/or radiation therapy within 4 weeks of treatment - Prior radiation therapy encompassing >25% of skeleton - Prior treatment with 89-Strontium or 153-Samarium containing compounds (e.g. Metastron®, Quadramet®) - Platelet count <150,000/mm3 - Absolute neutrophil count (ANC) <2,000/mm3 - Hematocrit <30 percent or Hemoglobin < 10 g/dL - Abnormal coagulation profile (PT or INR, PTT) > 1.3x ULN - Serum creatinine >2.5 mg/dL - AST (SGOT) >2x ULN - Bilirubin (total) >1.5x ULN - Serum calcium >11 mg/dL - Active serious infection - Active angina pectoris or NY Heart Association Class III-IV - Karnofsky Performance Status <70 - Life expectancy <12 months - History of deep vein thrombosis and/or pulmonary embolus within 3 months of study entry - Other serious illness(es) involving the cardiac, respiratory, CNS, renal, hepatic or hematological organ systems which might preclude completion of this study or interfere with determination of causality of any adverse effects experienced in this study. - Prior investigational therapy (medications or devices) within 6 weeks of treatment. - Prior use of ketoconazole for the purposes of prostate cancer therapy - Known history of HIV. - Currently active other malignancy other than non-melanoma skin cancer.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | Male |
Healthy Volunteers: | No |
Measure: | Proportion free of radiographically evident metastases at 18 months by CT and/or MRI scan of the abdomen and pelvis, chest x-ray or CT scan of the chest and bone scan |
Time Frame: | 18 months |
Safety Issue: | |
Description: |
Measure: | PSA response rate |
Time Frame: | every 4 weeks |
Safety Issue: | |
Description: |
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Weill Medical College of Cornell University |