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Hydroxychloroquine in Blocking Autophagy in Patients With Prostate Cancer Undergoing Surgery or Active Surveillance

Early Phase 1
Terminated
Conditions
Prostate Carcinoma
Interventions
Other: Laboratory Biomarker Analysis
Registration Number
NCT02421575
Lead Sponsor
Rutgers, The State University of New Jersey
Brief Summary

This phase 0 trial studies hydroxychloroquine in blocking autophagy in patients with prostate cancer who are undergoing surgery or active surveillance. Autophagy is a process in which cells break down some parts of themselves to stay alive during times of stress, such as starvation. This may allow cancer cells to survive damage from chemotherapy. Hydroxychloroquine may block this process from happening.

Detailed Description

PRIMARY OBJECTIVES:

I. To determine the effect of different doses of hydroxychloroquine on markers of autophagy in prostate tumor.

SECONDARY OBJECTIVES:

I. To determine the distribution of autophagic activity within prostate cancer tissue.

II. To determine the utility of beclin-1 as a marker of autophagic activity. III. To assess markers of apoptosis in tumor tissue. IV. To perform deep-sequencing on prostate tissue obtained at the time of surgery.

V. To assess prostate-specific antigen (PSA) as a biochemical endpoint of clinical activity.

VI. To determine the number of circulating tumor cells (CTCs) in pre- and post-treatment blood samples.

OUTLINE: Patients are assigned to 1 of 2 groups.

GROUP I (PLANNING PROSTATECTOMY): Patients in Group I are randomized to 1 of 2 arms.

ARM I: Patients receive hydroxychloroquine orally (PO) once daily (QD) for 14 days and then undergo prostatectomy.

ARM II: Patients receive a higher dose of hydroxychloroquine PO thrice daily (TID) for 14 days and then undergo prostatectomy.

GROUP II (ACTIVE SURVEILLANCE): Patients receive hydroxychloroquine PO QD. Treatment continues until the beginning of local therapy or for up to 1 year.

Recruitment & Eligibility

Status
TERMINATED
Sex
Male
Target Recruitment
4
Inclusion Criteria
  • Signed written informed consent
  • Have abnormal digital rectal examination, or abnormal prostate specific antigen (> 4.0 ng/ml), or obstructing prostate, or biopsy proven prostate cancer
  • Scheduled for prostate surgery, i.e. transurethral resection of the prostate (TURP) or prostatectomy
  • Planned to be treated by active surveillance
Exclusion Criteria
  • Patients on treatment for rheumatoid arthritis or systemic lupus erythematosus
  • Patients with psoriasis
  • Patients receiving any disease-modifying anti-rheumatic drug (DMARD)
  • Active clinically significant infection requiring antibiotics
  • Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Patients taking other commercially available medications which may theoretically either stimulate or inhibit autophagy, which are calcitriol and chloroquine
  • Patients taking medications which may lead to interactions with hydroxychloroquine, including penicillamine, telbivudine, botulinum toxin, digoxin, and propafenone
  • Patients must not have prior visual field changes from prior 4-aminoquinoline compound use
  • Must not be taking hydroxychloroquine for treatment or prophylaxis of malaria
  • History of hypersensitivity to 4-aminoquinoline compound

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group I, Arm I (lower dose hydroxychloroquine)Laboratory Biomarker AnalysisPatients receive hydroxychloroquine PO QD for 14 days and then undergo prostatectomy.
Group I, Arm II (higher dose hydroxychloroquine)Laboratory Biomarker AnalysisPatients receive hydroxychloroquine PO TID for 14 days and then undergo prostatectomy.
Group II (mid-dose hydroxychloroquine)Laboratory Biomarker AnalysisPatients receive hydroxychloroquine PO QD. Treatment continues until the beginning of local therapy or for up to 1 year.
Group I, Arm I (lower dose hydroxychloroquine)HydroxychloroquinePatients receive hydroxychloroquine PO QD for 14 days and then undergo prostatectomy.
Group II (mid-dose hydroxychloroquine)HydroxychloroquinePatients receive hydroxychloroquine PO QD. Treatment continues until the beginning of local therapy or for up to 1 year.
Group I, Arm II (higher dose hydroxychloroquine)HydroxychloroquinePatients receive hydroxychloroquine PO TID for 14 days and then undergo prostatectomy.
Primary Outcome Measures
NameTimeMethod
Change in markers of autophagy in prostate tumor (Group I)Baseline to 14 days (time of surgery)
Levels of markers of autophagy in prostate tumor (Group II)Up to 1 year
Secondary Outcome Measures
NameTimeMethod
Levels of markers of apoptosis in tumor tissueUp to 1 year
Distribution of autophagic activity in prostate cancer tissueUp to 1 year
Clinical activity, as assessed by PSA levelsUp to 1 year
Number of CTCs in blood samplesUp to 1 year

The number of CTCs in pre- and post-treatment blood samples will be determined.

Autophagic activity, assessed by beclin-1 levelsUp to 1 year

The utility of beclin-1 as a marker of autophagic activity will be determined.

Trial Locations

Locations (1)

Rutgers Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

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