Bicalutamide With or Without Enzastaurin in Treating Patients With Prostate Cancer
- Conditions
- Prostate Cancer
- Interventions
- Registration Number
- NCT00685633
- Lead Sponsor
- Eastern Cooperative Oncology Group
- Brief Summary
RATIONALE: Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as bicalutamide, may lessen the amount of androgens made by the body. Enzastaurin may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether giving bicalutamide together with enzastaurin is more effective than bicalutamide alone in treating prostate cancer.
PURPOSE: This randomized phase II trial is studying bicalutamide to see how well it works compared with giving bicalutamide together with enzastaurin in treating patients with prostate cancer.
- Detailed Description
OBJECTIVES:
Primary
* To compare the two regimens on the proportion of patients with undetectable prostate-specific antigen (PSA) level (\< 0.2 ng/mL) at 44 weeks.
Secondary
* To assess the proportion of patients with PSA decline \> 85% at 44 weeks on the combination therapy arm compared to that of bicalutamide monotherapy arm.
* To assess the distribution of best PSA response in each study arm.
* To assess the time to PSA progression and the time to PSA nadir in each arm of the study.
* To assess the duration of PSA response in each arm of the study.
* To characterize the PSA slope before, during, and after treatment.
* To evaluate the safety and tolerability of enzastaurin hydrochloride in this patient population.
* To determine whether Gleason score or prior hormonal therapy has any effect on PSA response to treatment.
OUTLINE: This is a multicenter study. Patients are stratified according to Gleason score (≤ 6 vs 7 vs 8-10) and prior hormonal therapy (yes vs no). Patients are randomized to 1 of 2 treatment arms.
* Arm A:
* Weeks 1-12: Patients are observed without treatment. Patients with a prostate-specific antigen (PSA) rise of \> 50% above baseline or nadir (whichever is lowest) and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide before the end of week 12 at the discretion of the treating physician.
* Weeks 13-44: Patients with a rise PSA ≥ 50% above baseline or nadir, and a PSA rise of at least 5 ng/mL confirmed by a repeat PSA at least 2 weeks later, are removed from study. Patients receive oral bicalutamide once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may continue to receive bicalutamide up to 72 weeks.
* Arm B:
* Weeks 1-12: Patients receive oral enzastaurin hydrochloride twice daily. Patients with a PSA rise of \> 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide before the end of week 12 at the discretion of the treating physician.
* Weeks 13-44: Patients with a PSA rise of ≥ 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, are removed from study. Patients receive oral enzastaurin twice daily and oral bicalutamide once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may continue on this combination therapy up to 72 weeks.
After completion of study treatment, patients are followed every 3 months for 5 years, and then every 6 months for up to 10 years.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- Male
- Target Recruitment
- Not specified
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Arm B enzastaurin hydrochloride In weeks 1-12, patients receive oral enzastaurin hydrochloride twice daily. Patients with a PSA rise of \> 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide before the end of week 12 at the discretion of the treating physician. In weeks 13-44, patients with a PSA rise of ≥ 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, are removed from study. Patients receive oral enzastaurin twice daily and oral bicalutamide once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may continue on this combination therapy up to 72 weeks. Arm A bicalutamide Patients are observed without treatment in weeks 1-12. Patients with a prostate-specific antigen (PSA) rise of \> 50% above baseline or nadir (whichever is lowest) and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide before the end of week 12 at the discretion of the treating physician. In weeks 13-44, patients with a rise PSA ≥ 50% above baseline or nadir, and a PSA rise of at least 5 ng/mL confirmed by a repeat PSA at least 2 weeks later, are removed from study. Patients receive oral bicalutamide once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may continue to receive bicalutamide up to 72 weeks. Arm B bicalutamide In weeks 1-12, patients receive oral enzastaurin hydrochloride twice daily. Patients with a PSA rise of \> 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, may be started on bicalutamide before the end of week 12 at the discretion of the treating physician. In weeks 13-44, patients with a PSA rise of ≥ 50% above baseline or nadir, and a rise of at least 5 ng/mL, confirmed by a repeat PSA at least 2 weeks later, are removed from study. Patients receive oral enzastaurin twice daily and oral bicalutamide once daily. Patients achieving a PSA decline ≥ 50% in the absence of toxicity may continue on this combination therapy up to 72 weeks.
- Primary Outcome Measures
Name Time Method Comparison of proportion of patients with undetectable prostate-specific antigen PSA level (< 0.2 ng/mL) at 44 weeks
- Secondary Outcome Measures
Name Time Method Comparison of proportion of patients achieving ≥ 85% PSA decline at 44 weeks PSA response Time to PSA progression Time to PSA nadir Duration of PSA response PSA slope at baseline, during, and after treatment Effect of Gleason score and prior hormonal therapy on PSA response to treatment