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Effect of Dutasteride on Androgen-Response Gene Expression in Patients With Advanced Prostate Cancer

Phase 2
Completed
Conditions
Prostate Cancer
Interventions
Drug: Placebo
Registration Number
NCT00668642
Lead Sponsor
NorthShore University HealthSystem
Brief Summary

The purpose of this study is to determine if the drug dutasteride increases expression of genes that slow the growth of prostate cancer during treatment with intermittent androgen ablation therapy (hormone therapy).

Detailed Description

We have shown in a murine model of treatment with intermittent androgen ablation therapy of prostate cancer that when dutasteride is given during the regrowth phase (off-phase) of intermittent therapy, that tumor growth is inhibited and that survival is improved. We have also shown that testosterone is a more potent inducer of certain tumor suppressor androgen response genes than dihydrotestosterone. In this murine model, we showed that use of a 5-alpha reductase inhibitor (dutasteride) resulted in significant hyperinduction of the U19 tumor suppressor androgen response gene during the regrowth phase of treatment. In the current clinical trial, we will determine if use of dutasteride in men with advanced prostate cancer during the off-phase of intermittent androgen ablation therapy will also result in hyperinduction of these tumor suppressor androgen response genes. Gene expression will be measured in tumor tissue obtained by prostate biopsies during the off-phase when the testosterone level has normalized. Prostate-specific antigen (PSA) levels will also be measured to determine the PSA doubling time during the off-phase to determine the effect of dutasteride on PSA kinetics.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
20
Inclusion Criteria
  • Histologically proven prostate cancer
  • Patients are hormone-naive
  • Patients either to begin androgen ablation therapy with luteinizing hormone-releasing hormone (LHRH) agonist or already receiving therapy with LHRH agonist
  • Advanced prostate cancer with either positive pelvic nodes or bone/visceral metastasis
  • Must have an intact prostate (no previous surgery or XRT)
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
  • Recovery from any major infection or surgical procedure
  • Signed informed consent
Exclusion Criteria
  • Known intolerance or allergy to dutasteride
  • Concomitant chemotherapy, biologic therapy, or XRT to prostate
  • Bilateral orchiectomy
  • Prior malignancy within 5 years of registration

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
A: Dutasteride During First Off-CycleDutasterideArm A patients received dutasteride (0.5 mg/day) during the first off-cycle and received placebo during the second off-cycle
B: Placebo During First Off-CyclePlaceboArm B patients received placebo during the first off-cycle and received dutasteride (0.5 mg/day) during the second off-cycle
Primary Outcome Measures
NameTimeMethod
Relative Expression of U19 Gene in Tumor From Prostate Gland During First Off-cycle.At the end of off-cycle 1 defined by when the testosterone level reaches normal (approximately 6 months)

Calculation of the level of gene expression of the U19 tumor suppressor gene compared between the 2 arms at the end of "off-treatment" cycle 1.

Secondary Outcome Measures
NameTimeMethod
Determination of Prostate-specific Antigen (PSA) Doubling Time During First Off-cycleAt month 9 and ongoing monthly until end of off-cycle 1 defined by when the testosterone level reaches normal (approximately 6 months)

Calculation of number of months when baseline PSA doubles compared between the 2 arms at the end of "off-treatment" cycle 1.

Trial Locations

Locations (3)

University of Chicago Hospitals and Clinics

🇺🇸

Chicago, Illinois, United States

Northwestern University Medical Center

🇺🇸

Chicago, Illinois, United States

NorthShore University HealthSystem

🇺🇸

Evanston, Illinois, United States

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