RATIONALE: Drugs used in chemotherapy, such as paclitaxel poliglumex, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Estradiol may kill prostate cancer cells that no longer respond to hormone therapy. Giving paclitaxel poliglumex together with estradiol may kill more tumor cells. PURPOSE: This phase II trial is studying how well giving paclitaxel poliglumex together with estradiol works in treating patients with stage IV prostate cancer.
OBJECTIVES: Primary * Determine the PSA response rate in patients with androgen independent metastatic prostate cancer treated with paclitaxel poliglumex and transdermal estradiol. Secondary * Determine the toxicity of this regimen in these patients. * Determine the response rate in patients treated with this regimen. * Determine the time to PSA progression and measurable disease progression in patients treated with this regimen. * Determine time to death from all causes in patients treated with this regimen. * Correlate levels of serum estradiol, serum cathepsin B, and bone turnover markers with PSA response in patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive transdermal estradiol continuously (patches changed every 7 days) until the PSA level rises. Patients whose PSA increases above baseline or PSA decreases \< 10% after 4 weeks of estradiol therapy or whose serum PSA reduction is \< 50% after 12 weeks of estradiol therapy also receive paclitaxel poliglumex therapy. These patients receive paclitaxel poliglumex IV over 10-20 minutes on day 1. Treatment with paclitaxel poliglumex repeats every 28 days for up to 10 courses in the absence of disease progression or unacceptable toxicity. After completion of study therapy, patients are followed every 6 months. PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
Transdermal estradiol given 0.2mg/day for duration of study.
Paclitaxel poliglumex (PPX) is a macromolecular polymer-drug conjugate of paclitaxel. PPX was given every 28 days, at a dose of 150 mg/m2
UCSF Helen Diller Family Comprehensive Cancer Center
San Francisco, California, United States
OHSU Knight Cancer Institute
Portland, Oregon, United States
Prostate Specific Antigen (PSA) Response Rate: Number of Subjects With Decreases in PSA of at Least 50%
PSA response rate is defined at the number of patients who experienced a PSA decline of equal to or greater than 50%, confirmed by a second measurement at least 4 weeks later.
Time frame: While receiving study agents (on average, 3 months)
Measurable Disease Response Rate (Soft Tissue)
Measurable disease response rate by RECIST criteria. Response is defined as at least a 30% decrease in the sum of the longest diameter in measurable lesions (larger than 10mm at baseline).
Time frame: While receiving study agents (on average, 3 months)
Time to Disease Progression
Time from Day 1 to Day of meeting criteria for PSA or Measurable Disease Progression
Time frame: At time of progression by PSA or RECIST criteria
Time to Death
Defined as time from Day 1 of study regimen to Date of death from any cause.
Time frame: Measured at Date of Death from any cause
Correlation of Levels of Serum Estradiol, Serum Cathepsin B, and Bone Turnover Markers With PSA Response
These correlative analyses were not completed. As there were no PSA responses, it was not possible to correlate serum estradiol, serum cathepsin B, or bone turnover markers with PSA response.
Time frame: Measured after 4 cycles of combination therapy
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