Docetaxel is the standard, first-line chemotherapeutic agent for castrate resistant prostate cancer. While it has clinically useful activity, there is a strong need for substantial improvement in its efficacy. Possible ways for improving docetaxel monotherapy would be to combine it with an agent that either minimized toxicity (thus allowing higher doses) or improves efficacy (by targeting synergistic pathways). Lycopene is an attractive agent for combination with docetaxel because of its known accumulation in prostate tissue, its low toxicity, and its ability to inhibit signaling through the IGF-1 axis, and to reduce IL6 levels. Lycopene is highly synergistic with docetaxel at inhibiting the growth of prostate cancer in mice. The purpose of this study is to determine the maximum tolerated dose (MTD) of lycopene given in combination with docetaxel. This dose can then be used for subsequent phase II or phase III studies. New findings from the ECOG E3805 study presented at ASCO 2014, showed that concurrent chemotherapy with first-line ADT for newly diagnosed metastatic prostate cancer markedly improved overall survival compared with delayed or no chemotherapy. These subjects could also benefit from intervention to increase docetaxel effectiveness.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
During administration of standard of care Docetaxel at 75 mg/m2 on day 15 and every 21 days, study patients will also receive Lycopene at the dose specified per the dose cohort they are enrolled. There are three dose cohort levels as follows: Dose level 1 = 30 mg PO every day; Dose level 2 = 90 mg PO every day; Dose level 3 = 150 mg PO every day.Treatment will continue until disease progression or toxicity or patient withdrawal.
Medical University of South Carolina
Charleston, South Carolina, United States
Ralph H. Johnson Veterans Administration Medical Center
Charleston, South Carolina, United States
Determination of the Maximum Tolerated Dose of Lycopene when given in combination with docetaxel
Time frame: The Dose Limiting Toxicity period is from Day 1 to Day 36 of study treatment with Lycopene and Docetaxel
IGF1 signaling inhibition at MTD
To determine the ability of lycopene given at the MTD in combination with docetaxel, to inhibit IGF1 signaling, as reflected in the level of phosphoIGF1R (Y1131) following ex vivo stimulation of PBMNCs.
Time frame: For patients treated at the dose determined to be the MTD, IGF1 signaling inhibition will be studied at Day 1 and Day 64.
Pharmacokinetic assessment of docetaxel and lycopene
To determine the effects of lycopene on the pharmacokinetics of docetaxel and effects of docetaxel on the pharmacokinetics of lycopene during combination therapy.
Time frame: For patients treated at the dose determined to be the MTD, IGF1 signaling inhibition will be studied at Day 1 and Day 64.
Assessment of plasma levels of IL6, IGF1, IGF-2, and IGFBP3; and IGF1R level
To determine the effects of lycopene + docetaxel therapy on plasma levels of IL6, IGF1, IGF-2, and IGFBP3; and IGF1R level in peripheral blood mononuclear cells.
Time frame: Pre-tx and Days 15,36,57,78,and 99. (during MTD phase only): pre-tx, Days 22, 43,64.
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