This study will test how effective the drug, Carfilzomib, reduces progression of prostate cancer in patients who have previously received chemotherapy and androgen inhibitors. Carfilzomib is approved for multiple myeloma but is not approved for prostate cancer. Therefore, it is considered investigational. Other approved methods of treatment for metastatic prostate cancer have demonstrated only modest benefits. Novel and tolerable agents are necessary to make further gains and extend overall survival.
First-line chemotherapy for metastatic castration-resistant prostate cancer (CRPC) combined with androgen inhibitors modestly extends overall survival. Carfilzomib is anticipated to enhance progression-free survival (PFS) as well as reduce pain and toxicities. Proteasome inhibitors are promising agents used in the therapy of prostate cancer. Carfilzomib is a more potent and irreversible proteasome inhibitor than the frequently used proteasome inhibitor, Bortezomib. In Phase I trials Carfilzomib demonstrated substantial antitumor activity while exhibiting tolerable side effects. Carfilzomib has been approved by the FDA for patients with multiple myeloma. The drug, however, is not approved for the use with CRPC patients. This trial will evaluate the tolerance and effectiveness of Carfilzomib in men with metastatic progressive CRPC following chemotherapy and androgen inhibitors.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Carfilzomib will be administered on days 1, 2, 8, 9, 15, 16 within each 4 week cycle.
Administered prior to administration of Study drug
Administered orally twice daily
Birmingham VA Medical Center
Birmingham, Alabama, United States
University of Alabama at Birmingham
Birmingham, Alabama, United States
Cancer Life Center, Navicent Health
Macon, Georgia, United States
University of Tulane
New Orleans, Louisiana, United States
Progression-free Survival (PFS)
The study will measure patient survival at 6 months but will continue to monitor overall survival as a secondary objective. The Kaplan-Meier method will be used.
Time frame: Baseline through 6 months for evaluating all patients
Overall Survival
Outcome measure was completed by using a count of participants.
Time frame: From baseline through 36 months.
Number of Participants With Prostate-Specific Antigen (PSA) Changes
PSA levels were collected at each visit on the day of treatment. Linear regression with PSA as the dependent variable and time as the dependent variable was performed.
Time frame: Baseline through 36 months
Number of Participants With Circulating Tumor Cell (CTC) Decline Over Three Time Points (Before Study Initiation, Day 1 of Cycles 2 and 4
The CTC marker will be used to evaluate efficacy of response to treatment. CTC changes will include changes from unfavorable (less than or equal to 5/7.5 ml) to favorable and declines by \>30%. Three collections: before study initiation, Day 1 of Cycles 2 and 4
Time frame: Baseline through 36 months
Assessment of Toxicities
Hematologic and non-hematologic toxicities will be graded. The new international criteria proposed by the Response Evaluation Criteria In Solid Tumors (RECIST) will serve as the guideline. On Day 1 of each cycle (4 weeks) for the duration of treatment and then 30 days following the last treatment
Time frame: Baseline through 36 months
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