This trial is designed as a randomized two-arm (LDE225 vs. observation groups) open-label prospective clinical trial in men with localized high-risk prostate cancer undergoing radical prostatectomy. The investigators propose to determine the effects of LDE225 on neoplastic prostate tissue from men at high risk of systemic disease progression, by comparing pre-surgical core-biopsy specimens to tumor tissue harvested at the time of prostatectomy.
High-risk patients will be identified based on their core-needle biopsy features, PSA levels, and clinical stage. After obtaining baseline laboratory and clinical values (including an ECG, PSA, hematologic, and renal and hepatic panels), men will receive oral LDE225 800 mg/day or observation daily for 4 weeks (±3 days) prior to prostatectomy. Patients will have a clinical visit and an ECG and laboratory testing will be performed at 2 weeks and then again at 4 weeks, including a 4-week pre-prostatectomy measurement of PSA and a blood sample to determine plasma LDE225 levels. Men will undergo radical prostatectomy (with bilateral pelvic lymphadenectomy as appropriate), at which point two 250-mg biopsies of prostate tissue will be obtained, frozen and stored for analysis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
14
Sonidegib was given as an oral drug at 800mg daily for 28 days prior to prostetoctomy
Johns Hopkins Hospital
Baltimore, Maryland, United States
Change From Baseline in Tissue Gli1 Expression Levels Using qRT-PCR Analysis in Each Group (LDE225 and Observation)
This was defined as the number of patients who achieved at least a two-fold reduction in GLI1 expression in post-treatment vs. pre-treatment tumor tissues.
Time frame: Up to 3 Years
Percentage of Participants With a Pathological Effect of Presurgical Treatment With LDE225
To determine whether presurgical treatment with LDE225 can exert a pathological effect on high-risk tumors (i.e. increase apoptosis, decrease proliferation).
Time frame: Up to 3 years
Effect of LDE225 on PSA Recurrence Following Prostatectomy
To evaluate whether presurgical treatment with LDE225 diminishes the risk of PSA recurrence following prostatectomy.
Time frame: Up to 3 years
Number of Participants With Adverse Events in Each Group (LDE225 and Observation)
Safety and tolerability, including any drug-related toxicities of Sonidegib, were reported via CTCAE version 4.0.
Time frame: Up to 3 years
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