This phase I trial studies the best dose and side effects of niclosamide when given together with enzalutamide in treating patients with castration-resistant prostate cancer that has come back or has spread to other places in the body. Androgens can cause the growth of prostate cancer cells. Hormone therapy using enzalutamide may fight prostate cancer by lowering the amount of androgen the body makes and/or blocking the use of androgen by the tumor cells. Niclosamide may block signals that enhance prostate cancer cell growth. Giving enzalutamide and niclosamide may work better in treating patients with castration-resistant prostate cancer.
PRIMARY OBJECTIVES: I. To determine the safety of niclosamide (PDMX1001/niclosamide) and enzalutamide in patients with castration-resistant prostate cancer (CRPC). II. To determine the recommended phase II dose (RP2D) of PDMX1001/niclosamide and enzalutamide for the treatment of patients with CRPC. SECONDARY OBJECTIVES: I. To determine the pharmacokinetics of PDMX1001/niclosamide. II. To determine the number of patients who have a prostate-specific antigen (PSA) response that is a 50% or more reduction from the baseline. III. To identify overall responses as determined by the Prostate Cancer Working Group 2 (PCWG2) criteria. IV. To evaluate the progression-free survival (PFS) of CRPC patients treated with PDMX1001/niclosamide and enzalutamide. V. To evaluate molecular correlatives for patient response and outcomes through the analysis of patient baseline tumor specimens (diagnostic biopsy) along with serial blood specimens. OUTLINE: This is a dose-escalation study of niclosamide. Patients receive niclosamide orally (PO) twice daily (BID) and enzalutamide PO once daily (QD) on weeks 1-4. Courses repeat every 4 weeks in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up for 3 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Given PO
Given PO
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States
Incidence of adverse events of grade 3 or higher assessed by National Cancer Institute Common Terminology Criteria for Adverse Events 4.0
Adverse events and adverse events of grade 3 or higher will be listed for each patient and summarized by body system in a frequency table.
Time frame: Up to 4 weeks
RP2D of niclosamide and enzalutamide
Determination of dose limiting toxicity as graded according to NCI CTCAE 4.0.
Time frame: Up to 2 years
Overall survival
Will be estimated using the product-limit method of Kaplan and Meier; medians and 95% confidence intervals will be computed.
Time frame: Up to 5 years
PFS
Will be estimated using the product-limit method of Kaplan and Meier; medians and 95% confidence intervals will be computed.
Time frame: Up to 5 years
Rate of PSA response which is defined as >= 50% decrease
The characteristics of the study participants will be summarized using frequencies and percentages for categorical variables and descriptive statistics (mean, standard deviation, median, minimum, maximum) for numeric variables. The proportion of participants who experience a PSA response will be computed, along with the exact 95% confidence interval.
Time frame: Baseline up to 2 years
Time to treatment failure
Will be estimated using the product-limit method of Kaplan and Meier; medians and 95% confidence intervals will be computed.
Time frame: Up to 2 years
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