A Phase II Study of Docetaxel Plus Carboplatin in Chemonaive Hormone-Refractory Prostate Cancer (HRPC) Patients

National University Health System (NUHS)

Status and phase: Completed; Phase 2

Conditions: Hormone-Refractory Prostate Cancer

Treatments: Drug: Docetaxel, Carboplatin

Study type: Interventional

Funder types: Other

Identifiers

NCT00675545

PR01/30/06

Details and patient eligibility

About

The primary objective is to determine the efficacy of docetaxel plus carboplatin as first line treatment in patients with hormone refractory prostate cancer.

Full description

Docetaxel-prednisolone is the current standard in HRPC, based on 2 large randomized trials showing improved survival compared to mitoxantrone-prednisolone. Carboplatin has activity in prostate cancer and the combination of Docetaxel-carboplatin is known to be synergistic and is used with good effect in many cancers. The advantage of using this combination in prostate cancer is suported by clinical data: high response rates of docetaxel-carboplatin-estramustine (with G-CSF support) in a phase II trial (Oh, Halabi, Kelly et al. Cancer. 2003 Dec 15;98(12):2592-8), and additional effect of this combination in prior taxane failures (Oh, George, Tay. Clin Prostate Cancer. 2005 Jun;4(1):61-4). Carboplatin itself has activity and theoretically could target the more hormone resistant clones or neuroendocrine components of the tumor.(Di Sant' Agnese. J Urol. 1994 Nov;152(5 Pt 2):1927-31.) We are studying the combination of docetaxel-carboplatin both given in a weekly, low-dose fashion, without estramustine and without G-CSF. This is expected to be an effective and tolerable treatment for HRPC patients. We will be documenting (to our knowledge) for the first time in this trial the efficacy of the combination given in this particular dose and schedule.

Enrollment: 2 patients

Sex: Male

Ages: 30+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Histologically confirmed adenocarcinoma of the prostate.

2. At the time of enrollment, patients must have evidence of metastatic disease, with either measurable disease per RECIST criteria or non- measurable disease (i.e. positive bones scan) and PSA > 5 ng/mm3.

3. Disease progression following androgen deprivation therapy.

4. Progression is defined according to the PSA Working Group criteria (see 6.1.3 and 6.3).

5. Serum testosterone levels < 50 ng/mm3 (unless surgically castrate). Patients must continue androgen deprivation with an LHRH analogue if they have not undergone orchiectomy.

6. No use of an antiandrogen for at least 4 weeks.

7. Have not been treated with chemotherapy before.

8. ECOG performance status of <= 2.

9. Laboratory criteria for entry:

   • White blood cell (WBC) => 3000/mm3
   • Platelets => 100,000/mm3
   • AST < 2.5 x upper limit of normal
   • Calculated CCT of => 40 ml/min

10. Signed informed consent form.

11. Age: 30 years old and above

Exclusion criteria

1. Significant peripheral neuropathy defined as grade 2 or higher.
2. Within 4 weeks since completing external beam radiotherapy or 8 weeks since completing radiopharmaceutical therapy (strontium, samarium).
3. Concomitant chemotherapy or investigational agents.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

2 participants in 1 patient group

docetaxel and prednisolone

Experimental group

Description:

Patients in study will receive both chemotherapeutic agents on day 1 and day 8 of every 21-day cycle as described below: * Docetaxel 30 mg/m2 over 1 hour IV infusion, followed by * Carboplatin (AUC 2) over 1 hour IV infusion * Additonal medication required: IV Dexamethasone 10 mg followed by PO dexamethasone 4 mg 8 hourly x 4 doses, starting 12 hours after starting iv docetaxel.

Treatment:

Drug: Docetaxel, Carboplatin