Trial Outcomes & Findings for Calcitriol in Combination With Ketoconazole and Therapeutic Hydrocortisone in Treating Patients With Prostate Cancer (NCT NCT00536991)

NCT ID: NCT00536991

Last Updated: 2017-06-14

Results Overview

Determine the maximum tolerated dose (MTD) of oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole (400 mg thrice daily \[TID\]) + oral hydrocortisone (20 mg AM, 10 mg PM)

Recruitment status

TERMINATED

Study phase

PHASE1/PHASE2

Target enrollment

51 participants

Primary outcome timeframe

up to 11 years

Results posted on

2017-06-14

Participant Flow

Participant milestones

Participant milestones
Measure
Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone
oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole, (400 mg TID) + oral hydrocortisone (20mg AM, 10mg PM) in men with androgen independent prostate cancer (AIPC).
Overall Study
STARTED
51
Overall Study
COMPLETED
38
Overall Study
NOT COMPLETED
13

Reasons for withdrawal

Reasons for withdrawal
Measure
Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone
oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole, (400 mg TID) + oral hydrocortisone (20mg AM, 10mg PM) in men with androgen independent prostate cancer (AIPC).
Overall Study
Withdrawal by Subject
10
Overall Study
Physician Decision
1
Overall Study
patient ineligible
2

Baseline Characteristics

Calcitriol in Combination With Ketoconazole and Therapeutic Hydrocortisone in Treating Patients With Prostate Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone
n=51 Participants
oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole, (400 mg TID) + oral hydrocortisone (20mg AM, 10mg PM) in men with androgen independent prostate cancer (AIPC).
Age, Categorical
<=18 years
0 Participants
n=39 Participants
Age, Categorical
Between 18 and 65 years
18 Participants
n=39 Participants
Age, Categorical
>=65 years
33 Participants
n=39 Participants
Age, Continuous
68.0 years
STANDARD_DEVIATION 8.7 • n=39 Participants
Sex: Female, Male
Female
0 Participants
n=39 Participants
Sex: Female, Male
Male
51 Participants
n=39 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=39 Participants
Race (NIH/OMB)
Asian
0 Participants
n=39 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=39 Participants
Race (NIH/OMB)
Black or African American
6 Participants
n=39 Participants
Race (NIH/OMB)
White
45 Participants
n=39 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=39 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=39 Participants

PRIMARY outcome

Timeframe: up to 11 years

Population: All Phase I participants

Determine the maximum tolerated dose (MTD) of oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole (400 mg thrice daily \[TID\]) + oral hydrocortisone (20 mg AM, 10 mg PM)

Outcome measures

Outcome measures
Measure
Treatment (Calcitriol, Ketoconazole, Hydrocortisone)
n=14 Participants
PHASE I: Patients receive calcitriol PO QD on days 1-3, 8-10, 15-17, and 22-24. Patients also receive ketoconazole PO TID on days 1-24 and therapeutic hydrocortisone PO BID on days -1 to 24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PHASE II: Patients receive calcitriol and therapeutic hydrocortisone as in phase I. Patients also receive ketoconazole PO TID on days 4-24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Calcitriol: Given PO Ketoconazole: Given PO Laboratory Biomarker Analysis: Correlative studies Pharmacological Study: Correlative studies Therapeutic Hydrocortisone: Given PO
Determine the Maximum Tolerated Dose (MTD)
10 mcg

PRIMARY outcome

Timeframe: Up to 11 years

Population: All treated and eligible patients

Patients will be considered evaluable for PSA response if they have at least two post-baseline PSA measurements at least 4 weeks apart, or if they have other evidence of disease progression. A PSA response will be considered a PSA decline of at least 50% must be confirmed by a second PSA value four or more weeks later. The reference PSA for these declines should be a PSA measured within 2 weeks prior to the initiation of therapy.

Outcome measures

Outcome measures
Measure
Treatment (Calcitriol, Ketoconazole, Hydrocortisone)
n=51 Participants
PHASE I: Patients receive calcitriol PO QD on days 1-3, 8-10, 15-17, and 22-24. Patients also receive ketoconazole PO TID on days 1-24 and therapeutic hydrocortisone PO BID on days -1 to 24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PHASE II: Patients receive calcitriol and therapeutic hydrocortisone as in phase I. Patients also receive ketoconazole PO TID on days 4-24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Calcitriol: Given PO Ketoconazole: Given PO Laboratory Biomarker Analysis: Correlative studies Pharmacological Study: Correlative studies Therapeutic Hydrocortisone: Given PO
PSA Response Rate
35 percentage of participants
Interval 22.0 to 50.0

SECONDARY outcome

Timeframe: Up to 11 years

Population: All treated and eligible patients

Count of participants with serious adverse event. Please refer to the adverse event reporting for more detail.

Outcome measures

Outcome measures
Measure
Treatment (Calcitriol, Ketoconazole, Hydrocortisone)
n=51 Participants
PHASE I: Patients receive calcitriol PO QD on days 1-3, 8-10, 15-17, and 22-24. Patients also receive ketoconazole PO TID on days 1-24 and therapeutic hydrocortisone PO BID on days -1 to 24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PHASE II: Patients receive calcitriol and therapeutic hydrocortisone as in phase I. Patients also receive ketoconazole PO TID on days 4-24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Calcitriol: Given PO Ketoconazole: Given PO Laboratory Biomarker Analysis: Correlative studies Pharmacological Study: Correlative studies Therapeutic Hydrocortisone: Given PO
Incidence of Toxicity Graded According to the National Cancer Institute CTC Version 3.0
14 Participants

SECONDARY outcome

Timeframe: Up to 11 years

Population: All treated and eligible patients. 26 patients were not evaluable.

Judged by monthly physical exam and radiographic evaluation. Patients will be considered evaluable for tumor response if they have at least two post-baseline tumor assessments at least 4 weeks apart, received study medication for 8 weeks or if they have evidence of disease progression. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Outcome measures

Outcome measures
Measure
Treatment (Calcitriol, Ketoconazole, Hydrocortisone)
n=25 Participants
PHASE I: Patients receive calcitriol PO QD on days 1-3, 8-10, 15-17, and 22-24. Patients also receive ketoconazole PO TID on days 1-24 and therapeutic hydrocortisone PO BID on days -1 to 24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. PHASE II: Patients receive calcitriol and therapeutic hydrocortisone as in phase I. Patients also receive ketoconazole PO TID on days 4-24. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. Calcitriol: Given PO Ketoconazole: Given PO Laboratory Biomarker Analysis: Correlative studies Pharmacological Study: Correlative studies Therapeutic Hydrocortisone: Given PO
Objective Tumor Response, Assessed by RECIST
24 percentage of participants
Interval 9.0 to 45.0

Adverse Events

Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone

Serious events: 14 serious events
Other events: 50 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone
n=51 participants at risk
oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole, (400 mg TID) + oral hydrocortisone (20mg AM, 10mg PM) in men with androgen independent prostate cancer (AIPC).
Gastrointestinal disorders
Constipation
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Gastric ulcer haemorrhage
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Nausea
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Pancreatitis acute
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Vomiting
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Dehydration
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Hypercalcaemia
5.9%
3/51 • Number of events 3
Metabolism and nutrition disorders
Hypernatraemia
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Hypokalaemia
3.9%
2/51 • Number of events 2
Musculoskeletal and connective tissue disorders
Muscular weakness
3.9%
2/51 • Number of events 2
Nervous system disorders
Cerebrovascular accident
2.0%
1/51 • Number of events 1
Nervous system disorders
Cervical cord compression
2.0%
1/51 • Number of events 1
Nervous system disorders
Headache
2.0%
1/51 • Number of events 1
Nervous system disorders
Hemiparesis
2.0%
1/51 • Number of events 1
Nervous system disorders
Spinal cord compression
2.0%
1/51 • Number of events 1
Nervous system disorders
Visual field defect
2.0%
1/51 • Number of events 1
Renal and urinary disorders
Renal failure acute
3.9%
2/51 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
3.9%
2/51 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Respiratory failure
3.9%
2/51 • Number of events 2
Vascular disorders
Hypertension
2.0%
1/51 • Number of events 1

Other adverse events

Other adverse events
Measure
Phase I/II: Oral Calcitriol, Ketoconazole, Hydrocortisone
n=51 participants at risk
oral calcitriol daily x 3 consecutive days a week in combination with oral ketoconazole, (400 mg TID) + oral hydrocortisone (20mg AM, 10mg PM) in men with androgen independent prostate cancer (AIPC).
Blood and lymphatic system disorders
Anaemia
15.7%
8/51 • Number of events 8
Blood and lymphatic system disorders
Leukopenia
2.0%
1/51 • Number of events 1
Blood and lymphatic system disorders
Thrombocytopenia
2.0%
1/51 • Number of events 1
Cardiac disorders
Bradycardia
2.0%
1/51 • Number of events 1
Cardiac disorders
Sinus bradycardia
2.0%
1/51 • Number of events 1
Cardiac disorders
Tachycardia
2.0%
1/51 • Number of events 1
Eye disorders
Glaucoma
2.0%
1/51 • Number of events 1
Eye disorders
Lacrimation increased
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Abdominal pain
3.9%
2/51 • Number of events 2
Gastrointestinal disorders
Constipation
11.8%
6/51 • Number of events 6
Gastrointestinal disorders
Diarrhoea
5.9%
3/51 • Number of events 3
Gastrointestinal disorders
Dry mouth
3.9%
2/51 • Number of events 2
Gastrointestinal disorders
Dyspepsia
13.7%
7/51 • Number of events 7
Gastrointestinal disorders
Dysphagia
5.9%
3/51 • Number of events 3
Gastrointestinal disorders
Gastrooesophageal reflux disease
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Lip dry
2.0%
1/51 • Number of events 1
Gastrointestinal disorders
Nausea
54.9%
28/51 • Number of events 28
Gastrointestinal disorders
Vomiting
35.3%
18/51 • Number of events 18
General disorders
Asthenia
5.9%
3/51 • Number of events 3
General disorders
Chest discomfort
2.0%
1/51 • Number of events 1
General disorders
Fatigue
47.1%
24/51 • Number of events 24
General disorders
Gait disturbance
3.9%
2/51 • Number of events 2
General disorders
Influenza like illness
2.0%
1/51 • Number of events 1
General disorders
Malaise
2.0%
1/51 • Number of events 1
General disorders
Oedema peripheral
3.9%
2/51 • Number of events 2
General disorders
Pain
5.9%
3/51 • Number of events 3
Hepatobiliary disorders
Hyperbilirubinaemia
2.0%
1/51 • Number of events 1
Immune system disorders
Hypersensitivity
2.0%
1/51 • Number of events 1
Infections and infestations
Cystitis
2.0%
1/51 • Number of events 1
Infections and infestations
Ear infection
2.0%
1/51 • Number of events 1
Infections and infestations
Herpes zoster
2.0%
1/51 • Number of events 1
Infections and infestations
Nasopharyngitis
3.9%
2/51 • Number of events 2
Infections and infestations
Pneumonia
3.9%
2/51 • Number of events 2
Infections and infestations
Sinusitis
2.0%
1/51 • Number of events 1
Infections and infestations
Upper respiratory tract infection
5.9%
3/51 • Number of events 3
Infections and infestations
Urinary tract infection
5.9%
3/51 • Number of events 3
Injury, poisoning and procedural complications
Arthropod bite
2.0%
1/51 • Number of events 1
Injury, poisoning and procedural complications
Fall
2.0%
1/51 • Number of events 1
Investigations
Alanine aminotransferase increased
7.8%
4/51 • Number of events 4
Investigations
Aspartate aminotransferase increased
13.7%
7/51 • Number of events 7
Investigations
Blood alkaline phosphatase increased
5.9%
3/51 • Number of events 3
Investigations
Blood bilirubin increased
2.0%
1/51 • Number of events 1
Investigations
Blood calcium abnormal
2.0%
1/51 • Number of events 1
Investigations
Blood calcium increased
2.0%
1/51 • Number of events 1
Investigations
Blood creatine increased
2.0%
1/51 • Number of events 1
Investigations
Blood creatinine increased
45.1%
23/51 • Number of events 23
Investigations
Blood phosphorus
2.0%
1/51 • Number of events 1
Investigations
Blood phosphorus increased
2.0%
1/51 • Number of events 1
Investigations
Blood potassium decreased
2.0%
1/51 • Number of events 1
Investigations
Blood potassium increased
2.0%
1/51 • Number of events 1
Investigations
Carbon dioxide abnormal
2.0%
1/51 • Number of events 1
Investigations
Glomerular filtration rate decreased
2.0%
1/51 • Number of events 1
Investigations
Glycosylated haemoglobin increased
2.0%
1/51 • Number of events 1
Investigations
Haematocrit decreased
2.0%
1/51 • Number of events 1
Investigations
Haemoglobin decreased
3.9%
2/51 • Number of events 2
Investigations
International normalised ratio increased
2.0%
1/51 • Number of events 1
Investigations
Low density lipoprotein increased
2.0%
1/51 • Number of events 1
Investigations
Prothrombin time prolonged
2.0%
1/51 • Number of events 1
Investigations
Red blood cell count decreased
2.0%
1/51 • Number of events 1
Investigations
Weight decreased
3.9%
2/51 • Number of events 2
Investigations
White blood cell count decreased
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Decreased appetite
19.6%
10/51 • Number of events 10
Metabolism and nutrition disorders
Dehydration
7.8%
4/51 • Number of events 4
Metabolism and nutrition disorders
Hypercalcaemia
54.9%
28/51 • Number of events 28
Metabolism and nutrition disorders
Hyperglycaemia
15.7%
8/51 • Number of events 8
Metabolism and nutrition disorders
Hyperkalaemia
5.9%
3/51 • Number of events 3
Metabolism and nutrition disorders
Hypernatraemia
7.8%
4/51 • Number of events 4
Metabolism and nutrition disorders
Hyperphosphataemia
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Hypoglycaemia
2.0%
1/51 • Number of events 1
Metabolism and nutrition disorders
Hypokalaemia
9.8%
5/51 • Number of events 5
Metabolism and nutrition disorders
Hypophosphataemia
2.0%
1/51 • Number of events 1
Musculoskeletal and connective tissue disorders
Arthralgia
5.9%
3/51 • Number of events 3
Musculoskeletal and connective tissue disorders
Back pain
3.9%
2/51 • Number of events 2
Musculoskeletal and connective tissue disorders
Flank pain
3.9%
2/51 • Number of events 2
Musculoskeletal and connective tissue disorders
Muscle spasms
2.0%
1/51 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscular weakness
7.8%
4/51 • Number of events 4
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
2.0%
1/51 • Number of events 1
Musculoskeletal and connective tissue disorders
Neck pain
3.9%
2/51 • Number of events 2
Musculoskeletal and connective tissue disorders
Pain in extremity
5.9%
3/51 • Number of events 3
Nervous system disorders
Ataxia
2.0%
1/51 • Number of events 1
Nervous system disorders
Cranial nerve disorder
2.0%
1/51 • Number of events 1
Nervous system disorders
Dizziness
9.8%
5/51 • Number of events 5
Nervous system disorders
Dysarthria
2.0%
1/51 • Number of events 1
Nervous system disorders
Dysgeusia
2.0%
1/51 • Number of events 1
Nervous system disorders
Headache
9.8%
5/51 • Number of events 5
Nervous system disorders
Neuropathy peripheral
2.0%
1/51 • Number of events 1
Nervous system disorders
Somnolence neonatal
2.0%
1/51 • Number of events 1
Psychiatric disorders
Anxiety
2.0%
1/51 • Number of events 1
Psychiatric disorders
Confusional state
5.9%
3/51 • Number of events 3
Renal and urinary disorders
Dysuria
2.0%
1/51 • Number of events 1
Renal and urinary disorders
Haematuria
5.9%
3/51 • Number of events 3
Renal and urinary disorders
Nephrolithiasis
2.0%
1/51 • Number of events 1
Renal and urinary disorders
Nocturia
2.0%
1/51 • Number of events 1
Renal and urinary disorders
Renal failure acute
2.0%
1/51 • Number of events 1
Renal and urinary disorders
Urinary retention
2.0%
1/51 • Number of events 1
Reproductive system and breast disorders
Pelvic pain
2.0%
1/51 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Cough
2.0%
1/51 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Dyspnoea
5.9%
3/51 • Number of events 3
Respiratory, thoracic and mediastinal disorders
Pneumonitis
2.0%
1/51 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Rhinorrhoea
2.0%
1/51 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Upper-airway cough syndrome
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Dry skin
13.7%
7/51 • Number of events 7
Skin and subcutaneous tissue disorders
Hyperhidrosis
3.9%
2/51 • Number of events 2
Skin and subcutaneous tissue disorders
Nail discolouration
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Nail disorder
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Onychoclasis
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Petechiae
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Pruritus
2.0%
1/51 • Number of events 1
Skin and subcutaneous tissue disorders
Rash
7.8%
4/51 • Number of events 4
Surgical and medical procedures
Cataract operation
2.0%
1/51 • Number of events 1
Vascular disorders
Hot flush
3.9%
2/51 • Number of events 2
Vascular disorders
Hypertension
5.9%
3/51 • Number of events 3
Vascular disorders
Hypotension
2.0%
1/51 • Number of events 1
Vascular disorders
Varicose vein
2.0%
1/51 • Number of events 1

Additional Information

Senior Administrator, Compliance - Clinical Research Services

Roswell Park Cancer Institute

Phone: 716-845-2300

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place