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Brief Title: Enzalutamide and Metformin Hydrochloride in Treating Patients With Hormone-Resistant Prostate Cancer
Official Title: Enzalutamide and Metformin Combination Therapy to Overcome Autophagy Resistance in Castration Resistant Prostate Cancer
Study ID: NCT02339168
Brief Summary: This phase I trial studies the side effects and best dose of metformin hydrochloride when given together with enzalutamide in treating patients with prostate cancer that has not responded to previous treatment with hormones. Hormone therapy using enzalutamide may fight prostate cancer by lowering the amount of androgens the body makes and blocking the use of androgens by the tumor cells. Metformin hydrochloride, used for diabetes, may also help kill tumor cells. Giving enzalutamide together with metformin hydrochloride may kill more tumor cells.
Detailed Description: PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD) of enzalutamide when given in combination with metformin (metformin hydrochloride) to patients with castration resistant prostate cancer (CRPC), where fewer than 33% of patients experienced dose limiting toxicity (DLT) attributable to the study regimen and to recommend a phase II dose for the combination. SECONDARY OBJECTIVES: I. To determine prostate-specific antigen (PSA) response in patients with CRPC with given enzalutamide in combination with metformin. II. To determine PSA progression in patients with CRPC with given enzalutamide in combination with metformin. III. To investigate the feasibility and safety of enzalutamide when given in combination with metformin hydrochloride to patients with CRPC. IV. To obtain preliminary evidence of efficacy for this combination. TERTIARY OBJECTIVES: I. To collect computed tomography (CT)-guided biopsies of metastatic soft tissue or bone tumor tissue for analysis of androgen receptor (AR) gene signature as an integrated biomarker (University of California San Francisco \[UCSF\] to conduct analysis). II. To collect serum samples for the measurement of PSA levels and bone re-absorption markers. OUTLINE: This is a dose-escalation study of metformin hydrochloride. Patients receive enzalutamide orally (PO) once daily (QD) and metformin hydrochloride PO twice daily (BID). Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up at 4, 8, and 12 weeks.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: MALE
Healthy Volunteers: No
University of California Davis Comprehensive Cancer Center, Sacramento, California, United States
Name: Christopher Evans
Affiliation: University of California, Davis
Role: PRINCIPAL_INVESTIGATOR