Abiraterone Acetate and Prednisone With or Without Dasatinib in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer

Inclusion Criteria:

Metastatic, castration-resistant prostate cancer

Defined as evaluable radiographic disease with rising PSA x 2 (at least 1 week apart) or radiographic progression (new soft tissue/bone lesions or enlarging soft tissue lesions) despite medical or surgical castration
No limit on prior hormonal therapies (i.e. anti-androgens, ketoconazole) except that subject must not have received abiraterone previously
No limit on prior biologic therapies (i.e. immune therapy, antiangiogenic, targeted) except that patient should not have received dasatinib or other v-src sarcoma (Schmidt-Ruppin A-2) viral oncogene homolog (avian) (src)-targeted therapy

No prior chemotherapy for metastatic disease

* Subjects who have received chemotherapy in the neoadjuvant or adjuvant setting will be eligible provided chemotherapy was completed > 6 months prior to enrollment

Eastern Cooperative Oncology Group (ECOG) 0-2
Total bilirubin =< 1.5 times the institutional upper limit of normal (ULN) except for Gilbert's syndrome
Hepatic enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] ) =< 2.5 times the institutional ULN
Serum sodium (Na), potassium (K+), magnesium (Mg+), phosphate and calcium (Ca+) > lower limit of normal (LLN)
Serum creatinine =< 1.5 time the institutional ULN
Hemoglobin (Hb) >= 9
Platelets >= 100,000
Absolute neutrophil count (ANC) >= 1000
Ability to take oral medication (study medications must be swallowed whole)
Men with fathering potential must agree to use contraception throughout study treatment; acceptable methods include: condoms, sponge, intrauterine device (IUD), oral contraceptives
Concomitant medications * Patient agrees to discontinue St. Johns wort while receiving dasatinib therapy (discontinue St. Johns wort at least 5 days before starting dasatinib)

Exclusion Criteria:

Known hepatitis B or C or human immunodeficiency virus (HIV), regardless of viral load

* Testing for the purposes of enrollment is not mandatory, however a documented history of these infections will be exclusionary due to concerns for drug-drug interactions with antivirals and potential for increased risk of liver toxicity

Radiation for palliation of bony metastases within the preceding 2 weeks

Prior chemotherapy for metastatic castration-resistant prostate cancer (CRPC)

* Immune therapy with sipuleucel-T is allowed, provided the last infusion was >= 28 days prior to study therapy and there has been at least one documented PSA value rising after completion of sipuleucel-T therapy or progression of disease on imaging after sipuleucel-T

Malignancy (aside from prostate cancer) which required radiotherapy or systemic treatment within the past 5 years

Superficial bladder cancer treated with intravesical therapy and currently in remission will not be an exclusion
Skin cancers will not be an exclusion, except for melanoma with a thickness > 1 mm

Concurrent medical condition which may increase the risk of toxicity, including:

Pleural or pericardial effusion of any grade at the time of study entry

Cardiac symptoms; any of the following should be considered for exclusion: ** Uncontrolled angina, congestive heart failure or myocardial infarction (MI) within (6 months)

Diagnosed congenital long QT syndrome
Any history of clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de pointes) ** Prolonged QTc/f interval on pre-entry electrocardiogram (> 450 msec)
Hypokalemia or hypomagnesemia if it cannot be corrected prior to abiraterone administration

History of significant bleeding disorder unrelated to cancer, including:

Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)
Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)
Ongoing or recent (=< 3 months) significant gastrointestinal bleeding

Prohibited treatments and/or therapies

Should not be on any additional anti-cancer therapy except for luteinizing hormone-releasing hormone (LHRH) agonist/antagonist; specifically excluded medications include ketoconazole, estrogens, and anti-androgens

Category I drugs that are generally accepted to have a risk of causing Torsades de pointes including: (Patients must discontinue drug 7 days prior to starting dasatinib)

Quinidine, procainamide, disopyramide
Amiodarone, sotalol, ibutilide, dofetilide
Erythromycin, clarithromycin
Chlorpromazine, haloperidol, mesoridazine, thioridazine, pimozide
Cisapride, bepridil, droperidol, methadone, arsenic, chloroquine, domperidone, halofantrine, levomethadyl, pentamidine, sparfloxacin, lidoflazine
Prisoners or subjects who are involuntarily incarcerated
Subjects who are compulsorily detained for treatment of either a psychiatric or physical (eg, infectious disease) illness