Prostate Cancer Clinical Trial
Phenelzine Sulfate in Treating Patients With Non-metastatic Recurrent Prostate Cancer
This phase II trial studies phenelzine sulfate in treating patients with prostate cancer that has not spread to other parts of the body and has come back. Phenelzine sulfate is a type of antidepressant that works by decreasing the amount of a protein called monoamine oxidase (MAO). MAO drugs may have an anticancer effect in prostate cancer.
I. To assess the proportion of patients with biochemical recurrent prostate cancer (BCR-PC) treated with phenelzine (phenelzine sulfate) who achieve a prostate-specific antigen (PSA) decline of >= 50% from baseline.
I. To monitor potential toxicities and/or beneficial effects on quality of life of phenelzine in prostate cancer patients.
II. To assess time to radiographic disease progression for patients with recurrent prostate cancer treated with phenelzine.
III. To collect blood and other samples to study the relationship between MAO activity and prostate cancer.
Patients receive phenelzine sulfate 30 mg by mouth (PO) twice daily (BID) (starting dose of 15 mg daily escalated to 30 mg BID over 16 plus or minus 5 days). Patients who have been treated at 30 mg BID for over 3 cycles with resolution of any and all toxicities to grade < or = 1 may increase the dose to a maximum of 45 mg BID at the discretion of the treating investigator. Treatment may continue in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for up to 3 years.
Histologically confirmed adenocarcinoma of the prostate
Recurrent prostate cancer following primary therapy as defined by:
Post-radical prostatectomy: Any PSA >= 0.4 ng/ml
Post-primary radiotherapy: PSA >= 2 ng/ml above a post-radiotherapy nadir
Post-primary androgen-deprivation therapy: A confirmed rise of PSA >= 2 ng/ml above a post-therapy nadir
For patients with non-castrate levels of circulating androgen levels (testosterone >= 50 g/dl)
PSA levels should be increasing on at least two occasions >= 1 week apart
Patients should not be considered candidates for radiation therapy
For patients with castrate levels of circulating androgen levels (testosterone < 50 ng/dl):
PSA levels must be >= 0.4 ng/ml (if history of radical prostatectomy) or >= 2 ng/ml (if history of non-surgical primary treatment) and found to be increasing on at least two occasions >= 1 week apart
At least 4 weeks must have elapsed since any changes to hormonal therapy, including at least 4 weeks since flutamide and at least 6 weeks since bicalutamide, nilutamide, or enzalutamide
No evidence of metastatic cancer on imaging including a bone scan and computed tomography (CT) scan of chest/abdomen/pelvis
Able to understand and adhere to dietary and medication restrictions as recommended for the safe use of phenelzine
Men with child bearing potential are required to use an effective means of contraception
Leukocytes >= 3,000/mcL
Absolute neutrophil count >= 1,500/mcL
Platelets >= 100,000/mcL
Total bilirubin =< 1.5 x upper limit of normal (ULN) except in cases of benign isolated hyperbilirubinemia such as Gilbert's syndrome.
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SPGT]) =< 2.5 x ULN
Creatinine =< 1.5 x ULN
Uncontrolled hypertension despite appropriate medical therapy (blood pressure [BP] greater than 160 mmHg systolic and 90 mmHg diastolic at 2 separate measurements no more than 60 minutes apart during the screening visit); Note: patients may be rescreened after adjustment of antihypertensive medications
Known prior history of mania or major psychiatric illness (schizophrenia, bipolar disorder, severe major depression requiring hospitalization, etc.)
Concurrent use of medications contra-indicated due to potential interactions with phenelzine
Inability to comply with dietary restrictions for foods, supplements, and medications with potential for adverse interactions with phenelzine or to otherwise cooperate fully with the investigator and study personnel
History of allergic reactions attributed to compounds of similar chemical or biologic composition to phenelzine or other monoamine oxidase inhibitors
Patients may not be receiving any other investigational agents
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
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There are 3 Locations for this study
Beverly Hills California, 90211, United States
Los Angeles California, 90033, United States
Los Angeles California, 90033, United States
Pasadena California, 91105, United States
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