Overview

Metformin for Rising PSA Remote Trial

Status:
Completed
Trial end date:
2016-12-01
Target enrollment:
0
Participant gender:
Male
Summary
Clinical trials are critical to informing the care of patients with cancer. However, only 3-5% of patients with cancer enroll in clinical trials. Poor accrual to trials has major implications with regards to the pace of progress, the cost of clinical cancer research, and the generalizability of results. The investigators have recently shown in an analysis of 7,776 cancer clinical trials registered on clinicaltrials.gov that approximately 20% of cancer clinical trials fail to complete enrollment at all; the most often cited reason was poor accrual. Prior research has identified barriers to cancer clinical trial accrual that can be generally categorized in the domains of availability, awareness, and acceptance. Much attention has been paid to the barriers involvement awareness and acceptance - however, trial availability is likely a "rate limiting step". This pilot study is the first in a series of planned steps to attempt to shift the current paradigm of "bringing patients to trials" to "bringing trials to patients." With the integration of telemedicine visits, the investigators aim to decrease the burden of participation for patients, begin to address geographic barriers, and ultimately improve trial accrual. In this study, men with biochemically recurrent prostate cancer (a rising PSA after definitive local therapy) will receive the antidiabetic drug, metformin. Patients will require a single on-site visit for study enrollment. The remainder of the 6 month study will be conducted via a HIPPA secure telemonitoring system (monthly visits conducted via telemedicine with tablet computers provided to each patients).
Phase:
N/A
Accepts Healthy Volunteers?
Accepts Healthy Volunteers
Details
Lead Sponsor:
Matthew Galsky
Treatments:
Metformin
Criteria
Inclusion Criteria:

- Histologically confirmed adenocarcinoma of the prostate. (*in situations where
pathology reports documenting prostate cancer are no longer available such as when the
initial biopsy or prostatectomy was performed in the remote past, a documented history
of prior prostate cancer and prostate cancer treatment in prior medical records will
be sufficient)

- Biochemical disease progression after radical prostatectomy and/or radiation therapy
(external-beam radiation therapy and/or brachytherapy), and no radiographic evidence
of metastases.

- Men with history of radical prostatectomy are required to have baseline PSA > 0.5
ng/mL (Prior treatment with neoadjuvant, adjuvant, or salvage radiation therapy
is allowed, again, with screening PSA greater than or equal to 0.5 ng/mL required
for eligibility).

- Men treated with primary radiation therapy are required to have baseline PSA ≥
1.0 ng/mL above their post radiation nadir for men who were treated with primary
radiation therapy (external beam and/or brachytherapy). Men who had primary
radiation therapy followed by salvage prostatectomy are eligible if screening PSA
is greater than or equal to 0.5 ng/mL.

- Men with previous neoadjuvant adjuvant hormone therapy are eligible if
testosterone level at screening is non-castrate (≥ 50 ng/dl). Men previously
treated with intermittent hormonal therapy are also eligible if level of
testosterone at screening is non-castrate (≥ 50 ng/dl).

- Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to 2
(Karnofsky greater than or equal to 60%).

- Subjects must have normal organ as defined below:

- AST(SGOT)/ALT(SGPT) less than or equal to 1.8 X institutional upper limit of
normal

- Serum bilirubin ≤ ULN (except for subjects with Gilbert's Disease who are
eligible despite elevated serum bilirubin level)

- Creatinine ≤ 1.5 mg/dL and/or creatinine clearance > 60 ml/min

- English speaking

Exclusion Criteria:

- Concurrent use of other investigational agents or other prostate cancer therapies
(e.g., androgen deprivation therapy)

- Currently taking metformin, sulfonylureas, thiazolidinedione, insulin, or other
antidiabetic drugs for any reason.

- Known hypersensitivity or intolerance to metformin

- Condition associated with increased risk of metformin-associated lactic acidosis:

- New York Heart Association Class III or IV Heart Failure

- Intake of 3 or more alcoholic beverages per day

- Known history of lactic acidosis