Prostate Cancer Chemoprevention Targeting Men with High-Grade Prostatic Intraepithelial Neoplasia (HGPIN) and Atypical Small Acinar Proliferation (ASAP): Model for Trial Design and Outcome Measures.

Abstract

In spite of the large number of nutrient-derived agents demonstrating promise as potential chemopreventive agents, most have failed to prove effectiveness in clinical trials. Critical requirements for moving nutrient-derived agents to recommendation for clinical use include adopting a systematic, molecular-mechanism based approach and utilizing the same ethical and rigorous methods such as are used to evaluate other pharmacological agents. Preliminary data on a mechanistic rationale for chemoprevention activity as observed from epidemiological, in vitro and preclinical studies, phase I data of safety in suitable cohorts, duration of intervention based on time to progression of preneoplastic disease to cancer and the use of a valid panel of biomarkers representing the hypothesized carcinogenesis pathway for measuring efficacy must inform the design of phase II clinical trials. The goal of this paper is to provide a model for evaluating a well characterized agent- Polyphenon E- in a phase II clinical trial of prostate cancer chemoprevention.

• Authors: Nagi Kumar, Theresa Crocker, Tiffany Smith, Shahnjayla Connors, Julio Pow-Sang, Philippe E Spiess, Kathleen Egan, Gwen Quinn, Michael Schell, Said Sebti, Aslam Kazi, Tian Chuang, Raoul Salup, Mohamed Helal, Gregory Zagaja, Edouard Trabulsi, Jerry McLarty, Tajammul Fazili, Christopher R Williams, Fred Schreiber, Kyle Anderson
• Journal: Journal of clinical trials (J Clin Trials) Vol. 2 Issue 1 (Jan 21 2012) ISSN: 2167-0870 [Print] United States
• PMID: 24533253 (Publication Type: Journal Article)