Intervention: Tanespimycin
Trial phase: Phase 2
SMILES: [H]C1=C(C)[C@]([H])(OC(=N)O)[C@@]([H])(OC)/C([H])=C([H])\C([H])=C(/C)C(O)=NC2=CC(=O)C(NCC=C)=C(C[C@@]([H])(C)C[C@]([H])(OC)[C@]([H])(O)[C@@]1([H])C)C2=O
Sex: Male
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 17
Group description: Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Eligibility criteria:
Inclusion Criteria:

Histologically confirmed adenocarcinoma of the prostate

Metastatic disease

Measurable or evaluable disease

Prostate-specific antigen (PSA) ≥ 5 ng/mL OR new areas of bony metastases on bone scan are required for patients with no measurable disease

Objective disease progression OR rising PSA despite receiving androgen deprivation therapy and undergoing antiandrogen withdrawal

Patients with a rising PSA must have 2 successive elevations (measured ≥ 1 week apart)

Must be castrate (testosterone < 50 ng/mL)

Luteinizing hormone-releasing hormone agonist therapy must be continued during study participation to maintain castrate levels of testosterone
Must have received ≥ 1 prior chemotherapy regimen for metastatic disease

No known brain metastases requiring active therapy

Previously treated asymptomatic brain metastases allowed
Performance status - ECOG 0-2
At least 12 weeks
Absolute neutrophil count ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 8.0 g/dL
Bilirubin ≤ 1.5 times upper limit of normal (ULN)
SGOT and/or SGPT ≤ 2.5 times ULN AND alkaline phosphatase normal
Alkaline phosphatase ≤ 4 times ULN AND SGOT and/or SGPT normal
Creatinine clearance ≥ 60 mL/min
Creatinine normal
QTc < 450 msec for male patients
LVEF > 40% by MUGA
EF normal by MUGA if prior anthracycline therapy
No congenital long QT syndrome
No left bundle branch block
Deep venous thrombosis or other clinically significant thromboembolic event within the past 6 months allowed provided patient is clinically stable on anticoagulation therapy
No history of serious ventricular arrhythmia (i.e., ventricular tachycardia or ventricular fibrillation ≥ 3 beats in a row)
No myocardial infarction within the past year
No cerebrovascular accident or transient ischemic attack within the past 6 months
No New York Heart Association class III or IV congestive heart failure
No poorly controlled angina
No uncontrolled dysrhythmia or dysrhythmias requiring medication
No active ischemic heart disease within the past 12 months
No other significant cardiac disease
Pulmonary embolus allowed within the past 6 months provided patient is clinically stable on anticoagulation therapy
Fertile patients must use effective contraception
Willing and able to provide blood samples
No serious allergy (i.e., hypotension, dyspnea, anaphylaxis, or edema) to eggs
No other concurrent malignancy or history of a curatively treated malignancy with a survival prognosis of < 5 years
No known HIV positivity
No active infection
No other severe acute or chronic medical or psychiatric condition or laboratory abnormality that would preclude study participation
At least 4 weeks since prior flutamide (6 weeks for bicalutamide or nilutamide)
At least 28 days since prior radiotherapy
No prior radiotherapy field that included the heart (e.g., mantle)
More than 6 months since prior coronary or peripheral artery bypass grafting
More than 28 days since prior investigational agents for prostate cancer
No concurrent agents that interact with cytochrome P450 3A4

No concurrent warfarin for anticoagulation

Concurrent low molecular weight heparin injection allowed
No concurrent medications that would prolong QTc
No other concurrent antineoplastic agents
Concurrent zoledronate for bone metastases or hypercalcemia allowed