Lenalidomide and Paclitaxel in Prostate Cancer

The goal of the Phase I part of this clinical research study is to find the highest tolerable dose of Revlimid® (lenalidomide) that can be given in combination with paclitaxel to patients with prostate cancer who have failed treatment with taxanes. The goal of the Phase II part of this clinical research study is to learn if lenalidomide and paclitaxel can help to control prostate cancer. The safety of this combination treatment will be studied in both phases of the study. UPDATE: Study was terminated early due to slow accrual as a Phase I dose escalation study, without progression to Phase II study portion.

Study Drugs: Lenalidomide is a drug that changes the immune system and it may also interfere with the development of tiny blood vessels that help support tumor growth. Taking lenalidomide could prevent the growth of cancer cells. Paclitaxel is designed to disrupt the growth of cancer cells, which may cause cancer cells to die. Phases I and II: If you are found to be eligible to take part in this study, you will be assigned to a study group based on when you joined the study. Up to 10 groups of 3 participants will be enrolled in the Phase I portion of the study, and 1 group of up to 42 participants will be enrolled in Phase II. If you are enrolled in the Phase I portion, the doses of lenalidomide you receive will depend on when you joined this study. The dose of paclitaxel will be the same for all patients. Up to 5 dose levels of lenalidomide will be tested in the Phase I portion. The first group of Phase I participants will receive the lower doses of lenalidomide. Each new group enrolled will receive the higher doses, if no intolerable side effects were seen. Groups will continue being enrolled (up to 10) until the highest tolerable dose of lenalidomide (in combination with paclitaxel) is found. If you are enrolled in the Phase II portion, you will receive lenalidomide at the highest dose that was tolerated in the Phase I portion in combination with paclitaxel. Study Drug Administration: Once you are assigned a dose, you will take lenalidomide capsules by mouth once a day for 21 days in a row, followed by 7 days of rest (Days 22-28). This will be called the "lead-in" period." You will the begin taking lenalidomide and paclitaxel on 28 day study cycles. You will take lenalidomide by mouth every day on Days 1-21 of each cycle. Paclitaxel will be given by vein over 1 hour on Days 1, 8, and 15 of each cycle. On Days 22-28 of each cycle, you will take no study drugs. The Day 1 dose of Lenalidomide in each combination cycle may occur within +/- 5 days of the Day 1 paclitaxel dose. You should swallow lenalidomide capsules whole with water at the same time each day. Do not break, chew, or open the capsules. If you miss a dose of lenalidomide, take it as soon as you remember on the same day. If you miss taking your dose for the entire day, take your regular dose the next scheduled day (do NOT take double your regular dose to make up for the missed dose). If you take more than the prescribed dose of lenalidomide you should seek emergency medical care, if needed, and contact study staff right away. Females of childbearing potential that might be caring for you should not touch the lenalidomide capsules or bottles unless they are wearing gloves. In order to participate in this study you must also register into and follow the requirements of the RevAssist® program of Celgene Corporation. This program provides education and counseling on the risks of fetal exposure, blood clots, and reduced blood counts. You will be required to receive counseling every 28 days during treatment with lenalidomide, follow the birth control requirements of the program that are appropriate for you, and take telephone surveys about your compliance with the program. Study Visits: On Day 1 of each cycle (before you receive paclitaxel), the following tests and procedures will be performed: * You will have a physical exam, including measurement of your weight. * Your performance status will be recorded. * You will be asked about any drugs or treatments you may be receiving. * Blood (about 2-3 teaspoons) will be drawn for routine tests and tests of your prostatic specific antigen (PSA) and testosterone levels. * You will be asked about any side effects you may have experienced since your last visit. On Days 8 and 15 of each cycle (before you receive paclitaxel), the following tests and procedures will be performed: * Your weight will be measured. * Blood (about 2 teaspoons) will be drawn for routine tests. On Day 1 of Cycle 3 and every 2 cycles thereafter, you will have the following tests and procedures performed: * You will have a chest x-ray and a CT scan of your abdomen and pelvis to check the status of the disease. * Blood (about 2 teaspoons) will be drawn to test your testosterone level and your liver function. * You will have a bone scan to check the status of the disease. * You will have an ECG. If you are being treated with paclitaxel at your local oncologist's office, you are only required to return to M. D. Anderson on Days 1 and 15 of Cycle 1 and on Day 1 of each cycle after that. All other study visits may be done at your local oncologist's office. Length of Study: You will continue on this study as long as you are benefiting. You will be removed from the study if you experience intolerable side effects, if the disease gets worse, or if the study doctor thinks it is in your best interest. End-of-Study Visit: Once you are off study, the following tests and procedures will be performed: * You will have a physical exam. * Blood (about 3-4 teaspoons) will be drawn for routine tests and tests of your PSA and testosterone levels. * You will be asked about any side effects you may have experienced since your last visit. * Your performance status will be recorded. This is an investigational study. Lenalidomide is approved by the Food and Drug Administration (FDA) and commercially available for the treatment of specific types of myelodysplastic syndrome (MDS) and in combination with dexamethasone for patients with multiple myeloma (MM) who have received at least 1 prior therapy. Paclitaxel is FDA-approved and commercially available for the treatment of bladder cancer, lung cancer, breast cancer, and pancreatic cancer. The use of these drugs in combination is investigational. Up to 72 participants will take part in this study. All will be enrolled at M. D. Anderson.