Neoadjuvant Weekly Ixabepilone for High Risk, Clinically Localized Prostate Cancer

Inclusion Criteria:

* Histologic documentation of prostatic adenocarcinoma. Patients with small cell, neuroendocrine or transitional cell carcinomas are not eligible.
* All eligible patients must have a known Gleason sum based on biopsy or TURP at the time of registration.
* Clinically Localized Disease: Patients must have clinical stage T1-T3a and no radiographic evidence of metastatic disease as demonstrated by:
* Either CT or MRI of the abdomen and pelvis, that demonstrate no nodes \> 1 cm: or endorectal MRI(If one or more lymph nodes(s) measures \> 1 cm, a negative biopsy is required.)
* Negative bone scan (with plain films and /or MRI and/or CT scan confirmation, if necessary).(Positive PET and Prostascint scans are not considered proof of metastatic disease.)
* Patients must have high risk disease defined as either:

  * Gleason Score 8-10
  * PSA \> 15 ng/ml
  * Stage T3a
  * Stage T2c and Gleason score of 7
  * Stage T2b, Gleason score of 7, greater than 50% of the cores positive from a single lobe.
* No prior treatment for prostate cancer including prior surgery (excluding TURP), pelvic lymph node dissection, radiation therapy, chemotherapy or hormone therapy.
* Patient must be appropriate candidates for radical prostatectomy with an estimated life expectancy \> 10 years as determined by an urologist.
* ECOG PS 0-1
* Age \> 18 years of age.
* Required initial laboratory values:

  * ANC \> 1500/ul
  * Platelet count \> 100,000/mm3
  * Creatinine \< 2.0 mg/dl
  * Serum PSA \< 100 ng/ml
  * Bilirubin \< upper institutional limit of normal (ULN)
  * AST/ALT \< 2.5 X ULN

Exclusion Criteria:

* Active or uncontrolled infection.
* Patients must not have other coexistent medical condition that would preclude protocol therapy.
* Previous severe hypersensitivity reaction to a drug formulated in CremophoreL (polyoxyethylated castor oil).
* Grade 1 or greater neuropathy (motor or sensory) at study entry