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A Phase II Study of Patupilone (EPO906A) as a Second Line Chemotherapy in Patients With Hormone Refractory Prostate Cancer

Phase 2
18 Years
Not Enrolling
Hormone Refractory Prostate Cancer

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Trial Information

A Phase II Study of Patupilone (EPO906A) as a Second Line Chemotherapy in Patients With Hormone Refractory Prostate Cancer

Prostate cancer is the most common cancer diagnosed and the second most common cause of
cancer death in men in North America (Jemal 2003). Many patients with localized disease have
an excellent long-term survival and high cure rates with standard approaches (D'Amico 1998).
However, patients with high risk, locally advanced and metastatic disease have a poor
prognosis, and although hormonal therapy in the form of medical or surgical castration can
induce significant long-term remissions,development of androgen independent disease is
inevitable. Androgen independent (AI) disease, also termed hormone refractory prostate
cancer (HRPC), is clinically detected by a rise in prostate specific antigen (PSA) and
worsening of symptoms. Once patients reach this stage, therapeutic options are limited and
prognosis is poor

Patients with hormone refractory prostate cancer after docetaxel chemotherapy have limited
treatment options and no treatment has been proven to be efficacious. Because of the
mechanism of action and the activity of anti-microtubule agents and combinations in general
for HRPC, patupilone has potential for therapeutic activity in patients with HRPC that have
progressed after first line docetaxel chemotherapy.

Inclusion Criteria:

- Patients must have histological or cytological diagnosis of adenocarcinoma of the

- Patients must have metastatic or locally recurrent disease.

- Patients must have documented evidence of PSA progression

- The PSA must be > 5 ng/mL at the time of study entry.

- ECOG performance status of 0, 1 or 2.

- Patients must have a life expectancy of at least 12 weeks in the judgment of the

- Chemotherapy: patients must have received prior docetaxel based chemotherapy (either
as a single agent or in combination). Patients must have evidence of progression
while receiving docetaxel based chemotherapy or within 6 months after the completion
of docetaxel based chemotherapy. Prior adjuvant or neoadjuvant chemotherapy is
permitted provided therapy was completed > 12 months prior to registration. Prior
therapy with mitoxantrone or experimental non-cytotoxic chemotherapy is permitted
(e.g. monoclonal antibodies, vaccine therapy, receptor tyrosine kinase inhibitors).

- Hormonal Therapy: Prior hormone therapy is permitted. Patients must be hormone
refractory and have been previously and currently treated with androgen ablative
therapy (medical or surgical castration). Therapy with LHRH agonist must continue for
those prostate cancer patients already receiving this treatment at the time of
enrollment. If the patient has discontinued the LHRH agonist, this must be restarted
and the castrate level of testosterone must be present. Patients must have
discontinued any use of non-steroidal antiandrogens (e.g. bicalutamide, nilutamide,
flutamide) at least 6 weeks prior to initiation of protocol therapy.

- Radiation: Prior external beam radiation is permitted provided a minimum of 4 weeks
has elapsed between the last dose and enrollment to the trial. Exceptions may be made
for low dose, nonmyelosuppressive radiotherapy after consultation with the principal
investigator. Prior strontium is not permitted. Patients must have had less than 30%
of marrow bearing areas irradiated.

- Steroids: Current treatment with steroids are permitted provided the dose is less
than or equivalent to a daily dose of prednisone of 20mg.

- Laboratory Requirements - within 7 days prior to enrollment Hematology: absolute
granulocytes ≥ 1.5 x 109/Lplatelets ≥ 100 x 109/Lhemoglobin ≥ 90 g/L Biochemistry:
bilirubin ≤ 1.0 x upper limit of normal serum creatinine ≤ 1.5 x upper limit of
normal AST/ALT ≤ 2.5 x upper limit of normal

- Patient consent must be obtained according to local Institutional and/or University
Human Experimentation Committee requirements.

- Patients must be accessible for treatment and follow-up. Patients registered on this
trial must be treated and followed at the participating centre.

Exclusion Criteria:

- Patients with a history of other invasive cancer, except adequately treated
non-melanoma skin cancer or other solid tumours curatively treated with no evidence
of disease for > 3 years.

- Patients with known brain metastases should be excluded from this clinical trial
because of their poor prognosis and because they often develop progressive neurologic
dysfunction that would confound the evaluation of neurologic and other adverse

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to Patupilone or other agents used in the study.

- Other serious intercurrent illness of medical condition that might be aggravated by
protocol treatment including: myocardial infarction within 6 months prior to study
entry congestive heart failure unstable angina active cardiomyopathy unstable
ventricular arrhythmia uncontrolled hypertension uncontrolled psychotic disorders
serious infections active peptic ulcer disease

- HIV-positive patients receiving combination anti-retroviral therapy

- Peripheral neuropathy > grade 1.

- Patients who have received treatment with other investigational agents or anti-cancer
therapy < 21 days prior to date of protocol treatment.

- Patients receiving anticoagulation with warfarin (Coumadin®).

- Patients with grade ≥ 1 diarrhea.

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

PSA response

Principal Investigator

Kim Chi, MD

Investigator Role:

Study Chair

Investigator Affiliation:

BC Cancer Agency - Vancouver Centre


Canada: Health Canada

Study ID:




Start Date:

February 2007

Completion Date:

Related Keywords:

  • Hormone Refractory Prostate Cancer
  • refractory
  • prostate
  • hormone
  • Prostatic Neoplasms