E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Cancer of the prostate is the most commonly diagnosed neoplasm in men in the United States after skin cancer. In 2002, over 189,000 new cases were diagnosed in United States representing 30% of all new cancer diagnoses in men comparable to the incidence of breast cancer in women. Patients with metastatic androgen-independent prostate cancer have a progressive and morbid disease with a median survival of 10 to 12 months. |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10062904 |
E.1.2 | Term | Hormone-refractory prostate cancer |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To explore the antitumor response of 3 different patupilone treatment groups where patupilone is administered IV once every three weeks and docetaxel administered at 75 mg/m2 once every three weeks as defined by the effect of treatment on PSA concentration. The PSA decrease will be documented in accordance with the consensus guidelines of the PSA working group.
To explore if 2 different high dose schedules of prednisone, concomitantly administered with patupilone will reduce the incidence, duration, and severity of grade 3 diarrhea observed in the patupilone Stage I patients.
To explore if a reduced dose of patupilone (8mg/m2) will reduce the incidence, duration, and severity of grade 3 diarrhea observed in the patupilone Stage I patients. |
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E.2.2 | Secondary objectives of the trial |
•To evaluate the measurable soft tissue disease response for all regimens (RECIST). •To compare the antitumor response determined by PSA response rate and safety profile between patupilone and docetaxel •To determine time to measurable and non-measurable disease progression (RECIST) •To determine time to PSA progression (date of randomization to the date of PSA progression) •To determine the duration of PSA response (date of the first 50% decline in PSA until PSA increases by 50% above the nadir) •To determine the duration of response for measurable disease •To explore the relationship between PK (Cmin) of patupilone in HRPC patients and clinical outcome. •Prednisone high dose groups - To explore the effects of higher dose schedules and 2 different schedules of prednisone, concomitantly administered with patupilone to reduce the incidence, duration, and severity of patuöilone-induced diarrhea (Arm 2 & Arm 3). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
•Patients with histologically proven adenocarcinoma of the prostate •Patients without evidence of PSA progression must have clinical or radiological evidence of metastatic disease for which no curative therapy exists and for which systemic chemotherapy is indicated. •Patients must have castrate levels of testosterone (serum testosterone ≤ 50ng/dl) by either being on androgen ablation therapy with a LHRH agonist or have had prior orchiectomy. •Progressive disease is defined as: a minimum of three consecutives elevations in PSA according to the PSA working Group (with the last value > 5 ng/mL) and/or new metastatic lesions on bone scan; and/or new or progressive measurable disease on computer tomography scan or magnetic resonance image. Bone scan findings alone for existing lesions are not adequate to define progression of disease. Patients previously treated with an antiandrogen must have disease progression documented after antiandrogen withdrawal. The first increase in PSA should occur at a minimum of one week from the reference value. This increase should then be confirmed by a second increase in PSA at least 1 week later. •Patients in whom flutamide, nilutamide, megestrol acetate, diethylstilbestrol, aminoglutethimide and ketoconazole has been recently withdrawn must demonstrate progression of disease at least four weeks beyond the discontinuation of such agents .Six weeks are required if prior treatment was bicatulamide. •Chemotherapy-naïve patients.(unlimited prior regimens of hormonal therapy) •Age ≥18 years •WHO Performance Status of 0,1 or 2 •Adequate hematologic , hepatic and renal functions . •Full recovery from the effect of any prior surgery or radiation therapy. •Current treatment with steroids is permitted provided that the patients is stable for at least 2 weeks before start of study, at, or less than, an equivalent daily dose of 10mg prednisone. •Concurrent biphosphonates can be allowed provided treatment was initiated at least 4 weeks prior to study entry |
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E.4 | Principal exclusion criteria |
•Patients who received palliative radiation therapy to tumors located centrally less than 4 weeks prior to planned enrollment date. Radiotherapy limited to no more than 25% of the bone marrow. •No prior strontium chloride (SR 89) or Samarium 153 lexidronam pentasodium •Known brain metastases. •Peripheral neuropathy > grade1. •Unresolved diarrhea of any grade in the last 7 days prior to study entry. •Significant cardiovascular disease (New York Heart Association Class III or IV congestive heart failure, active angina pectoris and /or myocardial infarction within the last 6 months. •Patients taking Coumadin® or other agents containing warfarin, with the exception of low dose Coumadin (1mg or less daily) for maintenance of indwelling lines or ports. •Patients who have gone under surgery for any cause less than 4 weeks prior to study entry.
•Patients with the presence of active or suspected acute or chronic uncontrolled infection and uncontrolled diabetes. •A concurrent active malignancy other than curatively treated non melanoma skin cancer. •A history of non compliance to medical regimen or inability or unwillingness to return for all scheduled visits. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Response in terms of PSA decrease measured according to the PSA Working Group guidelines. For measurable disease response will be measured according to the RECIST criteria.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 27 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Patients seen to be benefiting from patupilone treatment may continue to receive additional cycles of treatment (supplied by Novartis) until either progression of disease, satisfactory response, or unacceptable toxicities occur. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 5 |