Vinflunine in Hormone Refractory Prostate Cancer (HRPC)

Inclusion Criteria

Men age 18 years of age or older who have HRPC are eligible for this study based on the following inclusion criteria:

• Histologically confirmed adenocarcinoma of the prostate.
• Progressive hormone refractory locally advanced or metastatic disease.
• (Definition of HRPC): Clinical or serological evidence of disease progression despite adequate anti-androgen therapy, documented by castrate levels of serum testosterone ( 5 ng/mL), which has risen serially from the baseline PSA value (PSA value #1) on two occasions, each at least 1 week apart (these will be considered PSA values #2 and #3). (Note: if the level of PSA value #3 is less than the level of PSA value #2, a subsequent PSA value must be obtained (PSA value #4) at least 1 week after PSA value #3 was measured. In order for this event to be considered a PSA progression, the level of this final PSA value (PSA value #4) must be greater than the PSA level that was observed for PSA value #2.
• Progressive metastatic prostate carcinoma, documented by computed tomography (CT), magnetic resonance imaging (MRI), or radiograph of non osseous lesions (see Section 7.2).
• Bone Scan Progression, documented by the appearance of at least one or more new lesions that are not believed to be secondary to tumor flare phenomenon.
• Patients with bone only disease must have a PSA level >=5 ng/mL; patients with stable lesions must have evidence of PSA progression. Patients must have radiographically or clinically demonstrable metastatic disease.
• Receipt of either 1 or 2 previous chemotherapy regimens; one of these regimens must have included docetaxel.
• ECOG performance status of 0-2.
• Adequate bone marrow function, defined by: white blood cells >=3,500/uL, hemoglobin >=8 g/dL, platelet count >=100,000/uL.
• Adequate renal function, defined by: serum creatinine =60 cc/min. Patients with a creatinine clearance of >30 mL/min but 12 months).
• Patients on bisphosphonate therapy (at the discretion of the investigator).

Exclusion Criteria

• History of other prior malignancy in the past 5 years (excluding resected basal cell or squamous cell skin cancer).
• History of second- or third-degree heart block, uncontrolled angina, uncontrolled hypertension, or recent myocardial infarction or congestive heart failure (New York Heart Association Class III-IV) within the past 6 months (see Appendix F)
• Cerebral vascular accident within the past 6 months.
• Peripheral neuropathy > grade 2 per Common Terminology Criteria for Adverse Events (CTCAE) v3.0.
• Patients with rising PSA but no demonstrable metastases.
• Previous radiotherapy, outside of standard portals, utilized for prostate cancer (if total amount of radiotherapy encompasses >25% of bone marrow containing osseous regions).
• Prior therapy with Strontium 90, Samarium 150, or other injectable therapeutic radioisotopes.
• History of prior allergic reaction to any vinca alkaloid.
• Use of chemotherapy or investigational drugs within 4 weeks prior to the first dose of study drug.
• Treatment with ketoconazole, itraconazole, ritonavir, amprenavir, or indinavir within 4 weeks prior to the first dose of study drug.
• Previous treatment with an anthracycline.
• Patients who are unable to receive chemotherapy on a basis of once every three weeks as a result of physical, environmental, or co existent medical problems.