Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial looking at patupilone (Epo906) for people with advanced bowel cancer (CINATRA)
This trial looked at a new chemotherapy drug called patupilone for people with bowel cancer (colorectal cancer) that had spread locally, or to other parts of the body (metastatic).
Advanced bowel cancer is usually treated with chemotherapy. Capecitabine, oxaliplatin and irinotecan are some of the standard chemotherapy drugs doctors use. These drugs may help to control the growth of the cancer and to relieve symptoms. But if the cancer continues to grow or comes back, it becomes more difficult to treat.
An earlier phase 1 trial looked at patupilone (also called Epo906) in people who had already had standard chemotherapy for bowel cancer. Some people’s cancer shrank or stayed the same. So the results were promising but they need to be confirmed with a larger number of patients.
Bowel cancers have different types of changes in the DNA. Most have changes called chromosomal instability. A small number have DNA changes called microsatellite instability. Patupilone works by stopping the cancer cells from dividing and multiplying. And doctors think that it may work differently, depending on the type of changes in the cancer’s DNA.
This trial aimed to find out if patupilone
- Could shrink or control the growth of bowel cancer
- Worked better for bowel cancer when the DNA had microsatellite instability rather than chromosomal instability
Summary of results
The trial team found that patupilone didn’t shrink or control the growth of bowel cancer.
This was a phase 2 trial. Everyone had patupilone.
It was intended to recruit 110 people. But after recruiting 29 people, the team suggested closing the trial early. This was due to the side effects people had, especially diarrhoea. The committee that looks at the safety of the trial (Data Management Committee) agreed to close the trial early.
The most significant common side effects were
At 3 months the team found that no one’s cancer had responded to treatment. The average overall time that people survived was just over 6 months.
Because the trial closed early the trial team were unable to find out if patupilone worked better for bowel cancer that had DNA microsatellite instability rather than chromosomal instability.
The trial team concluded that patupilone had serious side effects and there was no evidence it helped people who have had previous treatment for bowel cancer.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Dr I. Chau
NIHR Royal Marsden Biomedical Research Centre
Novartis Pharmaceuticals UK
The Royal Marsden NHS Foundation Trust