
    poor patient recruitment
  
['prostate cancer metastatic']
['osteodex', 'placebo']

        Inclusion Criteria:

          1. Age ≥18 years at the time of signing the informed consent form.

          2. Histologically or cytologically confirmed diagnosis of adenocarcinoma of the prostate.

          3. Failing or not tolerating docetaxel therapy or for other reasons not suitable for such
             therapy and failing subsequent therapy with abiraterone and/or enzalutamide.

          4. Evidence of metastatic disease from bone scan (bone lesions) or other imaging
             modality.

          5. Evidence of PSA progression in two consecutive determinations at minimum 1 week
             interval.

          6. Castrate level of serum testosterone ≤1.7 nmol/L

          7. Performance status ECOG 0-2

          8. Laboratory requirements: Haematology: Neutrophils ≥ 1.5 x 109/l Hemoglobin ≥ 90 g/l
             Platelets ≥ 100 x 109/l Hepatic function: Total S-bilirubin ≤ 1.5 times the upper
             limit of normal (ULN) AST (SGOT) / ALT (SGPT) ≤ 2.5 times ULN Renal function:
             S-creatinine ≤ 1.5 times the upper limit of normal (ULN) Electrolytes: S-sodium,
             S-potassium, S-calcium (S-albumin corrected), S-phosphate, S-magnesium, all within
             normal ranges.

          9. No evidence (≤ 5 years) of prior malignancies (except successfully treated basal cell
             or squamous cell carcinoma of the skin).

         10. Able to adhere to the study visit schedule and other protocol requirements.

         11. Life expectancy ≥6 months

        Exclusion Criteria:

          1. Concurrent use of other anti-cancer agents or treatments, with the following
             exception: a stable dose of LHRH agonist/antagonist or polyestradiol phosphate
             bicalutamide. Washout period bicalutamide 6 weeks; after flutamide 4 weeks;
             abiraterone / enzalutamide 6 weeks.

          2. Any treatment modalities involving chemotherapy, radiation or major surgery within 4
             weeks prior to treatment in this study.

          3. Simultaneous participation in any other study involving investigational drugs or
             having participated in a study less than 4 weeks prior to start of study treatment.

          4. Any condition, including the presence of laboratory abnormalities, which confounds the
             ability to interpret data from the study or places the patient at unacceptable risk if
             he participates in the study.

          5. Plasma glucose level ≥7 mmol/l (or >120 mg/dl) at screening.

          6. Known brain metastases.

          7. Dental surgery (dental extraction), periodontal disease, local trauma including poorly
             fitting dentures within 6 months prior to the first dose of study drug.

          8. Treatment with bisphosphonates within 4 weeks prior to first dose of study medication.
      