Neuropathic Pain in Patients With Cancer

Neuropathic pain is a type of pain that results from nerve damage and is characterized by an
abnormal hypersensitivity to harmless as well as harmful stimuli. This type of pain is
extremely difficult to manage, fails to respond to standard analgesic medications or
interventions, and often gets worse instead of better over time. Current approved therapeutic
agents often have intolerable side effects and limited efficacy. Thus, there is an urgent
need to develop safe and effective drugs to treat neuropathic pain.

Study DTCL100 will be conducted at multiple centers and will enroll patients that have
advanced cancer AND neuropathic pain that has not responded well to previous treatment.
Eighteen patients will be randomly assigned to receive up to 8 doses of active drug (KRN5500)
or placebo. A maximum of 8 doses will be administered weekly over a 10 week period. Patients
are encouraged to complete at least 4 treatment visits before a decision is made to complete
the full 10 weeks of treatment and the 1 month followup period.

Inclusion Criteria:

- 18 years or older

- Diagnosis of advanced or recurrent cancer

- No options for curative chemotherapy, but palliative chemotherapy allowed under
certain conditions

- Refractory neuropathic pain rated 4 or greater on 0-10 scale and failure to respond to
2 commonly used treatments

- If taking opioids for pain, stable regimen over past week before enrolling

- Karnofsky performance status of 40 or more

- Females must be sterile or post-menopausal

Exclusion Criteria:

- Radiation to site of neuropathic pain for past 4 weeks

- Major surgery within past 2 weeks

- Liver function and other key labs outside normal parameters

- ECG showing significant abnormality

- Myocardial Infarction (heart attack) within past 6 months

- History of interstitial lung disease

- History of severe allergic reaction to drugs containing polysorbate 80

- Other investigational drug within 2 weeks or 5 half-lives (whichever is longer