A Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Dosimetry of [177Lu]Lu-PSMA-617 in Chinese Adult Male Patients With Progressive PSMA-Positive mCRPC

Metastatic Castration-Resistant Prostate Cancer (mCRPC) Clinical Trial

Official title: A Prospective, Open-label, Multi-center, Single-arm, Phase II Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Dosimetry of [177Lu]Lu-PSMA-617 in Chinese Adult Male Patients With Progressive PSMA-Positive Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Status Active, not recruiting

Clinical Trial Summary

The purpose of this study is to assess the efficacy, safety, tolerability, Pharmacokinetic(s) (PK) and dosimetry of [177Lu]Lu-PSMA-617 when administered in addition to Best Supportive/Best Standard of Care (BSC/BSoC) in Chinese participants with progressive PSMA-positive mCRPC who received at least 1 novel androgen receptor pathway inhibitor (ARPI) and were previously treated with 1 to 2 taxane regimens. Furthermore, the safety, PK, and dosimetry of [68Ga]Ga-PSMA-11 are assessed.

Data from this study will be used to bridge global pivotal phase III study (VISION, AAA617A12301) and to support China registration of [177Lu]Lu-PSMA-617 as a novel anticancer modality, namely radioligand therapy, in mCRPC.

Clinical Trial Description

This is a 2-part study:

1. Main part: Approximately 30 participants with at least 1 measurable lesion by PCWG3-modified RECIST v1.1 criteria will be enrolled in the main part. The primary endpoint of confirmed ORR will be analyzed with participants in this part, and will be assessed via independent centralized review of radiographic images provided by the Investigator and as outlined in PCWG3-modified RECIST v1.1 criteria.

2. Extension part: The extension part will enroll additional 30 participants with or without measurable lesions following the main part. The secondary endpoints will be analyzed with all participants in both main part and extension part.

Screening and enrollment period:

Written informed consent form (ICF) must be obtained prior to any screening procedures. All screening procedures described in the Assessment Schedule must be completed within 28 days prior to enrollment, except for radiographic imaging assessment, which must be done within 21 days prior to enrollment.

The participants will be assessed for eligibility and will undergo a mandatory [68Ga]Ga-PSMA-11 Positron Emission Tomography (PET)/Computed Tomography (CT) scan to evaluate Prostate-specific Membrane Antigen (PSMA) positivity for eligibility as assessed by central readers. Only participants with PSMA positive cancer and confirmed eligibility criteria will be enrolled.

Following completion of all required screening procedures and verifying participant eligibility, the participant will be enrolled. [177Lu]Lu-PSMA-617 will be ordered in parallel with interactive response technology (IRT) enrollment registration to allow at least 2 weeks to order and deliver [177Lu]Lu-PSMA-617.

Treatment period:

In principle, all participants should begin [177Lu]Lu-PSMA-617 dosing within 14 days after enrollment registration. However, Cycle 1 Day 1 (C1D1) can be delayed by up to an additional 3 days only for unexpected scheduling delays. Participants will receive 7.4 Gigabecquerel (GBq) (200 Millicuries (mCi)) +/- 10% [177Lu]Lu-PSMA-617 once every 6 weeks for a planned 6 cycles. BSC/BSoC may be used, including available care for the eligible participants according to best institutional practice. ARPIs (e.,g., abiraterone, etc.) are allowed. BSC/BSoC for each participant will be selected at the discretion of the Investigator prior to [177Lu]Lu-PSMA-617 administration, and can be modified over time as needed. BSC/BSoC will be administered per the physician's orders according to clinical best practice.

Radiographic imaging (CT with contrast/Magnetic Resonance Imaging (MRI) and bone scan) will be done at every 8 weeks (± 4 days) after first dose of [177Lu]Lu-PSMA-617 for the first 24 weeks (independent of dose delays), then every 12 weeks (± 4 days) thereafter and at End of Treatment (EOT) Visit (if not done within 28 days of EOT) until radiographic disease progression confirmed by central reader, death, withdrawal of consent, loss to follow-up, or subject/guardian's decision.

After the last day of study treatment period of [177Lu]Lu-PSMA-617 (i.e. after completion of 6 cycles of treatment OR treatment discontinuation for any reason) [e.g. upon radiographic progression as confirmed by blinded independent centralized review]), the participants must have an EOT visit performed ≤ 7 days and enter into the Post-treatment Follow-up period.

If a participant withdraws consent for the treatment period of the study, an EOT must be done and the participant will enter into the Post-treatment Follow-up unless he specifically withdraws consent for post-treatment Follow-up.

Post-treatment Follow-up period:

1. 30-day Safety Follow-up. All treated participants should have a safety follow-up conducted approximately 30 days after EOT visit.

2. Long term Follow-up. The long-term follow-up starts after the 30-day Safety follow-up and lasts until study completion. If a participant in the long term follow-up period discontinues treatment for reasons other than BICR-determined radiographic progression, his tumor assessments must be performed every 8 weeks after first dose of study treatment for the first 24 weeks (week 9, 17, 25) and then every 12 weeks (week 37, 49, etc) until confirmation of radiographic progression by BICR. The long-term follow-up period will also include the collection of survival and treatment updates, patient reported outcomes (PROs), serious adverse events (suspected to be related to study treatment), as well as blood sampling for hematology, chemistry testing, coagulation, and PSA. The visits will be carried out every 12 weeks (± 4 weeks) until death, lost to follow-up, withdrawal of consent, opposition to use data/biological samples or study completion, whichever occurs first. This follow-up will allow the data collection on medically significant long-term toxicities, such as long-term radiotoxicity.

If the participant withdraws consent for the collection of blood samples, PROs, and imaging assessments during the long-term follow-up, the information on survival, serious adverse events (SAEs) related to study treatment and post-treatment antineoplastic therapy will be collected.

PK/dosimetry assessments:

Both PK and dosimetry of [68Ga]Ga-PSMA-11 will be evaluated in at least 10 and up to 12 participants (at least 6 participants in main part). PK and dosimetry of [68Ga]Ga-PSMA-11 can be evaluated in any participant regardless of his PSMA status.

Both PK and dosimetry of [177Lu]Lu-PSMA-617 will be evaluated in at least 10 and up to 12 participants (at least 6 participants in main part).

Participants who take part in PK and dosimetry evaluation of [177Lu]Lu-PSMA-617 will also take part in the efficacy and safety evaluation together with the other participants. The treatment and assessment procedure follow the same as above. ;

Related Conditions & MeSH terms

• Metastatic Castration-Resistant Prostate Cancer (mCRPC)
• Prostatic Neoplasms

• NCT number: NCT05670106
• Study type: Interventional
• Source: Novartis
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: May 16, 2023
• Completion date: October 20, 2026