Neoadjuvant J591 Treatment for Prostate Cancer

A Pilot Study of Neoadjuvant Monoclonal Antibody Humanised (hu) J591 for the Treatment of High and/or Intermediate-Risk Prostate Cancer

10 patients will be enrolled in the initial cohort and will receive two infusions of unlabeled huJ591 on days 1 and 14. 89Zr-J591 will be administered on day 21 (+ 1 day) and a positron emission tomography-computed tomography (PET/CT) will be performed week later on day 28 + 1 (visit 4). Approximately 2 to 3 weeks after the 2nd dose of J591, the patient will undergo radical prostatectomy with or without lymph node dissection (day 31 + 4 days). The final visit for the study will include a postoperative visit two weeks following surgery.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is an open-label, single center pilot study to evaluate the efficacy of huJ591 to trigger antibody-dependent cellular cytotoxicity (ADCC) response manifested by a peri-tumoral inflammatory response with or without apoptosis of prostate cancer cells in patients diagnosed with either high or intermediate-risk prostate cancer. To participate the patients will be required to meet all eligibility criteria. Patients may not participate in other clinical trials while undergoing therapeutic treatment.

The initial screening period (up to 28 days prior to start of treatment under this clinical trial) consists of visit to confirm eligibility, discuss the risks / benefits of participating in the trial and radical prostatectomy (with or without lymph node dissection), and obtain patient prostate biopsy samples for anti-prostate specific membrane antigen (PSMA) expression review. An enrolled subject's participation in the study entails approximately 6 to 7 weeks of therapy along with the additional 2 weeks time involved in recovery from a radical prostatectomy. Adverse events will be collected throughout the entirety of the study. The total duration of the patient being in the study can be around 9 to 11 weeks. Medical information/Survival information will be collected from the routine followup visits (standard of care) for up to 3 years after the surgery.

Study Type

Interventional

Enrollment (Actual)

8

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New York
      • New York, New York, United States, 10065
        • Weill Cornell Medical College

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  1. Adult male > 18 years of age
  2. Histologically confirmed diagnosis of prostate cancer
  3. Intermediate or high risk prostate cancer defined by:

    • High risk (any one of the following):

      1. Gleason grade > 8
      2. Gleason grade 4+3 with more than 3 cores involved with > 20% of volume involved
      3. Any Gleason with PSA above 20 ng/mL
      4. Gleasone > 4+3 and tumor stage clinical T3 or above
    • Intermediate risk prostate cancer defined as:

      1. Gleason grade = 7
      2. Any Gleason with PSA between 10 and 20 ng/mL
  4. Eastern Cooperative Oncology Group (ECOG) Performance status of 0-1
  5. Ability to understand and willingness to sign a written informed consent document
  6. Prostate biopsy with + PSMA expression in tumor cells by immunohistochemistry

Exclusion Criteria:

  1. Serum creatinine > 3x upper limit of normal (ULN)
  2. Bilirubin (total) > 1.5 x ULN; subjects with Gilbert's syndrome will be allowed if direct bilirubin is within institutional normal limits
  3. Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT or SGOT) > 2.5x ULN
  4. Other severe acute or chronic medical condition or laboratory abnormality that may increase the risk associated with study participation
  5. On any other new anticancer therapy between screening and prostatectomy
  6. Frank metastasis identified during clinical staging
  7. Patient ineligible for radical prostatectomy for any other reason

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: NA
  • Interventional Model: SINGLE_GROUP
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: huJ591 followed by 89Zr-J591
Subjects will receive two infusions of unlabeled huJ591 on days 1 and 15 (+/- 1 day). 89Zr-J591 will be administered on day 22 (+/- 1 day) and 5-8 days later. PET/CT will be performed followed by repeat imaging of the prostate. Radical prostatectomy with or without lymph node dissection is performed 2 to 4 weeks after the second dose of J591.
Antibody is derived from a hybridoma originally produced in the Weill Medical College Laboratory of Urological Oncology. Treatment with 100 mg of HuJ591 will be administered as an intravenous infusion at a concentration of 5 mg/mL and rate of <5 mg/minute.
Other Names:
  • J591
Drug product is manufactured by the radiochemistry staff of Citigroup Biomedical Imaging Center (CBIC) research core facility. Radiolabeling of DFO-huJ591 with 89Zr is achieved by the addition of 89Zr-oxalate to the DFO-huJ591 in ammonium acetate buffer.
Other Names:
  • radiolabeled J591

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Induction of inflammatory and/or apoptotic response of prostate cancer cells by reviewing H&E stained slides from pre treatment biopsy and comparing to the post-treatment radical prostatectomy pathology using the Peri-tumoral inflammation 4-point scoring
Time Frame: Change from baseline in Peri-tumoral inflammation 4-point scoring at Day 31 post prostatectomy
Change from baseline in Peri-tumoral inflammation 4-point scoring at Day 31 post prostatectomy

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to biochemical (PSA) and/or radiographic recurrence will be followed by drawing PSA samples and performing radiographic scans.
Time Frame: From date of first treatment until the date of first documented progression or date of death, whichever came first, assessed up to 36 months
PSA values will be monitored at screening, then at months 3, 6, 9, 12, 18, 24, and 36 after Day 1 of treatment. Radiographic scans will be performed at screening and at months 6, 12, 18, 24, 30, and 36.
From date of first treatment until the date of first documented progression or date of death, whichever came first, assessed up to 36 months
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: Adverse events will be monitored on Days 1, 14, 21, 28, 31, and 45
Adverse events will be monitored on Days 1, 14, 21, 28, 31, and 45

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 4, 2016

Primary Completion (Actual)

February 10, 2017

Study Completion (Actual)

February 2, 2020

Study Registration Dates

First Submitted

February 12, 2016

First Submitted That Met QC Criteria

February 26, 2016

First Posted (Estimate)

February 29, 2016

Study Record Updates

Last Update Posted (Actual)

October 5, 2020

Last Update Submitted That Met QC Criteria

October 1, 2020

Last Verified

October 1, 2020

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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