- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04506567
Fractionated and Multiple Dose 225Ac-J591 for Progressive mCRPC
Phase I/II Dose-escalation Study of Fractionated and Multiple Dose 225Ac-J591 for Progressive Metastatic Castration Resistant Prostate Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This clinical trial is for men with progressive metastatic castration resistant prostate cancer. The purpose of this study is to find the highest dose level of the study drug, 225Ac-J591, that can be given without severe side effects. The research study is being done because the standard treatments for prostate cancer that has spread beyond the prostate gland are intended to minimize the adverse effects of the disease. These treatments, however, are not curative. Patients who choose to participate in this study will have a screening visit to determine whether or not they are eligible to participate in the study. The treatment phase is comprised of 8 weeks for the fractionated dose cohort (starting from cycle 1, day 1). For the multiple-dose cohort, the dose-limiting toxicity evaluation period is from date of first treatment through treatment on cycle 3, day 1. Following treatment, short-term follow up is planned until radiographic progression, expected to be 6 months.The study medication is called 225Ac-J591, and will be administered as a single fractionated cycle day 1 and day 15 in the fractionated dose regimen and as a single dose per cycle repeated every 6 weeks in the multiple dose regimen. Upon completion of investigational treatment with 225Ac-J591, subjects will undergo 68Ga-PSMA-HBED-CC injection and same day PET/CT at the end of study visit to document treatment response. 68Ga-PSMA-HBED-CC is comprised of gallium-68, which is a positron-emitting radionuclide linked to PSMA-HBED-CC (aka PSMA11), which is a small molecule targeting PSMA. 68Ga-PSMA-HBED-CC will be administered intravenously prior to PET/CT at screening and at follow up imaging x2. Subsequent survival data and additional treatment(s) information will be captured from their routine standard of care (SOC) visits. During the other study visits, participants will undergo routine tests and procedures, such as physical examinations, and blood tests. Some blood tests will be done for research purposes only. After completion of therapy, participants may be contacted on a periodic basis to see how they are doing.
Key eligibility:
- Open to men age 18 and older.
- Diagnosis of progressive metastatic prostate cancer
- Have been previously treated for their disease with particular types of therapy
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
- Name: GU Onc Research Team
- Phone Number: 212-746-1480
- Email: guonc@med.cornell.edu
Study Locations
-
-
New York
-
Brooklyn, New York, United States, 11215
- Recruiting
- Brooklyn Methodist Hospital - New York Presbyterian
-
Contact:
- Lina Flores, RN
- Phone Number: 646-923-5883
- Email: lif9061@nyp.org
-
Sub-Investigator:
- David M Nanus, MD
-
New York, New York, United States, 10065
- Recruiting
- Weill Cornell Medicine
-
Contact:
- GU Onc Research Team
- Phone Number: 212-746-1480
- Email: guonc@med.cornell.edu
-
Principal Investigator:
- Joseph R Osborne, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically or cytologically confirmed adenocarcinoma of prostate
Documented progressive metastatic CRPC based on Prostate Cancer Working
Group 3 (PCWG3) criteria, which includes at least one of the following criteria:
- PSA progression
- Objective radiographic progression in soft tissue
- New bone lesions
- Have serum testosterone < 50 ng/dL. Subjects must continue primary androgen deprivation with an LHRH/GnRH analogue (agonist/antagonist) if they have not undergone orchiectomy
Have previously been treated with at least one of the following in any disease state:
- Androgen receptor signaling inhibitor (such as enzalutamide)
- CYP 17 inhibitor (such as abiraterone acetate)
- Have previously received taxane chemotherapy (in any disease state), been determined to be ineligible for taxane chemotherapy by their physician, or refused taxane chemotherapy.
- Age > 18 years
Patients must have normal organ and marrow function as defined below:
- Absolute neutrophil count >2,000 cells/mm3
- Hemoglobin ≥9 g/dL
- Platelet count >150,000 x 109/uL
- Serum creatinine <1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 60 mL/min/1.73 m2 by Cockcroft-Gault
- Serum total bilirubin <1.5 x ULN (unless due to Gilbert's Syndrome in which case direct bilirubin must be normal)
- Serum AST and ALT <3 x ULN in absence of liver metastases; < 5x ULN if due to liver metastases (in both circumstances bilirubin must meet entry criteria)
- ECOG performance status of 0-2
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria
- Implantation of investigational medical device ≤4 weeks of Treatment Visit 1 (Day 1) or current enrollment in oncologic investigational drug or device study
- Use of investigational drugs ≤4 weeks or <5 half-lives of Cycle 1, Day 1 or current enrollment in investigational oncology drug or device study
- Prior systemic beta-emitting bone-seeking radioisotopes
- Known active brain metastases or leptomeningeal disease
- History of deep vein thrombosis and/or pulmonary embolus within 1 month of C1D1
- Other serious illness(es) involving the cardiac, respiratory, CNS, renal, hepatic or hematological organ systems which might preclude completion of this study or interfere with determination of causality of any adverse effects experienced in this study
- Radiation therapy for treatment of PC ≤4 weeks of Day 1 Cycle 1
- Patients on stable dose of bisphosphonates or denosumab, which have been started no less than 4 weeks prior to treatment start, may continue on this medication, however patients are not allowed to initiate bisphosphonate/Denosumab therapy during the DLT-assessment period of the study
- Having partners of childbearing potential and not willing to use a method of birth control deemed acceptable by the principle investigator and chairperson during the study and for 1 month after last study drug administration
- Currently active other malignancy other than non-melanoma skin cancer. Patients are considered not to have "currently active" malignancy if they have completed any necessary therapy and are considered by their physician to be at less than 30% risk of relapse
- Known history of myelodysplastic syndrome
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Dose- Fractionated Cohort
Patients will receive a single cycle of 225Ac-J591, administered as a fractionated dose on days 1 and 15.
This is a dose-escalation design, with up to 4 dosing cohorts.
|
Single cycle of fractionated dose of 225Ac-J591
68Ga-PSMA-HBED-CC PET/CT before and after treatment
Other Names:
Single dose of 225Ac-J591 every 6 weeks x 4
|
Experimental: Multiple Dose Cohort
Patients will receive 225Ac-J591 every 6 weeks, with up to 4 doses.
Some patients will be enrolled in a dose-escalation design, with up to 3 dosing cohorts.
Additional patients will be enrolled at 2 lower dosing-cohorts.
|
Single cycle of fractionated dose of 225Ac-J591
68Ga-PSMA-HBED-CC PET/CT before and after treatment
Other Names:
Single dose of 225Ac-J591 every 6 weeks x 4
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess the recommended phase II dose (RP2D) of 225Ac-J591 in fractionated dose and multiple dose regimens (phase I)
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
Will be collected at the time of visit 1 through end of study or 100 months
|
|
Number of subjects with dose limiting toxicity (DLT)
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
DLTs will be measured by utilizing the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Cumulative maximum tolerated dose (MTD)
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
The dose that produces an "acceptable" level of toxicity or that, if exceeded, would put subjects at "unacceptable" risk for toxicity.
MTD is defined as the dose level at which no more than two patients out of six experienced dose-limiting toxicity (DLT).
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Assess the proportion of those with PSMA+ tumors with >50% PSA decline following 225Ac-J591 in two regimens (phase II)
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
Proportion of patients achieving 50% or greater PSA decline (relative to baseline/pre-treatment PSA).
Response may occur at any time following treatment initiation and prior to going off study or initiation of new therapy.
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of subjects with radiographic response
Time Frame: Scans will be performed at screening, day 85, then again at end of study or 100 months
|
Response evaluation criteria in solid tumors RECIST (Version 1.1) criteria with prostate cancer working group 3 (PCWG3) modifications will be used
|
Scans will be performed at screening, day 85, then again at end of study or 100 months
|
Overall survival following fractionated dose and multiple doses of 225Ac-J591
Time Frame: Survival will be collected from Day 1 through study completion up to 100 months
|
Overall survival will be captured through in-clinic or telephone contact with subjects
|
Survival will be collected from Day 1 through study completion up to 100 months
|
Change in disease assessment with 68Ga-PSMA-11 PET/CT prior to and following investigational treatment
Time Frame: Scans will be performed at screening, day 85 and day 168
|
68Ga-PSMA-11 PET/CT will be utilized as part of the radiographic assessment.
|
Scans will be performed at screening, day 85 and day 168
|
Change in circulating tumor cells (CTC) and the rate of favorable and undetectable CTC count at 12 weeks following 225Ac-J591
Time Frame: Samples will be collected at screening, day 1, day 85 and at disease progression
|
CTCs will be analyzed through blood specimen collection via CellSearch methodology lab testing
|
Samples will be collected at screening, day 1, day 85 and at disease progression
|
Safety of treatment and adverse event rate
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 is used to grade all adverse events
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Assess biochemical progression-free survival
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
PSA progression will be defined as a rise of > 25% above either the pretreatment level or the nadir PSA level (whichever is lowest).
PSA must increase by > 2 ng/ml to be considered progression
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Assess the proportion with different levels of PSA decline following 225Ac-J591
Time Frame: Will be collected at the time of visit 1 through end of study or 100 months
|
PSA will be monitored through serial blood draws.
Response may occur at any time following treatment initiation and prior to going off study or initiation of new therapy.
|
Will be collected at the time of visit 1 through end of study or 100 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Joseph R Osborne, MD, Weill Medical College of Cornell University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20-01021288
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Prostate Cancer
-
Roswell Park Cancer InstituteRecruitingObesity | Overweight | Cancer Survivor | Prostate Adenocarcinoma | Stage I Prostate Cancer | Stage II Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate Cancer | Stage IVA Prostate Cancer | Stage IVB Prostate Cancer | Stage A Prostate Cancer | Stage... and other conditionsUnited States
-
Sidney Kimmel Cancer Center at Thomas Jefferson...Regeneron Pharmaceuticals; Prostate Cancer FoundationWithdrawnStage III Prostate Cancer | Stage IV Prostate Cancer | Stage IVA Prostate Cancer | Stage IVB Prostate Cancer | Stage IIIA Prostate Cancer | Stage IIIB Prostate Cancer | Stage IIIC Prostate Cancer
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI)CompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Ryan Kohlbrenner, MDRadiological Society of North AmericaCompletedProstate Adenocarcinoma | Stage IV Prostate Cancer AJCC v8 | Prostate Carcinoma | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IVA Prostate Cancer AJCC v8 | Stage...United States
-
Jonsson Comprehensive Cancer CenterProgenics Pharmaceuticals, Inc.TerminatedRandomized Trial of PSMA PET Scan Before Definitive Radiation Therapy for Prostate Cancer (PSMA-dRT)Stage II Prostate Cancer AJCC v8 | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IIA Prostate Cancer AJCC v8 | Stage IIB Prostate Cancer AJCC v8 | Stage I Prostate...United States
-
University of Southern CaliforniaNational Cancer Institute (NCI); SanofiTerminatedDiarrhea | Recurrent Prostate Cancer | Hormone-resistant Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Mayo ClinicNational Cancer Institute (NCI)WithdrawnStage I Prostate Cancer AJCC v8 | Stage II Prostate Cancer AJCC v8 | Stage IIIA Prostate Cancer AJCC v8 | Stage IIIB Prostate Cancer AJCC v8 | Stage IIC Prostate Cancer AJCC v8 | Stage III Prostate Cancer AJCC v8 | Stage IIIC Prostate Cancer AJCC v8 | Stage IIA Prostate Cancer AJCC v8 | Stage IIB Prostate...United States
-
Barbara Ann Karmanos Cancer InstituteGenentech, Inc.CompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
Ohio State University Comprehensive Cancer CenterRiverside Methodist HospitalCompletedStage I Prostate Cancer | Stage III Prostate Cancer | Stage IV Prostate Cancer | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
-
University of California, IrvineCompletedRecurrent Prostate Cancer | Stage I Prostate Cancer | Stage III Prostate Cancer | Adenocarcinoma of the Prostate | Stage IIA Prostate Cancer | Stage IIB Prostate CancerUnited States
Clinical Trials on 225Ac-J591
-
Weill Medical College of Cornell UniversityPOINT BiopharmaSuspendedProstate CancerUnited States
-
Xinhua Hospital, Shanghai Jiao Tong University...UnknownMetastatic Castration-resistant Prostate Cancer
-
Weill Medical College of Cornell UniversityRecruiting
-
Weill Medical College of Cornell UniversityCompletedKidney Cancer | Breast Cancer | Head and Neck Cancer | Colorectal Cancer | Pancreatic Cancer | Esophageal Cancer | Ovarian Cancer | Non-small Cell Lung Cancer | GliomasUnited States
-
Weill Medical College of Cornell UniversityNational Cancer Institute (NCI); United States Department of Defense; National... and other collaboratorsCompleted
-
Weill Medical College of Cornell UniversityCompleted
-
Erasmus Medical CenterDutch Cancer SocietyRecruitingProstatic Neoplasms, Castration-ResistantNetherlands
-
Weill Medical College of Cornell UniversityCompleted
-
Modulation Therapeutics, Inc.H. Lee Moffitt Cancer Center and Research InstituteRecruitingUveal Melanoma | MetastaticUnited States
-
Fusion Pharmaceuticals Inc.RecruitingCervical Cancer | Breast Cancer | Ovarian Cancer | Endometrial Cancer | Uveal Melanoma | Adrenocortical Carcinoma | Advanced Solid Tumours | HER2-negative Breast Cancer | Triple Negative Breast Cancer (TNBC) | Head and Neck Squamous Cell Carcinoma (HNSCC)United States, Australia, Canada