- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05435495
Mechanisms of Resistance to PSMA Radioligand Therapy
Mechanisms of Resistance to PSMA Radioligand Therapy: Radiation Resistance Versus Dose
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the relationship between whole body tumor absorbed dose and response Lutetium based prostate-specific membrane antigen-targeted radioligand therapy (177Lu-PSMA-RLT).
II. To determine the relationship between Post-Operative Radiation Therapy Outcomes Score (PORTOS) score and response to 177Lu-PSMA-RLT.
III. To determine the relative importance of radiation dose (whole body tumor absorbed dose) and radiation sensitivity (PORTOS score) as a marker of response to 177Lu-PSMA-RLT.
EXPLORATORY OBJECTIVES:
I. To develop novel signature of radiation sensitivity.
II. To evaluate tumor biopsies to understand mechanisms of resistance.
III. To understand utility of post-cycle 4 single-photon emission computed tomography (SPECT/CT) to evaluate treatment response.
Study participants will undergo a biopsy and blood draw prior to the initiation of planned therapy, as well as SPECT/CT imaging performed after the first and fourth treatments. One SPECT/CT scan will be performed 24 (+/- 6) after the first treatment, and after the fourth treatment, a 24 +/- 6-hour post-treatment SPECT/CT will be performed. Additionally, study participants may choose to undergo optional biopsy and blood draw at time of progression.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Maya Aslam
- Phone Number: (415) 514-8987
- Email: Maya.Aslam@ucsf.edu
Study Locations
-
-
California
-
Los Angeles, California, United States, 90095
- Recruiting
- University of California, Los Angeles
-
Principal Investigator:
- Matthew Rettig, MD
-
Principal Investigator:
- Johannes Czernin, MD
-
San Francisco, California, United States, 94143
- Recruiting
- University of California, San Francisco
-
Contact:
- Maya Aslam
- Phone Number: 415-514-8987
- Email: Maya.Aslam@ucsf.edu
-
Contact:
- Phone Number: 877-827-3222
- Email: cancertrials@ucsf.edu
-
Principal Investigator:
- Thomas Hope, MD
-
-
New York
-
New York, New York, United States, 10065
- Recruiting
- Memorial Sloan Kettering
-
Principal Investigator:
- Lisa Bodei, MD
-
Principal Investigator:
- Michael Morris, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Initiating treatment with Lutetium based PSMA-targeted RLT.
- Participants must have a PSMA-avid lesion that is accessible to biopsy. Biopsy of newly emerging radiographic metastases is desired and preferable to the biopsy of previously existing lesions whenever possible. Newly emerging lesions are defined as those that are absent on a previous scan, or those demonstrating unequivocal progression since initiation of the last treatment. Biopsies will be performed according to local institutional standards.
- Patients on warfarin, aspirin, or other anti-coagulants are eligible provided they are deemed able to tolerate discontinuation of anti-coagulation for at least five days prior to the biopsy. Conversion to low molecular weight heparin prior to biopsy is permitted per local standard operating procedures, provided there is approval by the interventional radiologist or the PI.
- Age >=18 years.
- Ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Patients with significant congenital or acquired bleeding disorders (eg von Wildebrand's disease, acquired bleeding factor inhibitors).
- Patients who are not able to undergo additional study related imaging procedures.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Participants undergoing 177Lu-PSMA-617 treatment
Participants undergoing PSMA targeted radioligand therapy with at least four cycles of treatment planned will undergo the following: SPECT/CTs will be performed 24 hours after the first treatment and after the fourth treatment, a tumor biopsy will be performed prior to the first 177Lu-PSMA radioligand therapy, a blood will be drawn prior to treatment for future research, and an optional tumor biopsy and blood draw for future research, may also be obtained at time of progression.
|
Imaging procedure
Other Names:
Blood draw for future research tests (45-60 mL).
Guided biopsy of lesion
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean whole body tumor absorbed dose (WB Dose) across all metastatic lesions
Time Frame: Up to 6 months
|
The unit density sphere model will be implemented using OLINDA, a second-generation personal computer software for internal dose assessment in nuclear medicine to measure mean dose across all metastatic lesions.
This approach uses the three time-point SPECT/CTs to create a whole-body dose map, which can then be segmented.
Using OLINDA, the total dose to each tumor will be calculated as the integral of activity over time estimated out to 500 hours.
Dose will be calculated in gray (Gy).
|
Up to 6 months
|
Median PORTOS score
Time Frame: Up to 6 months
|
PORTOS is a gene signature that predicts salvage radiation success.
A PORTOS score of zero (called a "low" PORTOS) means it predicts no benefit from salvage radiotherapy.
A PORTOS greater than zero (called a "high" PORTOS score) predicts a benefit from salvage radiation.
|
Up to 6 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Thomas Hope, MD, University of California, San Francisco
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19553
- R01CA235741-03 (U.S. NIH Grant/Contract)
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.
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