Personalisierte vs. Festaktivität 177LU-PSMA-617 Radiopharmazeutische Therapie (Prodigy-2) (PRODIGY-2)
Prostata-spezifische Membranantigen-Dosimetrie-geführte Endoradiotherapie: Eine randomisierte, kontrollierte, einzelne Blindstudie mit personalisierter vs. Fixed-Activity 177LU-PSMA-617 Radiopharmaceutical Therapy (Prodigy-2) (Prodigy-2)
The goal of this clinical trial is to assess if a personalized regime of 177Lu-PSMA-617 (Lutetium Lu 177 vipivotide tetraxetan, also known as Pluvicto) is feasible and safe in a population of patients with metastatic castrate-resistant prostate cancer (mCRPC). The main questions it aims to answer are:
- Can the administered activity (cumulative or per-cycle) be increased in a majority of participants?
- What is the incidence of some specific adverse reactions during the treatment?
Researchers will compare participants receiving a personalized regime to participants receiving the standard fixed-activity regime of 177Lu-PSMA-617 to see if the activity can be safely increased through personalization based on renal dosimetry (i.e. the measure of how much radiation is actually delivered to the kidney).
Participants will receive up to 6 treatments of 177Lu-PSMA-617 every 6 weeks and be regularly evaluated with imaging and laboratory tests, as well as with questionnaires.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 1
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Marie-Christine Dubé, Ph.D.
- Telefonnummer: 418-525-4444
- E-Mail: marie-christine.dube@crchudequebec.ulaval.ca
Studienorte
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Quebec
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Québec, Quebec, Kanada, G1R2J6
- Rekrutierung
- CHU de Québec-Université Laval
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Kontakt:
- Marie-Christine Dubé, Ph.D.
- Telefonnummer: 418-525-4444
- E-Mail: marie-christine.dube@crchudequebec.ulaval.ca
-
Hauptermittler:
- Jean-Mathieu Beauregard, MD
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Patient aged ≥18 years with metastatic adenocarcinoma of the prostate, defined by documented histopathology of prostate adenocarcinoma;
- Castration-resistant prostate cancer, as defined as disease progressing despite castration by orchiectomy or ongoing androgen deprivation therapy (serum testosterone level ≤ 1.7 nmol/dL within 60 days from first cycle);
- Biochemically progressive mCRPC with rising PSA level, defined by PCWG3 criteria (sequence of two rising values above a baseline at a minimum of 1-week intervals, with the second of these within 60 days from first cycle);
- PSA ≥2 ng/mL ;
- Prior treatment with at least one ARPI;
- PSMA-expressing cancer, with significant PSMA expression defined as SUVpeak in at least one lesion that is superior to SUVmean of the liver on PSMA-PET (68Ga-PSMA-11 or 18F-DCFPyL), within 45 days prior to randomization;
- ECOG Performance status 0 to 2;
- Calculated eGFR (by CKD-EPI formula) ≥ 45 mL/min/1.73m^2;
- Albumin ≥ 25 g/L;
- Platelets ≥ 100x10^9/L;
- Neutrophils ≥ 1.5x10^9/L;
- Hemoglobin ≥ 90 g/L without transfusion in the past 4 weeks;
- Signed, written informed consent
Exclusion Criteria:
- PSMA-PET "superscan" (i.e. extensive/diffuse PSMA-positive bone involvement);
- Site(s) of disease that are FDG-positive, defined as SUVpeak in at least one lesion that is superior to twice (2x) SUVmean of the liver, and PSMA-negative (as above), within 45 days prior to randomization;
- Prior treatment with more than two lines of chemotherapy for mHSPC and/or mCRPC (a line is counted if at least 2 cycles were administered; adjuvant and neoadjuvant chemotherapy does not count towards the maximum of two lines);
- Prior PSMA-directed radiopharmaceutical therapy (radium-223 is allowed);
- Known CNS metastasis unless they are deemed to be non-progressive, asymptomatic and off corticosteroid therapy for at least four weeks, as per investigator's assessment;
- Active malignancy other than prostate cancer;
- Patients who are sexually active and not willing/able to use medically acceptable forms of barrier contraception;
- Any other condition, diagnosis or finding that may in the investigator's opinion interfere with trial conduct;
- Known hypersensitivity to 177Lu-PSMA-617 or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: Personalisierte Aktivität
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6 cycles of personalized activity (1st cycle based on BSA and eGFR; cycles 2-6 based on renal dosimetry), maximum 22.2 GBq, every 6 weeks 6 cycles of 7.4 GBq every 6 weeks |
|
Aktiver Komparator: Feste Aktivität
|
6 cycles of personalized activity (1st cycle based on BSA and eGFR; cycles 2-6 based on renal dosimetry), maximum 22.2 GBq, every 6 weeks 6 cycles of 7.4 GBq every 6 weeks |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Administered activity of 177Lu-PSMA-617
Zeitfenster: From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
In GBq, cumulative and average per cycle. |
From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
|
Number of participants with subacute adverse events of special interest (AESIs)
Zeitfenster: From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
Subacute AESIs are:
|
From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Variation der Punktzahl auf dem EQ-5D-5L-Fragebogen (EQ-5D-5L) zu Studienbeginn
Zeitfenster: Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
|
|
Variation des Scores bei der funktionellen Bewertung der Krebstherapie - Prostata (FACT -P) zu Studienbeginn
Zeitfenster: Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
|
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Variation der Punktzahl auf dem Fragebogen zum BPI-SF (BPI-SF) in kurzem Schmerzinventar
Zeitfenster: Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
|
|
Variante des Score in der Multidisziplinären Speicheldrüsenfragebogen (MSGS) zu Studienbeginn
Zeitfenster: Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
Zu Studienbeginn, nach 18 Wochen und am Ende der Behandlung (jeder Zyklus beträgt 6 Wochen bis zu 6 aufeinanderfolgende Zyklen)
|
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Best biochemical response
Zeitfenster: From first administration until 52 weeks or the start of another anti-cancer treatment or death, whichever is earliest
|
Maximum percent decrease of serum prostate-specific antigen (PSA) after first administration. |
From first administration until 52 weeks or the start of another anti-cancer treatment or death, whichever is earliest
|
|
PSA progression-free survival (PSA-PFS)
Zeitfenster: From date of first administration until the date of PSA progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
Time from first administration to an increase in PSA greater than 25%, and greater than 2 ng/ml, above nadir, confirmed at least 3 weeks later. |
From date of first administration until the date of PSA progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
|
Radiological progression-free survival (rPFS)
Zeitfenster: From date of first administration until the date of radiological progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
Time from first administration to the date of radiographic disease progression based on RECIST 1.1/PCWG3. |
From date of first administration until the date of radiological progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
|
Investigator-assessed overall PFS
Zeitfenster: From date of first administration until the date of investigator-assessed progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
Time from first administration to the earliest of clinical (worsening of a patient's clinical status attributed to disease progression), biochemical or radiological progression considering all data (scheduled and unscheduled) available to the investigator. |
From date of first administration until the date of investigator-assessed progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
|
Time to first symptomatic skeletal event (SSE)
Zeitfenster: From date of first administration until the date of first SSE or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
Time to first Symptomatic Skeletal Event (SSE) is defined as the time from first administration to the date of the SSE. The SSE date is the date of first new symptomatic pathological bone fracture, spinal cord compression, tumor-related orthopedic surgical intervention, requirement for radiation therapy to relieve bone pain, or death due to any cause, whichever occurred first. |
From date of first administration until the date of first SSE or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
|
Overall survival (OS)
Zeitfenster: From date of first administration until the date of death, assessed over a minimum of 60 months
|
Overall Survival (OS) is defined as the time from the date of the first administration to the date of death due to any cause. |
From date of first administration until the date of death, assessed over a minimum of 60 months
|
|
Metabolic response on FDG-PET/CT
Zeitfenster: At baseline and at 12 weeks
|
Metabolic response is defined as complete metabolic response (CMR, disappearance of all lesions on FDG PET), partial metabolic response (PMR, decrease of uptake by ≥30%), stable metabolic disease (SMD, variation of FDG uptake by <30%), progressive metabolic disease (PMD, increase of FDG uptake by ≥30%) |
At baseline and at 12 weeks
|
|
Molecular response on PSMA-PET/CT
Zeitfenster: At baseline and at the end of treatment (each cycle is 6 weeks, up to 6 consecutive cycles)
|
Molecular response is defined as the variation of molecular tumor volume (MTV) on PSMA-PET/CT |
At baseline and at the end of treatment (each cycle is 6 weeks, up to 6 consecutive cycles)
|
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Best molecular response on quantitative 177Lu SPECT/CT during treatment
Zeitfenster: From first cycle's Day 3 until the last cycle's Day 3 (each cycle is 6 weeks, up to 6 consecutive cycles)
|
Best molecular response is defined as the maximum percent decrease of molecular tumor volume (MTV) at any time after post-treatment quantitative 177Lu SPECT/CT performed on the first cycle's Day 3, up to the post-treatment quantitative 177Lu SPECT/CT performed on the last cycle's Day 3 |
From first cycle's Day 3 until the last cycle's Day 3 (each cycle is 6 weeks, up to 6 consecutive cycles)
|
|
Number of participants with any adverse events (AEs)
Zeitfenster: From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
All adverse events that occur from the first administration of 177Lu-PSMA-617 until 6 weeks after the last administration of 177Lu-PSMA-617 or prior to the initiation of subsequent anticancer treatment. |
From first administration to the end of treatment (each cycle is 6 weeks, up to 6 cycles)
|
|
Number of participants with laboratory adverse events (AEs)
Zeitfenster: From date of first administration until the date of investigator-assessed progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
Adverse events seen on laboratory (hematology, biochemistry) that occur from the first administration of 177Lu-PSMA-617 until progression or until the initiation of subsequent anticancer treatment if earlier. |
From date of first administration until the date of investigator-assessed progression or of the start of another anti-cancer treatment or of death, whichever came first, assessed over a minimum of 60 months
|
|
Number of participants with delayed adverse events of special interest (AESIs)
Zeitfenster: From date of first administration until the date of death, assessed over a minimum of 60 months
|
Delayed AESIs (renal impairment and secondary hematological malignancies) that occur from the first administration of 177Lu-PSMA-617 until death (or study termination) |
From date of first administration until the date of death, assessed over a minimum of 60 months
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Jean-Mathieu Beauregard, MD, CHU de Québec-Université Laval
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 2025-7829
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
There is an intent to create an imaging and data bank from this study.
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Produkt, das in den USA hergestellt und aus den USA exportiert wird
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