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ALT-100 Monoclonal Antibody (mAb) in Bone-Predominant Metastatic Androgen Pathway Modulation Resistant (APMR) Prostate Cancer -- The ALTAR-100 Trial

3. November 2026 aktualisiert von: University of Florida

Aqualung Therapeutics Corporation has developed ALT-100, a humanized murine monoclonal antibody (mAb) that specifically targets and neutralizes extracellular nicotinamide phosphoribosyltransferase (eNAMPT) and prevents activation of a dysregulated proinflammatory signaling cascade.

Pre-clinical and clinical information from acute respiratory distress syndrome and prostate cancer studies show a novel treatment option for the patients with androgen pathway modulator-resistant (APMR) prostate cancer and bone metastases. Secreted eNAMPT drives prostate cancer progression, and a humanized eNAMPT-neutralizing antibody prevented aggressive disease in preclinical models by Sun et al. The anti-fibrotic activity of the eNAMPT-neutralizing antibody acts on type I collagen turnover-the same biology as osteoblastic bone metastasis.

Bone-predominant androgen pathway modulator-resistant (APMR) prostate cancer is a common clinical problem. Treatment options are often limited after progression on ADT and androgen receptor pathway inhibitors. The bone microenvironment itself is still largely untargeted. No eNAMPT-directed therapy has been tested in any oncology population, and no trial has asked whether eNAMPT/toll-like receptor 4 (TLR4) blockade can modify the osseous tumor microenvironment in humans. This trial would test a first-in-class agent aimed at the bone microenvironment rather than at the tumor alone, in a setting where most available therapies offer short-lived benefit.

This study will evaluate the safety, tolerability and efficacy of the use of ALT-100 for treatment of bone-predominant metastatic androgen pathway modulation resistant prostate cancer. The recommended phase 2 dose of ALT-100 for treatment of bone-predominant metastatic androgen pathway modulation resistant prostate cancer will also be determined in the phase 1 portion of this study.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

42

Phase

  • Phase 2
  • Phase 1

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Männlich

Beschreibung

Inclusion Criteria:

  • Male, age ≥ 18 years

  • Prostate cancer, histologically confirmed or presumed on the basis of clinical, biochemical, and/or radiographic findings.

  • Metastatic disease confined to bone and lymph nodes, with bone metastases predominant, documented on conventional imaging (CT/MRI and bone scan). Measurable soft tissue disease is not required.

  • Androgen pathway modulation-resistant (APMR) disease per Prostate Cancer Working Group 4 (PCWG4) with progression on at least one prior androgen receptor pathway inhibitor documented as any of the following:

    1. Serum PSA progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL,
    2. Soft tissue progression defined as an increase ≥20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions or unequivocal progression of existing non-target lesions,
    3. For PSMA-PET: Two new PSMA-avid lesions, or
    4. Progression of bone disease defined by the appearance of ≥2 new bone lesions on bone scan per PCWG4 criteria
  • Ongoing androgen deprivation therapy (ADT) with a Gonadotropin-releasing hormone analogue, or prior bilateral orchiectomy, with serum testosterone <50 ng/dL

  • ECOG performance status 0-2

  • Life expectancy ≥6 months

  • Adequate organ and marrow function defined as:

    1. ANC ≥1,500/µL
    2. Platelets ≥100,00/µL
    3. Hemoglobin ≥9.0 g/dL without transfusion within 14 days
    4. Total bilirubin ≤1.5 x ULN (≤ 3 x ULN for Gilbert's)
    5. AST and ALT ≤3 x ULN
    6. Creatinine clearance ≥30 mL/min
  • Concurrent bone-modifying agent (including, but not limited to denosumab or bisphosphonates such as zoledronic acid or pamidronate), permitted but not required. If receiving one, it must have been at a stable dose and scheduled for ≥8 weeks before C1D1.

  • Written informed consent obtained from the subject and the subject agrees to comply with all the study-related procedures.

  • Subjects with partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study and should avoid conceiving children for 6 months following the last dose of study drug.

Exclusion Criteria:

  • Visceral metastases, including liver, lung, adrenal, brain or peritoneal disease. Lymph node involvement is permitted
  • Known pure small cell or neuroendocrine prostate carcinoma
  • Radium-223 within 6 months of C1D1
  • External beam radiotherapy to a bone lesion within 4 weeks of C1D1 or radiotherapy planned during the DLT window of 30 days after first dose of ALT-100.
  • Impending skeletal-related event requiring immediate radiotherapy or surgical intervention or untreated spinal cord compression
  • Chemotherapy, investigational therapy, or any systemic anticancer therapy other than ADT within 4 weeks or 5 half-lives of C1D1, whichever is shorter
  • Prior exposure to any extracellular nicotinamide phosphoribosyltransferase (eNAMPT)-directed or toll-like receptor 4 (TLR4)-directed therapeutic agent.
  • Known hypersensitivity to a monoclonal antibody, or prior grade ≥3 infusion-related reaction to a biologic
  • Active infection requiring systemic therapy at C1D1
  • Known HIV infection, or known active hepatitis B or hepatitis C, that is uncontrolled or requires a change in therapy. Testing is not required at screening
  • Cardiovascular or thromboembolic disease that, in the investigator's judgment, is uncontrolled or would place the patient at undue risk on study
  • Chronic systemic immunosuppressive therapy at doses that in the investigator's judgement would place the patient at undue infection risk
  • Active osteonecrosis of the jaw, or invasive dental procedure planned during the DLT window of 30 days after first dose of ALT-100
  • Another malignancy requiring active treatment, except non-melanoma skin cancer or adequately treated in situ disease
  • Any condition that in the investigator's judgement would compromise safety or protocol compliance
  • Administration of a vaccine containing live virus within 30 days prior to the first dose of trial treatment. Note: Most flu vaccines are killed viruses, with the exception of the intra-nasal vainer (Flu-Mist) which is an attenuated live virus and therefore prohibited for 30 days prior to first dose.
  • Prisoners or subjects who are involuntarily incarcerated, or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Sequenzielle Zuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Phase 1 - Dose level 1 - 1.0 mg/kg ALT-100

This is the starting dose for the phase 1 portion of the study.

Participants will receive either 1.0 mg/kg or 4.0 mg/kg of ALT-100 intravenously once every 28 days for up to 6 treatment cycles while receiving standard of care androgen deprivation therapy. The assigned dose will determined by either a 3 + 3 design (for phase 1) or 1:1 randomization (for phase 2).

Experimental: Phase 1 - Dose Level 2 - 4.0 mg/kg of ALT-100

This is the second dose level that will be tested in the phase 1 portion of the study.

Participants will receive either 1.0 mg/kg or 4.0 mg/kg of ALT-100 intravenously once every 28 days for up to 6 treatment cycles while receiving standard of care androgen deprivation therapy. The assigned dose will determined by either a 3 + 3 design (for phase 1) or 1:1 randomization (for phase 2).

Experimental: Phase 2 - Recommended phase 2 dose of ALT-100

Participants randomized to this arm will receive the recommended phase 2 dose determined in the phase 1 portion of the study.

Participants will receive either 1.0 mg/kg or 4.0 mg/kg of ALT-100 intravenously once every 28 days for up to 6 treatment cycles while receiving standard of care androgen deprivation therapy. The assigned dose will determined by either a 3 + 3 design (for phase 1) or 1:1 randomization (for phase 2).

Aktiver Komparator: Phase 2 - Comparator dose of ALT-100

Participants randomized to this arm will receive a comparator dose of ALT-100 that is not the recommended phase 2 dose determined in phase 1.

Participants will receive either 1.0 mg/kg or 4.0 mg/kg of ALT-100 intravenously once every 28 days for up to 6 treatment cycles while receiving standard of care androgen deprivation therapy. The assigned dose will determined by either a 3 + 3 design (for phase 1) or 1:1 randomization (for phase 2).

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Incidence of dose limiting toxicities
Zeitfenster: first 30 days of treatment with ALT-100

Determine the incidence of dose-limiting toxicities during the dose-limiting toxicity evaluation period for participants on the phase 1 portion.

first 30 days of treatment with ALT-100
Percentage of participants who achieve a PSA decrease of at least 30%
Zeitfenster: After up to 6 months of treatment with ALT-100

Compare the percentage of participants on each arm on the phase 2 portion who achieve a PSA decrease of at least 30%

After up to 6 months of treatment with ALT-100
Percentage of participants who achieve a PSA decrease of at least 50%
Zeitfenster: After up to 6 months of treatment with ALT-100

Compare the percentage of participants on each arm on the phase 2 portion who achieve a PSA decrease of at least 50%

After up to 6 months of treatment with ALT-100
Radiographic progression-free survival
Zeitfenster: After up to 6 months of treatment with ALT-100

Compare the radiographic progression-free survival (per Prostate Cancer Working Group 4) of participants on each arm on the phase 2 portion.

After up to 6 months of treatment with ALT-100

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Maximum plasma concentration of ALT-100
Zeitfenster: At 4 hours after each dose of ALT-100

Determine the maximum plasma concentration of ALT-100 for participants on the Phase 2 portion.

At 4 hours after each dose of ALT-100
Time to reach maximum plasma concentration of ALT-100
Zeitfenster: At 4 hours after each dose of ALT-100

Determine the time to reach maximum plasma concentration of ALT-100 for participants on the Phase 2 portion.

At 4 hours after each dose of ALT-100
Area under the curve (AUC) up to the last measurable plasma concentration for ALT-100
Zeitfenster: At 4 hours after each dose of ALT-100

Determine the area under the curve (AUC) up to the last measurable plasma concentration for ALT-100 for participants on the Phase 2 portion.

At 4 hours after each dose of ALT-100
Area under the curve (AUC) over the dosing interval for ALT-100
Zeitfenster: Over the 4 weeks between doses of ALT-100

Determine the area under the curve (AUC) over the dosing interval for ALT-100 for participants on the Phase 2 portion.

Over the 4 weeks between doses of ALT-100
Half-life for ALT-100
Zeitfenster: At 4 hours after each dose of ALT-100

Determine the half-life for ALT-100 for participants on the Phase 2 portion.

At 4 hours after each dose of ALT-100
Trough plasma concentration for ALT-100
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Determine the trough plasma concentration for ALT-100 for participants on the Phase 2 portion.

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Average plasma concentration during a dosing interval for ALT-100
Zeitfenster: Over the 4 weeks between doses of ALT-100

Determine the average plasma concentration during a dosing interval for ALT-100 for participants on the Phase 2 portion.

Over the 4 weeks between doses of ALT-100
Plasma concentration of eNAMPT
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of eNAMPT

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of IL-6
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of IL-6

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of IL-8
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of IL-8

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of TNF-a
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of TNF-a

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of IL-1b
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of IL-1b

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of IL-1RA
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of IL-1RA

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of Ang2
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of Ang2

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of VEGF
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of VEGF

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of BMP-2
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of BMP-2

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of PDGF-BB
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of PDGF-BB

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of osteopontin
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of osteopontin

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of osteocalcin
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of osteocalcin

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)
Plasma concentration of bALP
Zeitfenster: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Measure the plasma concentration of bALP

Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Daniel Araujo, MD, University of Florida

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. Januar 2027

Primärer Abschluss (Geschätzt)

1. August 2028

Studienabschluss (Geschätzt)

1. August 2028

Studienanmeldedaten

Zuerst eingereicht

28. Oktober 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

3. November 2026

Zuerst gepostet (Tatsächlich)

4. November 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

4. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

3. November 2026

Zuletzt verifiziert

1. Oktober 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • UF-GU-015

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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