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177Lu-PSMA-617 Combined With Darolutamide in Neoadjuvant Treatment of High-risk Localized Prostate Cancer: a Prospective, Single-arm, Multi-center Clinical Trial (IUNU-PC-123)

The goal of this clinical trial is to explore the efficacy and safety of darolutamide combined with 177Lu-PSMA-617 in treating high-risk localized prostate cancer patients who are scheduled to undergo radical prostatectomy. The main questions it aims to answer are:

Does this combination treatment improve the pathological complete response rate (pCR)? What is the minimal residual disease (MRD) rate in these patients? What are the safety profiles and any adverse effects associated with this treatment? Researchers will compare the combination of darolutamide and 177Lu-PSMA-617 to a placebo to see if the combination is effective in treating high-risk localized prostate cancer.

Participants will:

Receive either darolutamide combined with 177Lu-PSMA-617 or a placebo every day for 12 weeks.

Visit the clinic every 6 weeks for checkups and tests. Keep a diary of their symptoms and any side effects experienced during the treatment.

Undergo imaging tests, including prostate MRI and PSMA PET/CT, before surgery and during follow-up.

연구 개요

상태

아직 모집하지 않음

연구 유형

중재적

등록 (추정된)

20

단계

  • 4단계

연락처 및 위치

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연구 연락처

연구 장소

    • Jiangsu
      • Nanjing, Jiangsu, 중국
        • Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

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설명

Inclusion Criteria:

  1. Patients must be ≥ 18 and ≤75 years of age
  2. All patients must have a histologically or cytologically diagnosis of prostate cancer,without distant metastasis, and suitable for radical prostatectomy
  3. All patients meet at least one of the following criteria: multi-parameter MRI or PSMA PET / CT shows clinical staging of primary tumor ≥ T2c; Gleason score of primary tumor ≥ 8; prostate specific antigen (PSA) ≥20 ng/ml; Radiographic assessment of regional lymph node metastases (N1)
  4. Eastern Cooperative Oncology Group (ECOG) physical condition score 0- 1
  5. Primary lesion SUVmax ≥ 20.0 as assessed by PSMA-PET examination.
  6. Adequate organ function: Complete Blood Count: White blood cell count (WBC) ≥ 3.0 × 10^9/L, platelet count ≥ 100 × 10^9/L, hemoglobin ≥ 9 g/dL. Renal Function: Serum creatinine ≤ 2 × ULN. Liver Function: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN, total bilirubin (TBIL) ≤ 1.5 × ULN. Coagulation Function: International normalized ratio (INR) < 1.5.
  7. Voluntary Participation: Participants must voluntarily agree to participate and sign the informed consent form (ICF), indicating their understanding of the purpose of the study and the required procedures, as well as their willingness to participate in the research. Participants must be willing to comply with the prohibitions and restrictions outlined in the study protocol.
  8. Patients of childbearing potential must be willing to take high-efficiency contraceptive measures during the study period and within 120 days after the last dose of treatment

Exclusion Criteria:

  1. Patients with prostate having neuroendocrine, small cell, or sarcoma-like features are not eligible
  2. Patients with low-risk and medium-risk, localized prostate cancer (the following conditions are met at the same time) are not eligible: prostate specific antigen (PSA) <20 ng/mL multiparameter MRI or PSMA PET / CT shows clinical staging of primary tumor < T3, Gleason score of primary tumor < 8
  3. Patients with clinical or radiological evidence of regional or extra-regional lymph node metastases or bone metastases or visceral metastases (any M1)
  4. Primary lesion SUVmax < 20.0 as assessed by PSMA-PET examination.
  5. Patients who have previously received androgen deprivation therapy (medical or surgical) more than 3 months or focal treatment of prostate cancer or prostate cancer radiotherapy or prostate cancer chemotherapy
  6. Patients with severe or uncontrolled concurrent infections
  7. Patients must not have New York Heart Association Class III or IV congestive heart failure at the time of screening. Patients must not have any thromboembolic event, unstable angina pectoris, myocardial infarction within 6 months prior to registration
  8. Uncontrolled severe hypertension, persistently uncontrolled diabetes, oxygen-dependent lung disease, chronic liver disease, or HIV infection
  9. Patients with a history of other malignancies within the past 5 years, except for prostate cancer, are not eligible; however, cured basal cell carcinoma or squamous cell carcinoma of the skin may be eligible
  10. Patients with mental illness, mental disability, or inability to provide informed consent

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 실험용 암

177Lu-PSMA-617: Eligible participants must start receiving 177Lu-PSMA-617 within 14 days. Participants will receive a dosage of 7.4 GBq (± 10%) of 177Lu-PSMA-617, administered once every 6 weeks (± 7 days), for a total of two doses.

Darolutamide: Administered at a dosage of 1200 mg orally in two divided doses with meals, starting from the first injection of 177Lu-PSMA-617 and continuing until 6 weeks after the second injection, for a total duration of 12 weeks.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
pCR + MRD
기간: Screening, End of Neoadjuvant Treatment( 12 weeks after baseline)
pCR + MRD (pCR: Pathological Complete Response; Minimal Residual Disease (MRD) rate: defined as the proportion of patients achieving MRD among all patients; MRD is defined as postoperative pathology indicating that the longest diameter of the tumor is ≤ 5 mm)
Screening, End of Neoadjuvant Treatment( 12 weeks after baseline)

2차 결과 측정

결과 측정
측정값 설명
기간
Patient Sexual Function
기간: Day 1 of Cycle 1&2 ( each cycle is 6 weeks), 1 month after treatment, 3 and 6 months after treatment, 6 months until 2 years
The International Index of Erectile Function (IIEF-5) will be used for assessment. This scale consists of five questions, with each question scored from 0 to 5, resulting in a total score range of 0 to 25. A total score greater than 21 indicates normal erectile function; a score of 12 to 21 indicates mild erectile dysfunction; a score of 8 to 11 indicates moderate erectile dysfunction; and a score of 1 to 7 indicates severe erectile dysfunction.
Day 1 of Cycle 1&2 ( each cycle is 6 weeks), 1 month after treatment, 3 and 6 months after treatment, 6 months until 2 years
PSA Response Rate (defined as a decrease in PSA of 50% or more)
기간: Day 1 of Cycle 1&2 (each cycle is 6 weeks), End of Neoadjuvant Treatment (12 weeks after baseline). The last week of each month for the first 3 months after the periprocedural, thereafter the last week of every 3rd month for a total duration of 1 year
Day 1 of Cycle 1&2 (each cycle is 6 weeks), End of Neoadjuvant Treatment (12 weeks after baseline). The last week of each month for the first 3 months after the periprocedural, thereafter the last week of every 3rd month for a total duration of 1 year
PSMA Response Rate
기간: Screening, End of Neoadjuvant Treatment (12 weeks after baseline)
PSMA Response Rate: The assessment of PSMA response will be conducted using PSMA PET/CT at 6 weeks after treatment with 177Lu-PSMA-617. If all PSMA lesions have disappeared, it is classified as PSMA complete response. If the SUVmax (maximum standardized uptake value) decreases by more than 30%, it is classified as partial response. If the SUVmax increases by more than 30% or new PSMA-avid lesions appear, it is classified as disease progression. If the response does not meet the criteria for complete response, partial response, or disease progression, it is classified as stable disease.
Screening, End of Neoadjuvant Treatment (12 weeks after baseline)
1-year biochemical recurrence-free survival, bRFS
기간: The last week of each month for the first 3 months after the periprocedural, thereafter the last week of every 3rd month for a total duration of 1 year
1-year Biochemical Recurrence-Free Survival (bRFS): Biochemical recurrence is defined as the occurrence of PSA levels exceeding 0.2 ng/ml in two consecutive tests after radical prostatectomy, with no evidence of recurrence or metastasis on imaging.
The last week of each month for the first 3 months after the periprocedural, thereafter the last week of every 3rd month for a total duration of 1 year
Perioperative Complications
기간: Perioperative Period
Perioperative Period
Patient Quality of Life
기간: Day 1 of Cycle 1&2 ( each cycle is 6 weeks), 1 month after treatment, 3 and 6 months after treatmnet,6 months until 2 years
The FACT-P scale (39 items) will be used for assessment. This scale includes a general functional status scale (composed of four subscales: physical, social and family, emotional, and functional) and a prostate cancer-specific subscale. The total score is calculated from the general functional and prostate cancer-specific scores, with a range from 0 to 156; a higher score indicates better functional status.
Day 1 of Cycle 1&2 ( each cycle is 6 weeks), 1 month after treatment, 3 and 6 months after treatmnet,6 months until 2 years
Tumor Radiation Absorbed Dose: The maximum absorbed dose of 177Lu-PSMA-617 treatment for the prostate (measured in Gray [Gy])
기간: Screening, End of Neoadjuvant Treatment(12 weeks after baseline)
Screening, End of Neoadjuvant Treatment(12 weeks after baseline)

기타 결과 측정

결과 측정
측정값 설명
기간
Adverse Event
기간: From Day 1 of cycle 1 to the 30 days after study completion, an average of 1year and 4 months.
All adverse events (AEs) will be assessed and graded according to NCI-CTCAE v5.0. Safety evaluations will be conducted and recorded after the initiation of the study drug, regardless of their relationship to the study drug, until 30 days after the last study treatment or the start of new anticancer therapy (whichever occurs first).
From Day 1 of cycle 1 to the 30 days after study completion, an average of 1year and 4 months.

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여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 7월 1일

기본 완료 (추정된)

2027년 7월 1일

연구 완료 (추정된)

2028년 12월 31일

연구 등록 날짜

최초 제출

2026년 6월 18일

QC 기준을 충족하는 최초 제출

2026년 6월 24일

처음 게시됨 (실제)

2026년 7월 1일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 1일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 6월 24일

마지막으로 확인됨

2026년 6월 1일

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