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A Phase 3 Study of [177Lu]Ludotadipep for Metastatic Castration-Resistant Prostate Cancer

28 сентября 2026 г. обновлено: FutureChem

A Multi-center, Open-label, Randomized, Phase 3 Study to Evaluate the Efficacy and Safety of [177Lu]Ludotadipep Treatment for Metastatic Castration-resistant Prostate Cancer

Primary Efficacy Endpoint

- Radiographic Progression-Free Survival (rPFS): rPFS is defined as the time from randomization to radiographic disease progression (PD), as assessed by Blinded Independent Central Review (BICR) according to PCWG3-modified RECIST version 1.1, or death from any cause, whichever occurs first.

rPFS will be analyzed using the Kaplan-Meier method. The median survival time and corresponding two-sided 95% confidence intervals (CIs) will be estimated for both the investigational and control arms, and Kaplan-Meier curves will be presented.

A comparison between the investigational and control arms will be performed using a stratified Cox proportional hazards regression model. The model will be adjusted for the following stratification factors: nomogram score (≥178 vs <178), ECOG Performance Status (0 or 1 vs 2), prior use of cabazitaxel before randomization (yes vs no), and receipt of best supportive care alone (yes vs no). The p-value will be reported.

Ties in event times will be handled using the Efron method. The hazard ratio (HR) of the investigational arm relative to the control arm and its corresponding two-sided 95% confidence interval will be provided.

Обзор исследования

Подробное описание

Study Procedures:

  • Before randomization, investigators determine the most appropriate BSC/SoC for each participant.
  • Participants start BSC/SoC from Cycle 1 Day 1 (C1D1). [177-Lu]Ludotadipep is administered every 8 weeks for up to 4 cycles; investigators may allow up to 6 cycles based on clinical judgment. (Participants who do not meet criteria or decline additional [177-Lu]Ludotadipep after 4 cycles will continue BSC/SoC alone.)
  • Control arm participants who experience radiographic disease progression may cross over to receive [177-Lu]Ludotadipep in combination with BSC/SoC after obtaining separate consent and confirming eligibility.
  • "Cross-over" is defined as [177-Lu]Ludotadipep treatment in the control arm after progression. "Cross-over screening" refers to the eligibility confirmation process for cross-over.

Тип исследования

Интервенционный

Регистрация (Оцененный)

114

Фаза

  • Фаза 3

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Контакты исследования

Места учебы

      • Gyeonggi-do, Южная Корея
        • Рекрутинг
        • National Cancer Center
        • Контакт:
          • Jae Young Joung
          • Номер телефона: 82 1588 8110
          • Электронная почта: urojy@ncc.re.kr
      • Seoul, Южная Корея
        • Рекрутинг
        • Samsung Medical Center
        • Контакт:
      • Seoul, Южная Корея
        • Рекрутинг
        • Seoul National University Hospital
        • Контакт:
          • Cheol Kwak
          • Номер телефона: +82 2 1588 5700
          • Электронная почта: mdrafael@snu.ac.kr
      • Seoul, Южная Корея
        • Рекрутинг
        • Severance Hospital
        • Контакт:
          • Seung Hwan Lee
          • Номер телефона: 82 2 1599 1004
          • Электронная почта: LEESEH@yuhs.ac
      • Seoul, Южная Корея
        • Рекрутинг
        • Seoul St. Mary's Hospital
        • Контакт:
          • Ji Youl Lee
          • Номер телефона: +82 2 1588-1511
          • Электронная почта: uroljy@catholic.ac.kr
      • Seoul, Южная Корея
        • Рекрутинг
        • Ewha Woman University Medical Center
        • Контакт:
          • Cheong Soo Kim
          • Номер телефона: 82 2 8650 5114
          • Электронная почта: cskim37345806@gmail.com
      • Seoul, Южная Корея
        • Еще не набирают
        • Korea University ANAM Hospital
        • Контакт:
          • Seok Ho Kang
          • Номер телефона: 82 2 1577 0083
          • Электронная почта: mdksh@korea.ac.kr
      • Suwon, Южная Корея
        • Рекрутинг
        • St. Vincent's Hospital
        • Контакт:
          • Seung Ju Lee
          • Номер телефона: 82 1577 8588
          • Электронная почта: lee.seungju@gmail.com

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

19 лет и старше (Взрослый, Пожилой взрослый)

Принимает здоровых добровольцев

Нет

Полы, имеющие право на обучение

Мужской

Описание

Inclusion Criteria:

  1. Adult male aged ≥19 years at the time of written informed consent.

  2. Histologically, pathologically, or cytologically confirmed prostate adenocarcinoma without small cell features.

  3. Patients with progressive metastatic castration-resistant prostate cancer (mCRPC) meeting at least one of the following criteria:

    1. PSA progression: Minimum PSA level of ≥2.0 ng/mL with at least two consecutive increases at intervals of ≥1 week.
    2. Soft tissue progression:

    i. ≥20% increase in the sum of diameters (SOD)* of target lesions compared to the smallest SOD since treatment initiation, or ii. Appearance of one or more new lesions.

    *Short axis for lymph nodes and long axis for non-nodal lesions. (c) Bone progression: Appearance of ≥2 new lesions on bone scan.

  4. At least one metastatic lesion documented by CT, MRI, or bone scan within 4 weeks prior to baseline.

  5. Castration-resistant status with serum testosterone ≤50 ng/dL (≤1.7 nmol/L), achieved by surgical or medical castration.

    Patients without bilateral orchiectomy receiving LHRH analogs must continue such therapy throughout the study.

  6. Prior therapy meeting all of the following:

    1. At least one novel anti-androgen drug (NAAD) (e.g., enzalutamide and/or abiraterone).

      (First-generation anti-androgens such as bicalutamide, flutamide, and nilutamide are not counted.)

    2. At least one, but no more than two, prior taxane regimens. Patients who have not received docetaxel may be enrolled if deemed unsuitable, refused treatment, or lack access.

  7. COG performance status ≤2.

  8. Life expectancy of at least 24 weeks.

  9. PSMA-positive mCRPC confirmed by [18F]PSMA PET/CT at screening by independent central review, meeting all of the following:

    1. At least one PSMA-positive metastatic lesion§.

      §Defined as uptake greater than liver background, regardless of organ system or lesion size.

    2. No PSMA-negative lesions∥. ∥Defined as metastatic lesions with uptake equal to or lower than liver background and measurable on CT¶.

      • i. Bone lesions with soft tissue component ≥1 cm (short axis) ii. Solid organ metastases ≥1 cm (short axis) iii. Lymph nodes ≥2.5 cm (short axis)
  10. Adequate bone marrow, hepatic, and renal function at screening (one repeat test allowed during screening).

  11. Agreement to avoid fathering a child and to use effective contraception from screening until 24 weeks after the last dose of study drug, and to refrain from sperm donation.

    Acceptable contraception methods include hormonal contraception, intrauterine device/system, surgical sterilization, double-barrier methods, or complete abstinence.

  12. Planned best supportive care/standard of care (BSC/SoC) must be permitted in this study, and both investigator and patient agree that disease management with BSC/SoC alone is appropriate.

  13. Ability to understand the study and provision of written informed consent prior to any study-specific procedures.

Exclusion Criteria:

  1. Prior treatment with any of the following therapies:

    1. PSMA-targeted radioligand therapy
    2. Systemic radionuclide therapy within 24 weeks prior to the first dose of study intervention (e.g., strontium-89, samarium-153, rhenium-186, rhenium-188, radium-223, or hemi-body irradiation)
    3. Any other anticancer therapy (including cytotoxic chemotherapy, immunotherapy, biologic therapy, or targeted therapy) within 4 weeks prior to randomization
  2. History of any of the following:

    1. Hypersensitivity to the active substance or any component of the investigation
    2. History of another primary malignancy within 3 years prior to screening, except for adequately treated basal cell carcinoma, squamous cell carcinoma of the skin, superficial bladder cancer, papillary thyroid cancer, or carcinoma in situ with no recurrence for at least 2 years, as judged by the investigator
    3. Clinically significant cardiovascular disease within 24 weeks prior to screening, including but not limited to:

    i. Myocardial infarction or severe/unstable angina ii. Congestive heart failure (NYHA Class III or IV) iii. QTcF >480 msec on ECG iv. Clinically significant seizures or conditions predisposing to seizures v. Symptomatic or impending spinal cord compression (d) Known human immunodeficiency virus (HIV) infection

  3. Presence of any of the following comorbidities:

    1. Uncontrolled hypertension (SBP ≥160 mmHg or DBP ≥90 mmHg)
    2. Symptomatic or uncontrolled central nervous system metastases (Patients may be eligible if clinically and radiologically stable for ≥4 weeks and off anticonvulsants and corticosteroids for ≥2 weeks prior to study treatment)
    3. Immunocompromised status (including splenectomy or hematopoietic stem cell transplantation) or active autoimmune disease (e.g., myasthenia gravis, Hashimoto's thyroiditis, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, scleroderma)
    4. Severe infection or other uncontrolled active infection that may interfere with study assessments, as judged by the investigator
    5. Active hepatitis B or C infection:

    Hepatitis B: Defined as HBsAg positive at screening; however, patients may be eligible if HBV DNA <500 IU/mL and on stable antiviral therapy for ≥2 weeks prior to first dose, with intent to continue during the study and for ≥24 weeks after the last dose Hepatitis C: Defined as HCV antibody positive; patients are eligible if HCV RNA is negative

  4. Presence of a superscan on bone scan at baseline.

  5. Failure to recover to baseline or ≤ Grade 1 from prior anticancer therapy-related toxicities (except for alopecia of any grade or other conditions deemed acceptable per eligibility criteria).

  6. Participation in another clinical study with administration of an investigational product or device within 4 weeks prior to the first dose of study intervention.

  7. Any other condition that, in the opinion of the investigator, would make the subject unsuitable for participation in the study.

Учебный план

В этом разделе представлена ​​подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

  • Основная цель: Уход
  • Распределение: Рандомизированный
  • Интервенционная модель: Назначение кроссовера
  • Маскировка: Нет (открытая этикетка)

Оружие и интервенции

Группа участников / Армия
Вмешательство/лечение
Экспериментальный: [177-Lu]Ludotadipep plus best supportive care/standard of care (BSC/SOC)

Each participant will receive 3.7 GBq (+/- 10%) [177-Lu]Ludotadipep every 8 weeks for a total of 4 cycles, with the possibility of up to 6 cycles based on clinical judgment. Best supportive care/standard of care (BSC/BSOC) might be used.

[177-Lu]Ludotadipep 3.7 GBq (+/- 10%) intravenously every 8 weeks for a maximum of 6 cycles.

Best supportive care/standard of care as defined by the investigator.

Активный компаратор: BSC/SoC

Control arms will receive best supportive care/standard of care (BSC/SoC) permitted in the trial, according to the investigator's discretion and the standard practices of the study site.

Best supportive care/standard of care as defined by the investigator.

Что измеряет исследование?

Первичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Radiographic Progression-Free Survival (rPFS)
Временное ограничение: up to 36 months.

Radiographic progression-free survival (rPFS) is defined as the time from the date of randomization to the date of first documented radiographic disease progression or death from any cause, whichever occurs first, as assessed by blinded independent central review (BICR) according to PCWG3-modified RECIST version 1.1.

Median rPFS and two-sided 95% confidence intervals (CIs) for each treatment group will be estimated using the Kaplan-Meier method, and Kaplan-Meier curves will be presented.

Treatment groups will be compared using a stratified Cox proportional hazards regression analysis, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). Ties will be handled using the Efron method. The hazard ratio (HR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.

Вторичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Radiographic Progression-Free Survival (rPFS)
Временное ограничение: up to 36 months.

Radiographic progression-free survival (rPFS) is defined as the Time from the date of randomization to the date of first documented radiographic disease progression or death from any cause, whichever occurs first, as assessed by blinded independent central review (BICR) and investigator according to RECIST version 1.1 and RECIP 1.0(RECIP BICR Only).

Median rPFS and two-sided 95% confidence intervals (CIs) for each treatment group will be estimated using the Kaplan-Meier method, and Kaplan-Meier curves will be presented.

Treatment groups will be compared using a stratified Cox proportional hazards regression analysis, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). Ties will be handled using the Efron method. The hazard ratio (HR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.
Overall Survival (OS)
Временное ограничение: up to 36 months.

Overall survival (OS) is defined as the time from the date of randomization to the date of death from any cause.

Median OS and two-sided 95% confidence intervals (CIs) for each treatment group will be estimated using the Kaplan-Meier method, and Kaplan-Meier curves will be presented.

Treatment groups will be compared using a stratified Cox proportional hazards regression analysis, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). Ties will be handled using the Efron method. The hazard ratio (HR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.
Duration of Response (DOR)
Временное ограничение: up to 36 months.

Duration of response (DOR) is defined as the time from the date of first documented partial response (PR) or complete response (CR) to the date of first documented radiographic disease progression (PD), as assessed by blinded independent central review (BICR) and investigator according to RECIST v1.1, PCWG3-modified RECIST v1.1, and RECIP 1.0 (RECIP BICR only).

Median DOR and two-sided 95% confidence intervals (CIs) for each treatment group will be estimated using the Kaplan-Meier method, and Kaplan-Meier curves will be presented.

Treatment groups will be compared using a stratified Cox proportional hazards regression analysis, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). Ties will be handled using the Efron method. The hazard ratio (HR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.
Progression-Free Survival (PFS)
Временное ограничение: up to 36 months.

Progression-free survival (PFS) is defined as the time from the date of randomization to the date of first documented radiographic progression, PSA progression, clinical progression, or death from any cause, whichever occurs first, as assessed by investigator according to RECIST v1.1 and PCWG3-modified RECIST v1.1.

Median PFS and two-sided 95% confidence intervals (CIs) for each treatment group will be estimated using the Kaplan-Meier method, and Kaplan-Meier curves will be presented.

Treatment groups will be compared using a stratified Cox proportional hazards regression analysis, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). Ties will be handled using the Efron method. The hazard ratio (HR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.
Objective Response Rate (ORR)
Временное ограничение: up to 36 months.

Objective response rate (ORR) is defined as the proportion (%) of participants who achieve a best overall response of complete response (CR) or partial response (PR), as assessed by BICR and investigator according to RECIST v1.1, PCWG3-modified RECIST v1.1, and RECIP 1.0 (RECIP 1.0 assessed by BICR only).

Frequencies, percentages, and two-sided 95% CIs will be presented for each treatment group. Between-group comparisons will be performed using a stratified logistic regression model, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). The odds ratio (OR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

up to 36 months.
Health-Related Quality of Life (HRQoL) - BPI-SF (Brief Pain Inventory - Short Form)
Временное ограничение: Baseline and Day 1 of each cycle during treatment

Evaluated using Brief Pain Inventory - Short Form (BPI-SF). Pain severity items range from 0 (no pain) to 10 (pain as bad as you can imagine), calculated as the mean of 4 items. Pain interference items range from 0 (does not interfere) to 10 (completely interferes), calculated as the mean of 7 items. Lower scores represent less pain and interference (better outcome); higher scores represent greater pain and interference (worse outcome).

Summary statistics (N, mean, SD, median, min, max) for baseline and post-baseline will be reported. Between-group comparisons will be analyzed using Analysis of Covariance (ANCOVA) on change from baseline, with treatment group as a fixed effect, and baseline score and stratification factors (nomogram score, ECOG PS, prior cabazitaxel use, BSC alone) as covariates. LSM, SE, LSM differences with 95% CIs, and p-values will be reported.

Baseline and Day 1 of each cycle during treatment
Biochemical Response - Best PSA Response Rate (best PSA-RR)
Временное ограничение: Up to 36 months

Best prostate-specific antigen response rate (best PSA-RR) is defined as the proportion (%) of subjects with a ≥50% reduction in Prostate-Specific Antigen (PSA) levels from baseline.

Frequencies and percentages for each treatment group will be presented. Between-group comparisons will be performed using a stratified logistic regression model, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG performance status [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). The odds ratio (OR) for the treatment group relative to the control group, along with its two-sided 95% confidence interval (CI) and corresponding p-value, will be reported.

Up to 36 months
Health-Related Quality of Life (HRQoL) - FACT-P (Functional Assessment of Cancer Therapy - Prostate)
Временное ограничение: Baseline and Day 1 of each cycle during treatment

Evaluated using Functional Assessment of Cancer Therapy - Prostate (FACT-P) total score (27-item FACT-General plus 12-item Prostate Cancer Subscale). Total scores range from 0 to 156, with higher scores indicating better quality of life. Questionnaire is completed prior to IP administration on Day 1 of each cycle.

Summary statistics (N, mean, SD, median, min, max) for baseline and post-baseline will be reported. Between-group comparisons will be analyzed using ANCOVA on change from baseline, with treatment group as a fixed effect, and baseline score and stratification factors (nomogram score [>178 vs. ≤178], ECOG PS [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone) as covariates. LSM, SE, LSM differences with 95% CIs, and p-values will be reported.

Baseline and Day 1 of each cycle during treatment
Biochemical Response - Changes in LDH (Lactate Dehydrogenase)
Временное ограничение: Baseline and scheduled study visits up to 36 months

Evaluated by the change from baseline in serum lactate dehydrogenase (LDH) level at specified time points.

Summary statistics (N, mean, SD, median, min, max) for baseline and post-baseline will be reported. Between-group comparisons will be analyzed using ANCOVA on change from baseline, with treatment group as a fixed effect, and baseline LDH level and stratification factors (nomogram score [>178 vs. ≤178], ECOG PS [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone) as covariates. LSM, SE, LSM differences with 95% CIs, and p-values will be reported.

Baseline and scheduled study visits up to 36 months
Biochemical Response - Changes in ALP (Alkaline Phosphatase)
Временное ограничение: Baseline and scheduled study visits up to 36 months

Evaluated by the change from baseline in serum alkaline phosphatase (ALP) level at specified time points.

Summary statistics (N, mean, SD, median, min, max) for baseline and post-baseline will be reported. Between-group comparisons will be analyzed using ANCOVA on change from baseline, with treatment group as a fixed effect, and baseline ALP level and stratification factors (nomogram score [>178 vs. ≤178], ECOG PS [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone) as covariates. LSM, SE, LSM differences with 95% CIs, and p-values will be reported.

Baseline and scheduled study visits up to 36 months
Disease Control Rate (DCR)
Временное ограничение: Up to 36 months

Disease Control Rate (DCR) is defined as the proportion (%) of subjects who achieved Complete Response (CR), Partial Response (PR), or Stable Disease (SD). Assessments are performed according to RECIST v1.1, PCWG3-modified RECIST v1.1, and RECIP 1.0 by both Independent Central Review (BICR) and Investigator, except for RECIP 1.0 which is evaluated by BICR only.

Frequencies, percentages, and two-sided 95% confidence intervals (CIs) for each treatment group will be presented. Between-group comparisons will be performed using a stratified logistic regression model, adjusting for stratification factors (nomogram score [>178 vs. ≤178], ECOG PS [0-1 vs. 2], prior cabazitaxel use, and best supportive care alone). The odds ratio (OR) for the treatment group relative to the control group, along with its two-sided 95% CI and corresponding p-value, will be reported.

Up to 36 months

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Спонсор

Следователи

  • Главный следователь: Ji Youl Lee, Seoul St. Mary's Hospital

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования (Действительный)

26 января 2026 г.

Первичное завершение (Оцененный)

26 марта 2028 г.

Завершение исследования (Оцененный)

26 января 2029 г.

Даты регистрации исследования

Первый отправленный

15 апреля 2026 г.

Впервые представлено, что соответствует критериям контроля качества

28 сентября 2026 г.

Первый опубликованный (Действительный)

1 октября 2026 г.

Обновления учебных записей

Последнее опубликованное обновление (Действительный)

1 октября 2026 г.

Последнее отправленное обновление, отвечающее критериям контроля качества

28 сентября 2026 г.

Последняя проверка

1 сентября 2026 г.

Дополнительная информация

Термины, связанные с этим исследованием

Другие идентификационные номера исследования

  • FC705-3

Планирование данных отдельных участников (IPD)

Планируете делиться данными об отдельных участниках (IPD)?

НЕТ

Информация о лекарствах и устройствах, исследовательские документы

Изучает лекарственный продукт, регулируемый FDA США.

Нет

Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.

Нет

Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .

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