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177Lu radiomärkt monoklonal antikropp HuJ591 (177Lu-J591) och ketokonazol hos patienter med prostatacancer

21 oktober 2026 uppdaterad av: Weill Medical College of Cornell University

En randomiserad fas 2-studie av 177Lu radiomärkt monoklonal antikropp HuJ591 (177Lu-J591) och ketokonazol hos patienter med högriskkastrat biokemiskt återfallande prostatacancer efter lokal terapi

The purpose of this study is to test the effectiveness of the experimental drug, 177Lu-J591 in combination with ketoconazole and hydrocortisone against prostate cancer.

Studieöversikt

Detaljerad beskrivning

This research is being done because the standard treatments for prostate cancer that has returned (PSA is elevated) after surgery and/or radiation and progressed on initial hormonal therapy are not curative. Existing treatments, such as the ketoconazole used as part of this study may decrease PSA temporarily, but unfortunately the cancer continues to grow. This experimental drug is designed to seek out all of the prostate cancer cells and to deliver a lethal dose of radiation to the areas of cancer, but not to normal areas. Some of the normal organs (liver, kidney and bone marrow) do receive some radiation dose that is within the acceptable limits.

The experimental drug in this study includes an antibody (abbreviated: mAb) called "J591". It is a protein molecule which can bind to a specific site on a prostate cancer cell. A very energetic radioactive (an unstable atom) metal called 177Lutetium (abbreviated: 177Lu) is attached to the J591 antibody. The fully assembled drug is called "177Lu-J591". The study will assess the potential of the energy given off by the radioactive compound to kill cancer cell. This study may also involve the use of 111Indium (abbreviated 111In). This is also an energetic radioactive particle, but does not generally give off enough energy to kill cancer cells, but allows researchers to take pictures. This radioactive particle is also attached to the J591 antibody (called 111In-J591) and will serve as a placebo (treatment with no active medicine).

Studietyp

Interventionell

Inskrivning (Faktisk)

55

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • California
      • Los Angeles, California, Förenta staterna, 90048
        • Cedars Sinai
      • Los Angeles, California, Förenta staterna, 90089
        • USC/Norris Comprehensive cancer center
    • District of Columbia
      • Washington D.C., District of Columbia, Förenta staterna, 20007
        • Georgetown University Medical Center
    • Indiana
      • Indianapolis, Indiana, Förenta staterna, 46202
        • Indiana University Melvin and Bren Simon Cancer Center
    • Iowa
      • Iowa City, Iowa, Förenta staterna, 52242
        • University of Iowa Hospitals and Clinics
    • Kansas
      • Westwood, Kansas, Förenta staterna, 66205
        • The University of Kansas Cancer Center
    • Nebraska
      • Omaha, Nebraska, Förenta staterna, 68130
        • XCancer Omaha
    • New York
      • New York, New York, Förenta staterna, 10021
        • Weill Cornell Medical College
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Förenta staterna, 15232
        • UPMC Hillman Cancer Center
    • Utah
      • Salt Lake City, Utah, Förenta staterna, 84108
        • University of Utah

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Manlig

Beskrivning

Inclusion Criteria:

  • Histologically or cytologically confirmed adenocarcinoma of the prostate previously treated with surgery and/or radiotherapy.

  • Biochemical progression (rising PSA) after medical or surgical castration

  • High risk of systemic progression defined as:

    1. Rising PSA as defined above and either:
    2. Absolute PSA > 20 ng/mL AND/OR
    3. PSA doubling time < 8 months
  • No evidence of local recurrence or distant metastases

  • Age >18 years.

  • Serum testosterone < 50 ng/ml

  • Patients capable of fathering children must agree to use an effective method of contraception for the duration of the trial.

  • Subjects on bisphosphonate therapy must be on a stable dose and must have started therapy > 4 weeks prior to protocol therapy.

  • Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Use of red blood cell or platelet transfusions within 4 weeks of treatment

  • Use of hematopoietic growth factors within 4 weeks of treatment

  • Prior cytotoxic chemotherapy and/or radiation therapy within 4 weeks of treatment

  • Prior radiation therapy encompassing >25% of skeleton (see Appendix C)

  • Prior treatment with 89Strontium or 153Samarium containing compounds (e.g. Metastron®, Quadramet®)

  • Platelet count <150,000/mm3 or known primary qualitative platelet disorder

  • Absolute neutrophil count (ANC) <2,000/mm3

  • Hematocrit <30 percent and Hemoglobin < 10 g/dL

  • Abnormal coagulation profile (PT or INR, PTT > 1.3x ULN) unless on therapeutic anticoagulation - see concomitant meds section

  • Serum creatinine >2.5 mg/dL

  • AST (SGOT) >2x ULN

  • Bilirubin (total) >1.5x ULN; subjects with Gilbert's syndrome will be allowed if direct bilirubin is within institutional normal limits

  • Active serious infection

  • Active angina pectoris or NY Heart Association Class III-IV

  • ECOG Performance Status > 2

  • Life expectancy <12 months

  • History of deep vein thrombosis and/or pulmonary embolus within 1 month of study entry

  • Other serious illness(es) involving the cardiac, respiratory, CNS, renal, hepatic or hematological organ systems which might preclude completion of this study or interfere with determination of causality of any adverse effects experienced in this study

  • Prior investigational therapy (medications or devices) within 4 weeks of treatment. Furthermore, other investigational therapy is not permitted during the treatment phase.

  • Prior use of ketoconazole for the purposes of prostate cancer therapy for greater than 1 month

  • Known history of HIV. The effects of J591 are unknown in this population. Furthermore, ketoconazole has many well-described drug-drug interactions which could affect antiviral therapy. If necessary, this population will be studied separately.

  • Currently active other malignancy other than non-melanoma skin cancer. Patients are considered not to have "currently active" malignancy if they have completed any necessary therapy and are considered by their physician to be at less than 30% risk of relapse.

    - Known history of known myelodysplastic syndrome

  • Adrenal hormone inhibitors (other than ketoconazole) within 4 weeks prior to study enrollment

  • Finasteride (Propecia® or Proscar®) or dutasteride (Avodart®) within 4 weeks of enrollment

  • Patients on corticosteroids prior to enrollment must have either discontinued and shown biochemical progression or have biochemical progression on a stable dose

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Fyrdubbla

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 1. 177Lu-J591 + Ketoconazole

Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 177Lu-J591 Infusion, continue ketoconazole and hydrocortisone

177Lu-J591 70 mCi/m2 on day 29 (+/- 2 days) of treatment

Andra namn:
  • J591

Ketoconazole at a dose of 400 mg (two 200 mg tabs) to be taken orally (preferably on an empty stomach) three times per day (total daily dose of 1200 mg)

Andra namn:
  • Nizoral

Hydrocortisone at a dose of 20 mg orally each morning, 10 mg orally each evening (total daily dose of 30 mg)

Andra namn:
  • Cortef
Placebo-jämförare: 2. 111In-J591 + Ketoconazole

Ketoconazole 400 mg 3 times a day plus hydrocortisone 20 mg AM, 10 mg PM x 4 weeks followed by 111In-J591 (placebo) Infusion, continue ketoconazole and hydrocortisone

Ketoconazole at a dose of 400 mg (two 200 mg tabs) to be taken orally (preferably on an empty stomach) three times per day (total daily dose of 1200 mg)

Andra namn:
  • Nizoral

Hydrocortisone at a dose of 20 mg orally each morning, 10 mg orally each evening (total daily dose of 30 mg)

Andra namn:
  • Cortef

111In-J591 at a dose of 5 mCi on day 29 (+/- 2 days) of treatment

Andra namn:
  • J591

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Proportion of Participants Free of Radiographically Evident Metastases From Baseline to 18 Months After Study Drug Administration
Tidsram: Baseline and 18 months after study drug administration

Subjects will perform a CT and/or MRI scan of the abdomen and pelvis, chest x-ray or CT scan of the chest and bone scan to determine the proportion of participants free of radiographically evident metastases from baseline to 18 months after study drug administration.

Baseline and 18 months after study drug administration

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in PSA Response Rate
Tidsram: Collected at screening, V2, V3, V5, V9 then every 4 weeks till PSA progression or end of study at approximately 100 months

PSA response will be determined by comparing the PSA levels after therapy to the baseline and pre-treatment PSA via blood specimens

Collected at screening, V2, V3, V5, V9 then every 4 weeks till PSA progression or end of study at approximately 100 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Scott T Tagawa, M.D., Weill Medical College of Cornell University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 juni 2009

Primärt slutförande (Faktisk)

10 februari 2022

Avslutad studie (Beräknad)

1 juni 2027

Studieregistreringsdatum

Först inskickad

10 mars 2009

Först inskickad som uppfyllde QC-kriterierna

10 mars 2009

Första postat (Beräknad)

11 mars 2009

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

21 oktober 2026

Senast verifierad

1 oktober 2026

Mer information

Termer relaterade till denna studie

Plan för individuella deltagardata (IPD)

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NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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