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Phase I Trial of 225Ac-J591 in Patients With mCRPC

Primary Purpose

Prostate Cancer

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
225Ac-J591
Sponsored by
Weill Medical College of Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Histologically or cytologically confirmed adenocarcinoma of prostate
  2. Documented progressive metastatic CRPC based on Prostate Cancer Working Group 3 (PCWG3) criteria, which includes at least one of the following criteria:

    1. PSA progression
    2. Objective radiographic progression in soft tissue
    3. New bone lesions
  3. ECOG performance status of 0-2
  4. Have serum testosterone < 50 ng/dL. Subjects must continue primary androgen deprivation with an LHRH analogue (agonist/antagonist) if they have not undergone bilateral orchiectomy.
  5. Have previously been treated with at least one of the following:

    1. Androgen receptor signaling inhibitor (such as enzalutamide)
    2. CYP 17 inhibitor (such as abiraterone acetate)
  6. Have previously received taxane chemotherapy, been determined to be ineligible for taxane chemotherapy by their physician, or refused taxane chemotherapy.
  7. Age > 18 years
  8. Patients must have normal organ and marrow function as defined below:

    1. Absolute neutrophil count >2,000 cells/mm3
    2. Hemoglobin ≥9 g/dL
    3. Platelet count >150,000 x 109/microliter
    4. Serum creatinine <1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 60 mL/min/1.73 m2 by Cockcroft-Gault
    5. Serum total bilirubin <1.5 x ULN (unless due to Gilbert's syndrome in which case direct bilirubin must be normal
    6. Serum AST and ALT <3 x ULN in absence of liver metastases; <5x ULN if due to liver metastases (in both circumstances, bilirubin must meet entry criteria)
  9. Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  1. Implantation of investigational medical device ≤4 weeks of Cycle 1, Day 1 or current enrollment in oncologic investigational drug or device study
  2. Use of investigational drugs ≤4 weeks or <5 half-lives of Cycle 1, Day 1 or current enrollment in investigational oncology drug or device study
  3. Prior systemic beta-emitting bone-seeking radioisotopes
  4. Known active brain metastases or leptomeningeal disease
  5. History of deep vein thrombosis and/or pulmonary embolus within 1 month of C1D1
  6. 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
  7. Radiation therapy for treatment of PC ≤4 weeks of Day 1 Cycle 1
  8. Patients on stable dose of bisphosphonates or Denosumab, which have been started no less than 4 weeks prior to treatment start, may continue on this medication, however patients are not allowed to initiate bisphosphonate/Denosumab therapy during the DLT-assessment period of the study.
  9. Having partners of childbearing potential and not willing to use a method of birth control deemed acceptable by the principle investigator and chairperson during the study and for 1 month after last study drug administration
  10. 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.
  11. Known history of known myelodysplastic syndrome

Sites / Locations

  • Tulane Cancer Center Clinic
  • Weill Cornell Medical College

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

All Subjects

Arm Description

A single dose of 225Ac-J591 will be given to subjects with documented progressive metastatic CRPC.

Outcomes

Primary Outcome Measures

Number of Subjects With Dose Limiting Toxicities (DLT)
Count of participants will be measured by the recommended phase II dose in utilizing the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 for DLTs.
Number of Subjects Who Reached Maximum Tolerated Dose (MTD)
The MTD is the highest dose amongst the different dose-level cohorts in this study at which no more than 2 (33%) of the subjects in a cohort experience DLT.

Secondary Outcome Measures

Number of Subjects With Prostate Specific Antigen (PSA) Response
PSA will be analyzed through blood specimen collection
Number of Subjects With Circulating Tumor Cells (CTC) Response
CTCs will be analyzed through blood specimen collection via CellSearch methodology lab testing
Number of Subjects With Radiographic (Imaging) Response
Radiographic response rate by Response evaluation criteria in solid tumors (RECIST) criteria with Prostate Cancer Working Group 3 (PCWG3) modifications
Progression Free Survival (PFS)
Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.

Full Information

First Posted
August 3, 2017
Last Updated
November 15, 2022
Sponsor
Weill Medical College of Cornell University
Collaborators
Prostate Cancer Foundation, United States Department of Defense, National Institutes of Health (NIH), National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT03276572
Brief Title
Phase I Trial of 225Ac-J591 in Patients With mCRPC
Official Title
Phase I Dose-Escalation Trial of 225Ac-J591 in Patients With Metastatic Castration-Resistant Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 10, 2017 (Actual)
Primary Completion Date
January 7, 2021 (Actual)
Study Completion Date
July 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Weill Medical College of Cornell University
Collaborators
Prostate Cancer Foundation, United States Department of Defense, National Institutes of Health (NIH), National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open-label, single-center Phase I dose escalation study designed to determine the dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD) of 225Ac-J591 in a single dose regimen.
Detailed Description
This clinical trial is for men with advanced prostate cancer. The purpose of this study is to find the highest dose level of the study drug, 225Ac-J591 that can be given without severe side effects. The research study is being done because the standard treatments for prostate cancer that has spread beyond the prostate gland are intended to minimize the adverse effects of the disease. These treatments, however, are not curative. Patients who choose to participate in this study will have a screening visit to determine whether or not they are eligible to participate in the study. The treatment phase is comprised of 8 visits over approximately 12 weeks. The study medication is called 225Ac-J591, and participants will receive an infusion of the study drug on the Treatment visit of the study. Upon completion of investigational treatment with single dose of 225Ac-J591, subjects will undergo 68Ga-PSMA-HBED-CC injection and same day PET/CT at the end of study visit to document treatment response. Subsequently survival data and additional treatment(s) information will be captured from their routine Standard of care (SOC) visits.During the other study visits, participants will undergo routine tests and procedures, such as physical examinations, and routine blood tests. Some blood tests will be done for research purposes only. After completion of therapy, participants may be contacted on a periodic basis to see how they are doing. Key eligibility: Open to men age 18 and older. Diagnosis of progressive metastatic prostate cancer Have been previously treated for their disease with particular types of therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
All Subjects
Arm Type
Experimental
Arm Description
A single dose of 225Ac-J591 will be given to subjects with documented progressive metastatic CRPC.
Intervention Type
Drug
Intervention Name(s)
225Ac-J591
Other Intervention Name(s)
68Ga-PSMA-HBED-CC injection for PET/CT Scan on day 1 and at end of study
Intervention Description
225Ac-J591 (13.3 KBq/Kg - 93.3 KBq/Kg or 0.36 uCi/Kg - 2.52 uCi/Kg) on day 1
Primary Outcome Measure Information:
Title
Number of Subjects With Dose Limiting Toxicities (DLT)
Description
Count of participants will be measured by the recommended phase II dose in utilizing the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 for DLTs.
Time Frame
Assessed from start of treatment to up to 8 weeks after first study drug administration.
Title
Number of Subjects Who Reached Maximum Tolerated Dose (MTD)
Description
The MTD is the highest dose amongst the different dose-level cohorts in this study at which no more than 2 (33%) of the subjects in a cohort experience DLT.
Time Frame
Assessed from start of treatment to up to 8 weeks after first study drug administration.
Secondary Outcome Measure Information:
Title
Number of Subjects With Prostate Specific Antigen (PSA) Response
Description
PSA will be analyzed through blood specimen collection
Time Frame
PSA was assessed at screening, and up to 6 months after first treatment with study drug.
Title
Number of Subjects With Circulating Tumor Cells (CTC) Response
Description
CTCs will be analyzed through blood specimen collection via CellSearch methodology lab testing
Time Frame
CTC was assessed at screening and 12 weeks after starting study drug.
Title
Number of Subjects With Radiographic (Imaging) Response
Description
Radiographic response rate by Response evaluation criteria in solid tumors (RECIST) criteria with Prostate Cancer Working Group 3 (PCWG3) modifications
Time Frame
Response were assessed for patients throughout their duration on the study, up to 3 years.
Title
Progression Free Survival (PFS)
Description
Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time Frame
From the start of treatment to progression, up to 3 years

10. Eligibility

Sex
Male
Gender Based
Yes
Gender Eligibility Description
Adult male patients of >18 years age with documented progressive metastatic CRPC
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed adenocarcinoma of prostate Documented progressive metastatic CRPC based on Prostate Cancer Working Group 3 (PCWG3) criteria, which includes at least one of the following criteria: PSA progression Objective radiographic progression in soft tissue New bone lesions ECOG performance status of 0-2 Have serum testosterone < 50 ng/dL. Subjects must continue primary androgen deprivation with an LHRH analogue (agonist/antagonist) if they have not undergone bilateral orchiectomy. Have previously been treated with at least one of the following: Androgen receptor signaling inhibitor (such as enzalutamide) CYP 17 inhibitor (such as abiraterone acetate) Have previously received taxane chemotherapy, been determined to be ineligible for taxane chemotherapy by their physician, or refused taxane chemotherapy. Age > 18 years Patients must have normal organ and marrow function as defined below: Absolute neutrophil count >2,000 cells/mm3 Hemoglobin ≥9 g/dL Platelet count >150,000 x 109/microliter Serum creatinine <1.5 x upper limit of normal (ULN) or calculated creatinine clearance ≥ 60 mL/min/1.73 m2 by Cockcroft-Gault Serum total bilirubin <1.5 x ULN (unless due to Gilbert's syndrome in which case direct bilirubin must be normal Serum AST and ALT <3 x ULN in absence of liver metastases; <5x ULN if due to liver metastases (in both circumstances, bilirubin must meet entry criteria) Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Implantation of investigational medical device ≤4 weeks of Cycle 1, Day 1 or current enrollment in oncologic investigational drug or device study Use of investigational drugs ≤4 weeks or <5 half-lives of Cycle 1, Day 1 or current enrollment in investigational oncology drug or device study Prior systemic beta-emitting bone-seeking radioisotopes Known active brain metastases or leptomeningeal disease History of deep vein thrombosis and/or pulmonary embolus within 1 month of C1D1 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 Radiation therapy for treatment of PC ≤4 weeks of Day 1 Cycle 1 Patients on stable dose of bisphosphonates or Denosumab, which have been started no less than 4 weeks prior to treatment start, may continue on this medication, however patients are not allowed to initiate bisphosphonate/Denosumab therapy during the DLT-assessment period of the study. Having partners of childbearing potential and not willing to use a method of birth control deemed acceptable by the principle investigator and chairperson during the study and for 1 month after last study drug administration 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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Tagawa, MD
Organizational Affiliation
Weill Medical College of Cornell University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tulane Cancer Center Clinic
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Weill Cornell Medical College
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33465252
Citation
Vlachostergios PJ, Niaz MJ, Skafida M, Mosallaie SA, Thomas C, Christos PJ, Osborne JR, Molina AM, Nanus DM, Bander NH, Tagawa ST. Imaging expression of prostate-specific membrane antigen and response to PSMA-targeted beta-emitting radionuclide therapies in metastatic castration-resistant prostate cancer. Prostate. 2021 Apr;81(5):279-285. doi: 10.1002/pros.24104. Epub 2021 Jan 19.
Results Reference
derived

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Phase I Trial of 225Ac-J591 in Patients With mCRPC

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