Safety, Tolerability, Pharmacokinetics, and Efficacy of Acapatamab in Subjects With mCRPC
Metastatic Castration-resistant Prostate Cancer, Prostate Cancer

About this trial
This is an interventional treatment trial for Metastatic Castration-resistant Prostate Cancer focused on measuring acapatamab, HLE-BiTE®, mCRPC, Metastatic Castration-resistant Prostate Cancer, Prostate cancer, PSMA, BiTE®, Bispecific T-Cell engager, Immunotherapy, Immuno-oncology, Immunooncology, Solid tumor, PSMA Targeted Therapy
Eligibility Criteria
All Parts
Inclusion Criteria:
- Subject has provided informed consent prior to initiation of any study specific activities/procedures
- Subjects with histologically or cytologically confirmed mCRPC who are refractory to a novel antiandrogen therapy (abiraterone, enzalutamide, and/or apalutamide) and have failed at least 1 (but not more than 2) taxane regimens (or who are deemed medically unsuitable to be treated with a taxane regimen or have actively refused treatment with a taxane regimen). Progression on novel antiandrogen therapy may have occurred in the non-metastatic CRPC setting
- Subjects must have undergone bilateral orchiectomy or must be on continuous ADT with a gonadotropin releasing hormone (GnRH) agonist or antagonist
- Total serum testosterone </= 50 ng/dL or 1.7 nmol/L
- Evidence of progressive disease, defined as 1 or more PCWG3 criteria:
- PSA level >/= 1 ng/mL that has increased on at least 2 successive occasions at least 1 week apart
- nodal or visceral progression as defined by RECIST 1.1 with PCGW3 modifications
- appearance of 2 or more new lesions in bone scan
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 - 1
- Life expectancy >/= 6months
Exclusion Criteria:
- Any anticancer therapy or immunotherapy within 4 weeks of start of first dose, not including luteinizing hormone-releasing hormone agonist (LHRH)/GnRH analogue (agonist/antagonist). Subjects on a stable bisophosphonate or denosumab regimen for >/= 30 days prior to randomization are eligible
- Prior PSMA-targeted therapy (subjects on prior therapy may be eligible if discussed with Amgen medical monitor prior to enrollment)
- Central nervous system (CNS) metastases, leptomeningeal disease, or spinal cord compression
- Active autoimmune disease or any other diseases requiring immunosuppressive therapy while on study
- Needing chronic systemic corticosteroid therapy (prednisone > 10 mg per day or equivalent) or any other immunosuppressive therapies (including anti-tumor necrosis factor alpha [TNF alpha] therapies) unless stopped 7 days prior to start of first dose
- Myocardial infarction, unstable angina, cardiac arrhythmia requiring medication, and/or symptomatic congestive heart failure (New York Heart Association > class II) within 12 months of first dose of acapatamab
Part 2 only:
- Subjects on a prior PD-1 or PD-L1 inhibitor who experienced a Grade 3 or higher immune-related adverse event prior to first day of dosing
- History or evidence of interstitial lung disease or active, non-infectious pneumonitis
Part 3 only:
- Evidence of active tuberculosis on chest radiograph within 3 months prior to the first dose of investigational product
Part 6 only:
Subjects are excluded from this cohort if any of the following additional criteria apply:
- Subjects taking strong OAT3 inhibitors (eg, probenecid) or adjust the dosing to 1 mg PO QD.
- Subjects with latent or active tuberculosis at screening
Sites / Locations
- El Camino Hospital
- City of Hope National Medical Center
- City of Hope at Long Beach Elm
- University of California Los Angeles
- Emory University
- Indiana University
- University of Iowa Hospitals and Clinics
- Tulane Medical Center
- Washington University
- Comprehensive Cancer Centers of Nevada
- Memorial Sloan Kettering Cancer Center
- Weill Cornell Medical College
- University of Texas Southwestern Medical Center
- Chris OBrien Lifehouse
- Scientia Clinical Research Ltd
- Peter MacCallum Cancer Centre
- Ordensklinikum Linz Elisabethinen
- Landeskrankenhaus Salzburg
- Krankenhaus der Barmherzigen Brueder Wien
- Universitaetsklinikum Allgemeines Krankenhaus Wien
- Universite Catholique de Louvain Cliniques Universitaires Saint Luc
- Universitair Ziekenhuis Gent
- BC Cancer Vancouver
- Institut Gustave Roussy
- National Cancer Center Hospital East
- Yokohama City University Medical Center
- Erasmus Medisch Centrum
- National University Hospital
- National Cancer Centre Singapore
- Linkou Chang Gung Memorial Hospital of Chang Gung Medical Foundation
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Part 1 Dose-exploration: acapatamab treatment
Part 1 Dose-expansion: acapatamab treatment
Part 2: acapatamab + Pembrolizumab
Part 3: acapatamab + Etanercept Prophylaxis
Part 4: acapatamab 24 Hour Monitoring
Part 5: acapatamab Outpatient Cohort
Part 6: acapatamab + Cytochrome P450 (CYP) Cocktail Drug Interaction
Part 1 dose-exploration: acapatamab is administered intravenously. The dose-exploration phase of the study will estimate the MTD of acapatamab. RP2D may be identified based on emerging safety, efficacy, and pharmacodynamic data prior to reaching an MTD.
Part 1 dose-expansion: acapatamab is administered intravenously at the MTD/RP2D.
Part 2: acapatamab is administered intravenously at the MTD/RP2D. Pembrolizumab will be administered intravenously.
Part 3: acapatamab is administered intravenously at RP2D/MTD levels. Etanercept will be administered subcutaneously in cycle 1 only.
Part 4: acapatamab is administered intravenously at RP2D/MTD with 24-hour monitoring.
Part 5: acapatamab is administered intravenously at RP2D/MTD in an outpatient setting with 8-hour monitoring.
Part 6: acapatamab is administered intravenously at RP2D/MTD. A CYP phenotyping cocktail will be administered orally.