Phase 2 Randomized Trial of Flexible Dosing Schedule of 177Lu-PSMA-617 for the Treatment of Metastatic Castration-Resistant Prostate Cancer (FLEX-MRT)

  • Recruiting
  • Treatment
  • Interventional
  • Randomized
  • Drug & Other
  • PHASE2
  • Jonsson Comprehensive Cancer Center
  • 18 Years -


Study Purpose

In advanced metastatic castration resistant prostate cancer (mCRPC) progressing after chemotherapy and androgen receptor (AR)-targeted therapy 177Lu-PSMA-617 is an effective treatment. 177Lu-PSMA-617 RLT is administered with a fixed schedule: 6 treatment cycles, administered every 6 weeks. However, the optimum number of cycles of 177Lu-PSMA in patients who show good response remains unknown. Some patients may benefit from more than 6 cycles of therapy. Additionally, some patients experience a complete or almost complete response before the last cycle. It is unclear whether these patients benefit from the subsequent remaining treatment cycle(s). A treatment holiday period would spare these patients some exposure to the therapy agent and avoid potentially unnecessary toxicity when treatment efficacy is already maximal and additional treatment effect cannot be expected. This randomized phase 2 study compares a group of patients treated with LuPSMA on a flexible and extended dosing schedule including "treatment holiday" periods (investigational arm, up to 12 cycles, as described below) to a control group treated with a fixed dosing schedule of 6 treatments cycles maximum administered every 6 weeks. The flexible dosing schedule in the investigational arm will be based on single photon emission computed tomography (SPECT)/computed tomography (CT) response assessments obtained 24h after injection of LuPSMA therapy cycle. The response assessment during treatment holiday period will be based on positron emission tomography/computed tomography (PET/CT) every 12 weeks. Single-time point SPECT/CT dosimetry protocol at every cycle will be performed and will allow to determine the number of cycles that subjects may receive under the study without exceeding the kidney dose threshold.

Intervention

Procedure : Computed Tomography

Other : Gallium Ga 68 Gozetotide

Drug : Lutetium Lu 177 Vipivotide Tetraxetan

Procedure : Positron Emission Tomography

Procedure : PSMA PET Scan

Other : Questionnaire Administration

Procedure : Single Photon Emission Computed Tomography


Eligibility Requirements

info icon Patients must have prostate cancer proven by histopathology

info icon Patients must have ≥ 1 metastatic lesion by any imaging (CT, magnetic resonance imaging \[MRI\], bone scan, PET)

info icon Patients must have received at least one regimen of chemotherapy for mCRPC

info icon Patients must have received at least one androgen-receptor signaling inhibitors (ARSI)

info icon Patients must be eligible by PSMA PET VISION criteria. PSMA PET/CT must be performed within 8 weeks of planned first cycle of 177Lu-PSMA-617

info icon White blood cell (WBC) ≥ 2,500/ul

info icon Platelets (PLT) ≥ 100,000/ul

info icon Hemoglobin (Hb) ≥ 9.0 g/dl

info icon Absolute neutrophil count (ANC) ≥ 1,500 mm\^3

info icon Patients must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2

info icon Patients must be adults ≥ 18 years of age

info icon Patients must have the ability to understand and sign an approved informed consent form (ICF)

info icon Patients must have the ability to understand and comply with all protocol requirements

info icon Prior cycle of 177Lu-PSMA-617 therapy

info icon Less than 6 weeks between last myelosuppressive therapy (including docetaxel, cabazitaxel, strontium-89, samarium-153, rhenium-186, rhenium-188, radium-223, hemi-body irradiation) and first cycle of 177Lu-PSMA-617 therapy

info icon Glomerular filtration rate (GFR) \< 50 ml/min

info icon Urinary tract obstruction or marked hydronephrosis

Recruiting status

Recruiting

Estimated enrollment

90

 
Study start date

Aug 01, 2024

Study end date

Dec 31, 2028

Last updated

Mar 23, 2025

Primary purpose

Treatment

Design

Interventional

Intervention

Drug & Other

Study phase

PHASE2

Allocation

Randomized

 

Sponsor:

Jonsson Comprehensive Cancer Center

Collaborator:

Novartis Pharmaceuticals

Investigator:

Jeremie Calais

NCT06216249

Clinic Location Investigator Distance RECRUITING STATUS Contact