Open-Label, Phase 2 Clinical Trial of Pre-Radiation and Post-Radiation Immunotherapy With N-803, ETBX-071, and M-CENK in Combination With Radiation for Participants With High-Risk Prostate Cancer
试验速览
- 阶段
- 2 期
- 状态
- 撤回
- 入组人数
- 20
- 主要终点
- Complete Pathologic Response (CPR) after pre-radiation immunotherapy.
研究概览
简要总结
This study tests a new treatment for men with high-risk prostate cancer who can't have surgery. The treatment combines three experimental drugs and radiation therapy. Researchers will track how well the treatment works and how safe it is. The study will last about five years.
详细描述
This study (ResQ110B-PROS, IND 027158) is a Phase 2, open-label clinical trial designed to assess the safety and efficacy of a novel, multi-component treatment strategy for men with high-risk prostate cancer who are unsuitable for prostatectomy. The experimental treatment combines three investigational products with standard external beam radiation therapy (EBRT). The study is interventional, not observational.
The Investigational Products:
N-803 (nogapendekin alfa inbakicept): A soluble complex of an IL-15 variant bound to a human IL-15 receptor alpha subunit/human IgG1 Fc fusion protein. It acts as a growth and activation factor for NK cells and effector and memory T cells, aiming to stimulate the immune system's response to the cancer. Administered subcutaneously (SC).
ETBX-071 (hAd5 [E1-, E2b-, E3-]-PSA): A replication-defective human adenovirus serotype 5 (hAd5) vector modified to encode human prostate-specific antigen (PSA). This acts as a cancer vaccine, designed to generate an immune response targeting PSA-expressing prostate cancer cells. Administered subcutaneously (SC).
M-CENK (cytokine-induced memory-like NK cells): Autologous natural killer (NK) cells expanded and modified ex vivo using a cytokine cocktail (IL-12, IL-15, and IL-18) to enhance their cytotoxic activity and persistence. These cells are administered intravenously (IV).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •The inclusion criteria:
- •Age: ≥18 years old.
- •Ability to understand and provide informed consent: Participants must be able to understand the study and provide written informed consent fulfilling all relevant Institutional Review Board (IRB) or Independent Ethics Committee (IEC) guidelines.
- •Histologically confirmed prostate adenocarcinoma: A diagnosis confirmed through a pathology report or a clinical course consistent with the disease, as determined by a local pathologist, if a pathology specimen is unavailable.
- •ECOG performance status: 0 or 1 (fully active or restricted in strenuous activity but ambulatory).
- •Life expectancy: >5 years.
- •Germline testing: Must have germline testing completed at the time of initial diagnosis and, if applicable, at recurrence.
- •No evidence of distant metastasis: No evidence of soft tissue disease metastasis (visceral or lymph nodes) on CT/MRI scan.
- •No active or organ-threatening autoimmune disease: Participants must not have an active or organ-threatening autoimmune disease.
- •High-risk or very high-risk prostate cancer: Based on 2024 NCCN guidelines: PSA >20 ng/mL or Gleason Grade Group ≥4 or ≥cT3a.
- •Adequate hematologic and organ function: Defined by specific laboratory values (ANC, lymphocyte count, platelet count, hemoglobin, INR/aPTT, AST, ALT, alkaline phosphatase) obtained within 14 days prior to baseline, with specific exceptions stated in the protocol for participants with liver or bone metastases or those with known Gilbert disease.
- •Ability to attend study visits and return for adequate follow-up.
- •Agreement to practice effective contraception: Non-sterile males must agree to use effective contraception (condom, vasectomy, or other barrier methods) for up to 7 months after treatment.
排除标准
- •Prior treatment for prostate cancer: Participants who have undergone any prior surgical, cryotherapy, or high-intensity focused ultrasound treatment for prostate cancer are excluded.
- •Prior hormonal therapy: Prior orchiectomy or hormonal therapy (GnRH agonists, NSAA) is an exclusion criterion.
- •Prior treatment with androgen receptor (AR) inhibitors: Prior treatment with first-generation (bicalutamide, flutamide, nilutamide, cyproterone acetate) or second-generation (enzalutamide, apalutamide, or darolutamide) AR inhibitors is an exclusion criterion.
- •Organ transplantation: Receipt of any organ transplantation (excluding those not requiring immunosuppression, such as corneal or hair transplants) excludes participants from the study.
- •Chronic systemic corticosteroid use: Chronic administration (>14 days) of systemic corticosteroids within 28 days of study treatment initiation excludes participants. However, minimal systemic absorption (inhaled steroids, nasal sprays, topical agents) is permitted.
- •Active autoimmune disease: Active autoimmune diseases (Addison's disease, Hashimoto's thyroiditis, systemic lupus erythematosus, Sjögren syndrome, scleroderma, myasthenia gravis, Goodpasture syndrome, or active Grave's disease) exclude participants. However, a history of autoimmunity that did not require systemic immunosuppression and did not threaten vital organ function is permitted.
- •Use of medications affecting PSA: Use of medications known to alter PSA levels (5-alpha reductase inhibitors, phytoestrogens, saw palmetto) within 28 days before study treatment initiation excludes participants.
- •Major surgery: Major surgery within 28 days of study treatment initiation excludes participants.
- •Systemic therapy: Systemic therapy (including any investigational therapy) within 28 days of study treatment initiation is an exclusion criterion.
- •Allergic reactions: A history of allergic reactions to compounds with similar chemical or biologic composition to the study drugs excludes participants.
- •Clinically significant cardiovascular/cerebrovascular disease: This includes cerebral vascular accident/stroke, myocardial infarction, or unstable angina, congestive heart failure, or uncontrolled hypertension within specific timeframes before study enrollment.
- •Serious intercurrent medical illness: Any serious intercurrent medical illness that could interfere with treatment participation.
- •Active infections: Active HIV, hepatitis B (positive HBsAg), or hepatitis C infections exclude participation.
- •Live attenuated vaccine administration: Administration of a live, attenuated vaccine within 3 weeks prior to study entry or anticipated during the study.
- •Inability or unwillingness to comply: Participants assessed by the investigator as unable or unwilling to comply with the study requirements are excluded.
研究组 & 干预措施
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: External Beam Radiation Therapy (EBRT) (Radiation)
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: N-803 (IL-15 Superagonist) (Drug)
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: ETBX-071 (PSA-based Oncolytic Virus) (Drug)
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: M-CENK (Activated NK Cells) (Drug)
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: Androgen Deprivation Therapy (ADT) (Radiation)
Standard of care + Radiation therapy
Combination of N-803, ETBX-071, and M-CENK, along with radiation therapy.
干预措施: Post-radiation immunotherapy (Radiation)
结局指标
主要结局
Complete Pathologic Response (CPR) after pre-radiation immunotherapy.
时间窗: CPR: Assessed within approximately 6 weeks of study start.
Complete Pathologic Response (CPR) after pre-radiation immunotherapy: Assesses the complete absence of cancer in tissue samples taken after the pre-radiation immunotherapy phase. This signifies a complete eradication of the cancer at that stage of the treatment process.
PSA30 response at end-of-treatment (EOT) after post-radiation immunotherapy
时间窗: Assessed at EOT, which occurs roughly 30 to 39 weeks after the study begins.
Measures a ≥30% reduction in Prostate-Specific Antigen (PSA) levels from baseline to the end of treatment. PSA is a common biomarker used to monitor prostate cancer treatment success. A decrease in PSA suggests successful treatment in reducing the cancer burden.
次要结局
- Clinical Pathologic Response (after pre-radiation immunotherapy)(Within approximately 6 weeks of the study start.)
- Time to Recurrence Interval (TTRI)(Variable, ranging from the end of radiation therapy (around 2-9 weeks after pre-radiation immunotherapy, depending on individual schedules) to up to 5 years (260 weeks).)
- Safety (AEs and SAEs)(Continuous monitoring throughout the entire study duration (approximately 303 weeks).)
