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177 LuPSMA-617 vs Docetaxel in Metastatic Castration Resistant and PSMA-Positive Prostate Cancer

Phase 2
Active, not recruiting
Conditions
Prostate Cancer
Interventions
Registration Number
NCT04663997
Lead Sponsor
Canadian Cancer Trials Group
Brief Summary

177Lu PSMA 617 is a new type of therapy which is designed to deliver high doses of radiation directly to prostate cancer sites in the body. The purpose of this study is to find out whether 177Lu PSMA 617can slow the growth of prostate cancer compared to standard chemotherapy treatment

Detailed Description

The standard or usual treatment for this disease is a chemotherapy drug called docetaxel, given by intravenous every 3 weeks, for up to 12 treatments.

177Lu-PSMA-617 is a new type of therapy for prostate cancer. Laboratory tests show that it may help slow the growth of prostate cancer. 177Lu-PSMA-617 has been shown to shrink tumours in animals and has been studied in limited numbers of men with prostate cancer and seems promising but it is not clear if it can offer better control of prostate cancer compared to docetaxel chemotherapy .

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
200
Inclusion Criteria
  • Histological evidence of prostate cancer with no evidence of small cell component
  • Patients must have castration resistance and metastatic disease with evidence of biochemical or imaging progression in the setting of surgical/medical castration
  • Progression on treatment with abiraterone and/or enzalutamide, or similar next-generation androgen receptor (AR) targeted therapy
  • Evidence of PSMA positive metastatic disease, as assessed on PSMA-PET imaging studies obtained as part of other clinical trial protocols are mandated, provided they are obtained within a timeframe that meets the requirements of this study. The radiopharmaceuticals must be based on a lysine-urea-glutamate backbone, with a 18F or 68Ga radionuclide label.
  • Prior orchiectomy, or if on LHRH agonist/antagonist then testosterone < 1.7 nmol/L
  • Adequate organ function
  • Recover from all previous cancer treatment toxicities to grade ≤ 2 (as per CTCAE v5.0)
  • Male subject ≥ 18 years of age
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2
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Exclusion Criteria
  • Prior treatment with chemotherapy for castration-resistant disease or prior chemotherapy in the castration-sensitive (hormone-sensitive) setting ≤ 1 year prior to enrollment.
  • Prior treatment with 177Lu-PSMA (including other radiolabeled therapeutic PSMA-ligands) or radio-immunotherapy. Prior treatment with radium-223 is allowed but requires a minimum of a 6-month interval between the last dose of radium-223 and enrollment.
  • Radiotherapy to target lesions (measurable disease) ≤ 12 weeks prior to enrolment.
  • Presence of majority (> 50% of extra-osseous lesions) or large (> 5 cm) soft tissue lesions that are negative on PSMA-Ligand PET/CT or PSMA-Ligand PET/MR
  • Known parenchymal brain metastases
  • Active epidural disease (treated epidural disease is permitted)
  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.
  • Clinically significant cardiac disease
  • Major surgery within 4 weeks of starting study treatment
  • Patients with a history of hypersensitivity to the study drug or components
  • Patients with a clinically significant medical condition which, in the opinion of the treating physician, makes it undesirable for the patient to participate in the study or which could jeopardize compliance with study requirements including, but not limited to: ongoing or active infection, significant uncontrolled hypertension, or sever psychiatric illness/social situations.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
177 Lu-PSMA-617177Lu-PSMA-617-
DocetaxelDocetaxel-
Primary Outcome Measures
NameTimeMethod
Progression-free survival3 years
Secondary Outcome Measures
NameTimeMethod
Progression-free survival rate at 6 months defined by RECIST 1.16 months
Progression-free survival rate at 6 months defined by PSA6 months
Progression-free survival rate at 6 months defined by PCWG 36 months
Second rPFS in patients who meet the criteria for rPFS and cross over to the alternate therapy3 years
Clinical benefit rate (CBR) > 24 weeks (RECIST v1.1).3 years
Time to commencement of third line therapy3 years
Response duration including partial response, complete response or stable disease > 24 (RECIST v1.1)3 years
Overall Survival3 years
Proportions of patients with decreased PSA from baseline and the magnitude of change3 years

e.g. ≥ 30%, ≥ 50%, ≥ 90% decline from baseline

Adverse event (AE) profile (CTCAE v5.0)3 years

Trial Locations

Locations (10)

Tom Baker Cancer Centre

🇨🇦

Calgary, Alberta, Canada

BCCA - Vancouver Cancer Centre

🇨🇦

Vancouver, British Columbia, Canada

University Health Network

🇨🇦

Toronto, Ontario, Canada

Cross Cancer Institute

🇨🇦

Edmonton, Alberta, Canada

Odette Cancer Centre

🇨🇦

Toronto, Ontario, Canada

London Regional Cancer Program

🇨🇦

London, Ontario, Canada

CHUM-Centre Hospitalier de l'Universite de Montreal

🇨🇦

Montreal, Quebec, Canada

The Jewish General Hospital

🇨🇦

Montreal, Quebec, Canada

Hotel-Dieu de Quebec

🇨🇦

Quebec City, Quebec, Canada

CIUSSS de l'Estrie - Centre hospitalier

🇨🇦

Sherbrooke, Quebec, Canada

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