The FDA has granted Fast Track designation to Perspective Therapeutics' VMT01 for the diagnosis and treatment of unresectable or metastatic melanoma that expresses the melanocortin 1 receptor (MC1R). This designation is intended to accelerate the development and review of VMT01, a targeted alpha-particle therapy, offering a potential new treatment option for patients with this aggressive form of skin cancer.
VMT01 is designed to target and deliver the alpha-emitting isotope 212Pb to tumor sites that overexpress MC1R, a protein frequently found in metastatic melanoma. The therapy utilizes a proprietary clinical-stage low molecular weight peptide, which can also be labeled with 203Pb for patient selection, diagnostic imaging, and dosimetry via SPECT imaging.
Clinical Development and Trial Design
VMT01 is currently being evaluated in a Phase 1/2a study (NCT05655312), building upon a completed pilot imaging study at the Mayo Clinic. The ongoing study is a first-in-human, multicenter, open-label, dose escalation and expansion trial involving patients aged 18 to 90 with stage IV metastatic or stage III unresectable, MC1R-positive melanoma who have progressed on at least one prior therapy. Key inclusion criteria include uptake of [68Ga]VMT02 or [203Pb]VMT01 by PET or SPECT imaging, measurable disease per RECIST 1.1 criteria, and an ECOG performance score of 0 or 1.
The dose-escalation phase aims to determine the maximum tolerated dose or maximum feasible dose of [212Pb] VMT01 after a single administration. The dose expansion phase is designed to select the appropriate dose for further clinical trials. A dosimetry sub-study using the imaging surrogate [203Pb] VMT01 is included to evaluate normal organ distribution, tumor uptake, and estimate radiation dosimetry, correlating these factors with observed toxicities and treatment efficacy.
Perspective Therapeutics' Stance
Markus Puhlmann, MD, MBA, chief medical officer of Perspective Therapeutics, stated, "We are pleased with the FDA’s recognition of the need for additional treatment options for patients with metastatic melanoma. We are dedicated to working closely with the agency to accelerate VMT01's clinical development." The company plans to open a VMT01/anti-PD-1 combination cohort, pending institutional review board approval.
Significance of Fast Track Designation
The Fast Track designation allows Perspective Therapeutics to have more frequent interactions with the FDA and makes VMT01 eligible for accelerated approval, priority review, and rolling review. This designation underscores the unmet medical need in metastatic melanoma and the potential of VMT01 to address this need by targeting MC1R-expressing tumors with precision alpha-particle therapy.
