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Radiopharmaceutical
Targeted Radiation + Therapy for Metastatic Prostate Cancer
Phase 2
Recruiting
Led By Nicholas George Nickols, MD PhD
Research Sponsored by VA Office of Research and Development
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
PSMA avid metastatic disease as determined by 18F-DCFPyL: at least one lesion with PSMA avidity greater than that of liver (see Prescribing Information for Pluvicto)
Progressive castration resistant prostate cancer as defined by serum testosterone < 50 ng/mL and one of the following:
Must not have
Small cell/neuroendocrine carcinoma by hematoxylin and eosin light histology (immunohistochemical detection of rare/occasional cells that stain for neuroendocrine markers such as synaptophysin, neuron specific enolase, or chromogranin A is not sufficient to make a diagnosis of small cell/neuroendocrine carcinoma)
Symptomatic local recurrence in the setting of prior curative intent therapy (surgery and/or radiation to the prostate)
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to two years
Awards & highlights
No Placebo-Only Group
Summary
This trial tests a new treatment for metastatic prostate cancer, using radiotherapy, drugs and hormone treatment.
Who is the study for?
Men with advanced prostate cancer that's resistant to hormone therapy can join this trial. They must be fit enough for treatment (ECOG PS 0-2), have metastatic disease confirmed by scans, and agree to use contraception. Men who've had certain treatments or surgeries recently, those with specific other cancers within the last two years, or severe psychiatric issues cannot participate.
What is being tested?
The study is testing if stopping hormone therapy and adding testosterone replacement after targeted radiation therapies can effectively treat advanced prostate cancer. Patients will receive stereotactic ablative radiotherapy and a radiopharmaceutical called Pluvicto; half will also get testosterone replacement.
What are the potential side effects?
Possible side effects include reactions from radiation like skin changes and fatigue, plus potential risks from Pluvicto such as dry mouth, nausea, kidney problems, low blood counts leading to increased infection risk or bleeding tendencies.
Eligibility Criteria
Inclusion Criteria
You may be eligible if you check “Yes” for the criteria belowSelect...
My scans show a cancer spot more active than my liver.
Select...
My prostate cancer is worsening despite low testosterone levels.
Select...
I have been treated with specific prostate cancer medications for at least 4 weeks.
Select...
I have 10 cancer spots visible on special scans that can be treated with targeted radiation.
Select...
My cancer has grown or spread according to recent scans.
Select...
I have been diagnosed with prostate cancer, specifically adenocarcinoma.
Select...
I can take care of myself and perform daily activities.
Select...
I am 18 years old or older.
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My cancer has spread to other parts of my body.
Select...
My scans have shown bone metastases at some point.
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20% of my cancer spread shows on PET scans but not on PSMA scans.
Exclusion Criteria
You may be eligible for the trial if you check “No” for criteria below:Select...
My cancer is confirmed as small cell/neuroendocrine by specific testing, not just by the presence of certain markers.
Select...
My prostate cancer has returned and is causing symptoms after initial treatment aimed at curing it.
Select...
I need urgent radiation therapy due to spinal cord compression.
Select...
My cancer has spread to my liver or brain, but not my lungs.
Select...
I am currently being treated for an infection with antibiotics.
Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ up to two years
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to two years
Treatment Details
Study Objectives
Study objectives can provide a clearer picture of what you can expect from a treatment.Primary study objectives
6-month radiographic progression-free survival (rPFS)
Secondary study objectives
Objective response rate
Overall survival
PSA30, PSA50, PSA90, maximal PSA response
+7 moreAwards & Highlights
No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Trial Design
2Treatment groups
Experimental Treatment
Group I: Arm 2Experimental Treatment3 Interventions
Metastasis directed therapy with stereotactic ablative radiotherapy to all detectable sites of disease plus PSMA radiopharmaceutical therapy and discontinuation of castration, followed by restoration of physiologic testosterone
Group II: Arm 1Experimental Treatment2 Interventions
Metastasis directed therapy with stereotactic ablative radiotherapy to all detectable sites of disease plus PSMA radiopharmaceutical therapy and discontinuation of castration
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
stereotactic ablative radiotherapy
2021
N/A
~10
topical testosterone
2011
Completed Phase 2
~90
Find a Location
Who is running the clinical trial?
VA Office of Research and DevelopmentLead Sponsor
1,658 Previous Clinical Trials
3,361,588 Total Patients Enrolled
15 Trials studying Prostate Cancer
8,919 Patients Enrolled for Prostate Cancer
Nicholas George Nickols, MD PhDPrincipal InvestigatorVA Greater Los Angeles Healthcare System, West Los Angeles, CA
1 Previous Clinical Trials
28 Total Patients Enrolled
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