A Phase I Study of [225Ac]-AZD2284 in Patients With Metastatic Castration-Resistant Prostate Cancer

Clinicaltrials.gov ID: NCT06879041
db-list-check Status RECRUITING
b-loader Phase PHASE1
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 134

Conditions

Metastatic Castration-Resistant Prostate Cancer

Drugs

AZD2287, AZD2275, AZD2284

Summary

The main purpose of the study is to assess the safety and tolerability of AZD2284, AZD2287, and AZD2275.

Detailed Description

This is a first-in-human, Phase I, non-randomized, open-label clinical trial designed to evaluate AZD2284, AZD2287, and AZD2275.

This trial will consist of 2 Parts:

Part A (Imaging):

* Part A (Cold Antibody Exploration): aims to determine the optimal dosing regimen, with or without unconjugated antibody (AZD2275) pre-administration to improve the biodistribution of AZD2287.
* Part A Expansion: aims to explore the prevalence of PSMA and STEAP2 expression by imaging.

Part B (Therapeutic):

* Part B (Actinium-225 Dose Escalation): aims to assess the safety, tolerability, and efficacy of escalating doses of AZD2284 informed by the optimal dosing regimen identified in Part A.
* Part B Expansion Cohorts 1 and 2: aims to explore efficacy of AZD2284.

Locations

3 locations Found with status Recruiting

Status

  • RECRUITING

Central Contacts

Status

  • RECRUITING

Central Contacts

Status

  • RECRUITING

Central Contacts

Eligibility Criteria

Main Inclusion Criteria:

* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
* Histologically confirmed diagnosis of adenocarcinoma of the prostate or neuroendocrine differentiated prostate cancer.
* Must have had prior bilateral orchiectomy and/or ongoing androgen-deprivation therapy and a castrate level of serum/plasma testosterone (< 50 ng/dL or < 1.7 nmol/L).
* At least one metastatic lesion present on baseline Computed Tomography (CT), Magnetic Resonance Imaging (MRI), or bone scan obtained ≤ 28 days prior to the first dose of Investigational Medicinal Product (IMP). Participants may have non-measurable lesions including bone only metastases.
* Adequate organ function

Main Exclusion Criteria:

* Treatment with any radiopharmaceutical within 6 weeks of the first dose of Investigational Medicinal Product (IMP).
* Radiation therapy (RT) within 28 days prior to the first dose and all RT-related events have not recovered to Grade ≤ 1.
* Administration of any systemic cytotoxic or investigational therapy ≤ 28 days of the first dose of IMP or 5 half-lives, whichever is shorter.
* All prior treatment-related adverse events must have resolved to Grade ≤ 1.
* Concurrent severe and/or uncontrolled illness not related to cancer and/or social situation that would limit compliance with study requirements.
* Known or suspected allergies or contraindications to any of the investigational drugs or any component of the investigational drug formulation.
* Clinically relevant proteinuria

Study Plan

Part A: Cohort A1: AZD2287 (Hot only)

EXPERIMENTAL

Participants will receive 1 dose of AZD2287. If eligible for treatment, will receive low dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part A: Cohort A2: AZD2275 + AZD2287 (Cold +Hot)

EXPERIMENTAL

Participants will receive low dose of AZD2275 followed by 1 dose of AZD2287. If eligible for treatment, will receive low dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part A: Cohort A3: AZD2275 + AZD2287 (Cold +Hot)

EXPERIMENTAL

Participants will receive medium dose of AZD2275 followed by 1 dose of AZD2287. If eligible for treatment, will receive low dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part A Expansion: AZD2287 + AZD2275 (Cold + Hot)

EXPERIMENTAL

Participants will receive dose of AZD2275 determined earlier in the study followed by 1 dose of AZD2287.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.

Part B (Actinium-225 Dose Escalation): low dose: AZD2284

EXPERIMENTAL

Participants will receive AZD2287 (u00b1 AZD2275 as determined in Part A). If eligible for treatment, will receive low dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part B (Actinium-225 Dose Escalation): medium dose: AZD2284

EXPERIMENTAL

Participants will receive AZD2287 (u00b1 AZD2275 as determined in Part A). If eligible for treatment, will receive medium dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part B (Actinium-225 Dose Escalation): high dose 1: AZD2284

EXPERIMENTAL

Participants will receive AZD2287 (u00b1 AZD2275 as determined in Part A). If eligible for treatment, will receive high dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part B (Actinium-225 Dose Escalation): high dose 2: AZD2284

EXPERIMENTAL

Participants will receive AZD2287 (u00b1 AZD2275 as determined in Part A). If eligible for treatment, will receive high dose of AZD2284.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part B: Cohort E1

EXPERIMENTAL

Participants will receive dose of AZD2284 determined by the earlier results. Expansion cohort may be opened to further characterize the safety and efficacy of the dose level.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Part B: Cohort E2

EXPERIMENTAL

Participants will receive dose of AZD2284 determined by the earlier results. Expansion cohort may be opened to further characterize the safety and efficacy of the dose level.

  • DRUG:

    AZD2287

    Description:

    AZD2287 is administered through intravenous injection.
  • DRUG:

    AZD2275

    Description:

    AZD2275 is administered through intravenous infusion.
  • DRUG:

    AZD2284

    Description:

    AZD2284 is administered through intravenous injection.

Outcome Measures

Primary Outcome Measures

Number of participants with adverse event (AEs)

Time Frame: Part A: From Screening (Day -28) to Day 28; Part B: Screening (Day -42 to Day -14) up to 5 years

Number of participants with Dose Limiting Toxicities (DLTs)

Time Frame: Part B: Screening (Day -42 to Day -14) up to 2 cycles (84 days) of AZD2284

Estimates of residence time

Time Frame: Part A: Up to Day 8 after dosing with AZD2287 on Day 1

Absorbed radiation doses for AZD2287 and AZD2284

Time Frame: Part A: Up to Day 8 after dosing with AZD2287 on Day 1; Part B: Up to Day 8 after dosing with AZD2287 on Day -14

Compare organ uptake of AZD2287 with and without pre-dose administration of AZD2275

Time Frame: Part A: Up to Day 8 after dosing with AZD2287 on Day 1; Part B: Up to Day 8 after dosing with AZD2287 on Day -14

Tumor uptake of AZD2287 in selected regions of interest on SPECT/CT and/or planar images

Time Frame: Part A: Up to Day 8 after dosing with AZD2287 on Day 1; Part B: Up to Day 8 after dosing with AZD2287 on Day -14

Secondary Outcome Measures

Overall Response Rate (ORR)

Time Frame: Up to 12 months after the last dose of AZD2284

Proportion of participants with Prostate-Specific Antigen (PSA) 50

Time Frame: Up to 12 months after the last dose of AZD2284

Proportion of participants with PSA90

Time Frame: Up to 12 months after the last dose of AZD2284

Time to maximum PSA % decline

Time Frame: Up to 12 months after the last dose of AZD2284

Duration of Response (DoR)

Time Frame: Up to 12 months after the last dose of AZD2284

Radiographic Progression Free Survival (rPFS)

Time Frame: Up to 12 months after the last dose of AZD2284

Overall Survival (OS)

Time Frame: Part A: Up to Day 28; Part B: Up to 5 years

Pharmacokinetic Clearance

Time Frame: Part A: Up to Day 28; Part B: Up to Cycle 2 (each cycle is 42 days)

Area under concentration-curve from time 0 to the last quantifiable concentration (AUClast)

Time Frame: Part A: Up to Day 28; Part B: Up to Cycle 2 (each cycle is 42 days)

Maximum observed drug concentration (Cmax)

Time Frame: Part A: Up to Day 28; Part B: Up to Cycle 2 (each cycle is 42 days)

Half-life (t1/2)

Time Frame: Part A: Up to Day 28; Part B: Up to Cycle 2 (each cycle is 42 days)

Changes in plasma concentrations of AZD2287 and AZD2284 following AZD2275 pre-administration compared to AZD2287 and AZD2284 alone

Time Frame: Part A: Up to Day 28; Part B: Up to Cycle 2 (each cycle is 42 days)

Number of participants with positive antidrug antibodies (ADAs)

Time Frame: Part A dose exploration: Up to Day 28; Part B: Up to End of Trial (approximately 1 year)

Timeline

  • Last Updated
    July 23, 2025
  • Start Date
    March 17, 2025
  • Today
    October 27, 2025
  • Completion Date ( Estimated )
    April 16, 2029

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