Study of Lutetium (177Lu) Vipivotide Tetraxetan in mCRPC Participants With Moderately and Severely Impaired and With Normal Renal Function
Conditions
Metastatic Castration-Resistant Prostate Cancer (mCRPC)Drugs
AAA617, 68Ga-PSMA-11Summary
This study will address health authorities' requests to determine whether moderate and severe renal impairment have an impact on the biodistribution, dosimetry and safety of lutetium (177Lu) vipivotide tetraxetan (AAA617) administered to participants with progressive PSMA-positive metastatic castration-resistant prostate cancer. The study will also characterize the risk of QT prolongation of AAA617 in this participant population.
Detailed Description
This open-label, non-randomized, multicenter, single arm phase II study in mCRPC participants aims to better characterize the safety and tolerability of AAA617 in participants with moderate and severe renal impairment compared with normal renal function. Since both severe and moderate renal impairment have very low incidence within mCRPC participant population compared to participants with normal renal function, the enrollment will occur in parallel for the 3 cohorts; participants will be stratified in one of the three cohorts (A:normal, B: moderate or C: severe) based on their eGFR at screening.
All participants will undergo a 68Ga-PSMA-11 PET/CT scan at screening to confirm PSMA positivity.
Participants will receive a dose of 7.4 GBq (±10%) of AAA617 once every 6 weeks for a planned 6 cycles for cohorts A and B and for 3 cycles (and 3 additional cycles) for cohort C.
After treatment period, participants will be asked to join a long term follow up (LTFU) study to monitor their safety up to 10 years after the 1st dose of AAA617. In case of the LTFU study is not available at the time of end of treatment period (safety follow-up visit), participants will continue in Long Term Follow-up period in this study for up to one year until they can roll over into the separate LTFU study.
The primary outcome will be to determine the effect of radiation absorption in kidney and other organs at risk as well as the concentration in blood and radioactivity in urine in PSMA- positive mCRPC participants with moderate and severe renal impairment. In addition, the study will assess the relationship between drug concentrations and QTcF.
20 participants with 6 countries are expected to be included with at least 6 evaluable participantts per cohort.
Locations
1 location Found with status Recruiting
Status
- RECRUITING
Contact Person
- Dylan Magistro
- 212-241-6500
- [email protected]
Study Director
- Novartis Pharmaceuticals
Eligibility Criteria
Key Inclusion Criteria:
1. An Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
2. 68Ga-PSMA-11 Positron emission tomography (PET)/CT scan positive, and eligible as determined by the sponsor's central reader.
3. A castrate level of serum/plasma testosterone (< 50 ng/dL or < 1.7 nmol/L).
4. Documented progressive mCRPC will be based on at least 1 of the following criteria:
* Serum/plasma Prostate-Specific Antigen (PSA) progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL
* Soft-tissue progression defined as an increase >= 20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions.
* Progression of bone disease: evaluable disease or new bone lesions(s) by bone scan (2+2 PCWG3 criteria)
5. Documented stable renal disease without evidence of renal progressive disease (stable renal disease is defined as no significant change, such as a stable eGFR, within 4 weeks prior to study entry)
6. Kidney function based on eGFR by Modification of Diet in Renal Disease (MDRD) equation:
* Normal renal function: participants with eGFR >= 90 mL/min
* Moderate renal impairment: participants with eGFR >= 30 to =< 59 mL/min
* Severe renal impairment: participants with eGFR >= 15 to =< 29 mL/min
Key Exclusion Criteria:
1. Previous treatment with PSMA-targeted radioligand therapy.
2. Previous treatment with any of the following within 6 months of enrollment confirmation: Strontium-89, Samarium-153, Rhenium-186, Rhenium-188, Radium-223 or hemi-body irradiation.
3. Use of agents known to prolong the QT interval from start of screening to end of Cycle 1, unless they can be permanently discontinued for the duration of study.
4. Current severe urinary incontinence, hydronephrosis, severe voiding dysfunction, any level of urinary obstruction requiring indwelling/condom catheters. Participants with postrenal impairment, like obstructions, retroperitoneal fibrosis (eg after prostectomy) must be excluded or first resolved to ≤ Grade 1.
5. History or current diagnosis of ECG abnormalities indicating significant risk of safety for participants participating in the study such as:
* Concomitant clinically significant cardiac arrhythmias, e.g. sustained ventricular tachycardia, and clinically significant second- or third-degree AV block without a pacemaker.
* History of familial long QT syndrome or known family history of Torsades de Pointe.
* Resting heart rate (physical exam or 12 lead ECG) <60 bpm
Other protocol-defined inclusion/exclusion criteria may apply.
Study Plan
AAA617
EXPERIMENTAL
Participants will receive a dose of 7.4 GBq (200 mCi) +/- 10% of AAA617 which will be administered once every 6 weeks (1 cycle) for 3 to 6 cycles according to eGFR calculation at screening and radiation absorbed dose results from Cycle1 Day1.
DRUG:
AAA617Description:
Administered intravenously once every cycles (1 cycle = 6 weeks)DRUG:
68Ga-PSMA-11Description:
Single intravenous dose of approximately 150 MBq
Outcome Measures
Primary Outcome Measures
Absorbed radiation dose in kidneys and selected organs
Concentrations of AAA617 in blood over time
Area under the serum concentration-time curve from time zero to the time of last quantifiable concentration (AUClast) of 177Lu-PSMA-617
Time of maximum observed drug concentration occurrence (Tmax) of 177Lu-PSMA-617
Observed maximum plasma concentration (Cmax) of 177Lu-PSMA-617
Terminal elimination half-life (T^1/2) of 177Lu-PSMA-617
Area under the concentration-time curve from time zero (pre-dose) extrapolated to infinite time (AUCinf) of 177Lu-PSMA-617
Total systemic clearance for intravenous administration (CL) of 177Lu-PSMA-617
Volume of distribution during the terminal phase following intravenous elimination (Vz) of 177Lu-PSMA-617
Renal clearance of 177Lu-PSMA-617
Change from baseline in eGFR
Dose modifications for AAA617
Dose intensity for AAA617
Secondary Outcome Measures
Change from baseline in QTcF interval (u0394QTcF)
Relationship between drug concentrations and QTcF
Overall Response Rate (ORR)
Disease Control Rate (DCR)
PSA50 response
Timeline
Last Updated
April 18, 2025Start Date
August 22, 2023Today
November 1, 2025Completion Date ( Estimated )
October 1, 2026
Sponsors of this trial
Lead Sponsor
Novartis Pharmaceuticals