Radioligand Therapy after PSMA PET Guided External Beam Radiotherapy for Treating Post-Prostatectomy Patients with Biochemically Recurrent Prostate Cancer
Prostate Cancer
Unknown Primary
RAD5633-23 (primary)
NCI-2023-03480
STUDY00005677
Summary
This phase I trial tests the safety, side effects and best dose of radioligand therapy (lutetium Lu 177 PSMA-10.1 [177Lu-rhPSMA-10.1]) after prostate specific membrane antigen (PSMA) positron emission tomography (PET)-guided external beam radiotherapy in treating post-prostatectomy patients with prostate cancer that has come back after a period of improvement (recurrent). In this study, radioligand therapy is a radioactive drug called 177Lu-rhPSMA-10.1. It works by binding to PSMA-expressing prostate tumor cells and delivering the radioactive portion of the drug directly to the tumor cells while not harming normal cells. Radiation therapy such as external beam radiotherapy uses high energy x-rays to kill tumor cells and shrink tumors. Giving radioligand therapy with PSMA PET-guided external beam radiotherapy may kill more tumor cells in post-prostatectomy patients with biochemically recurrent prostate cancer.
Objectives
PRIMARY OBJECTIVES:
I. Demonstrate the safety and feasibility of treating radiotherapy (RT) prostate cancer patients via addition of lutetium Lu 177 PSMA-10.1 (177Lu-rhPSMA-10.1) in a selected post-prostatectomy population.
II. Analyze dosimetry of radioligand therapy (RLT) after each cycle of 177Lu-rhPSMA-10.1.
EXPLORATORY OBJECTIVE:
I. Determine the feasibility of and develop preliminary data in the correlation of circulating tumor circulating tumor deoxyribonucleic acid (ctDNA) at baseline, after RT, and RLT.
OUTLINE: This is a dose-escalation study of 177Lu-rhPSMA-10.1.
Patients undergo external beam radiation therapy (EBRT) followed by 177Lu-rhPSMA-10.1 intravenously (IV) on study. Patients also receive flotufolastat F-18 gallium (rhPSMA-7.3) IV with positron emission tomography (PET)/computed tomography (CT) at screening and undergo single-photon emission computed tomography (SPECT)-CT and collection of blood samples on study.
Patients follow up 6 weeks after the last 177Lu-rhPSMA-10.1 administration.
Eligibility
- Adenocarcinoma of the prostate, post radical prostatectomy with detectable prostate specific antigen (PSA)
- Clinical PSMA PET/CT obtained, with findings of pelvic uptake only (prostate bed, pelvic lymph node uptake, or both)
- Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status of 0-2
- Age over 18
Treatment Sites in Georgia
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