A Phase Ib/II Open-label Study of AMO959 With Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI in Adult Participants With PSMA-positive mCRPC

Trial statusRecruiting
Trial phasePhase 1, Phase 2
Trial typeInterventional
Biological sexMale
Age18+
SponsorNovartis Pharmaceuticals

About this trial

The purpose of this phase Ib/II study is to (a) in Phase Ib evaluate the safety, tolerability, and pharmacokinetics (PK) of AMO959 when given in combination with lutetium (177Lu) vipivotide tetraxetan (also known as \[177Lu\]Lu-PSMA-617 or 177Lu-PSMA-617 and hereafter referred to as AAA617) with an androgen receptor pathway inhibitor (ARPI) in participants with metastatic castration resistant prostate cancer (mCRPC) who have failed one prior ARPI and with or without prior taxane exposure, and (b) in Phase II evaluate the preliminary efficacy of AMO959 in combination with AAA617 and ARPI in participants with mCRPC who have failed one prior ARPI, but who have not yet been exposed to taxane treatment.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Signed informed consent must be obtained prior to participation in the study.

Participants must be adults ≥ 18 years of age.

Participants must have an ECOG performance status of 0 to 2.

Participants must have histologically confirmed adenocarcinoma of the prostate. Participants with other histology (e.g. neuroendocrine, intraductal subtype) are not eligible.

Disqualifiers

Concurrent local (radiation therapy to the prostate with curative intent or other prostate antineoplastic ablative procedures) or systemic (hormonal ablation, chemotherapy, immunotherapy, , RLTs) antineoplastic treatments, or within 28 days of enrollment (Phase Ib) or randomization (Phase II)

Prior treatment with any RLT or PSMA-targeted agents (approved or investigational)

Any other investigational agents within 28 days prior to first dose of any study treatment

Concurrent serious medical conditions that may interfere with study procedures or followup

Trial design

Design model

Sequential

Treatments tested in this trial

  • AMO959

    Drug

    DNA Damage Response inhibitor

  • AAA617

    Radiation

    PSMA-targeted radiopharmaceutical

  • Enzalutamide

    Drug

    Androgen receptor pathway inhibitor

  • Abiraterone

    Drug

    Androgen receptor pathway inhibitor

Treatment groups

123 Participants
are divided into 6 treatment groups

6

Treatment groups

See each treatment group below.

Group A: Phase 1b: DoubletExperimental treatment 2 interventions
Group B: Phase 1b: TripletExperimental treatment 4 interventions
Group C: Phase 1b: Food EffectExperimental treatment 2 interventions
Group D: Phase II: Arm 1Experimental treatment 4 interventions
Group E: Phase II: Arm 2Experimental treatment 4 interventions
Group F: Phase II: Arm 3Experimental treatment 3 interventions

Trial outcomes

Primary outcomes

1

Phase Ib: Incidence rate of Dose-limiting toxicities (DLTs)

Incidence of dose limiting toxicities (DLTs) with AMO959 in combination with AAA617 +/- ARPI A dose-limiting toxicity (DLT) is defined as an adverse event or abnormal laboratory value assessed as unrelated to disease, disease progression, inter-current illness/injury, or concomitant medications that occurs within the evaluation period and meets any of the criteria specified in the protocol. The National Cancer Institute Common Terminology Criteria for Adverse events (NCI CTCAE) version 5.0 will be used for all grading.

Time frame
Up to 42 days after the first AAA617 dose administration
2

Phase Ib: Incidence rate of Adverse Events (AEs) and Serious Adverse Events (SAEs)

Incidence of adverse events by type, frequency, and severity, as graded by the NCI CTCAE version 5.0.

Time frame
From date of start of study treatment, assessed up to approximately 45 months
3

Phase Ib: Number of Participants with dose adjustments

The number of participants with dose adjustments (reductions, interruption, or permanent discontinuation).

Time frame
From date of start of study treatment, assessed up to approximately 24 months
4

Phase Ib: Dose Intensity

Dose intensity (computed as the ratio of actual cumulative dose received and actual duration of exposure) and the relative dose intensity (computed as the ratio of dose intensity and planned dose intensity).

Time frame
From date of start of study treatment, assessed up to approximately 24 months

Secondary outcomes

1

Prostate Specific Antigen 90 (PSA90) response

PSA90 response is defined as the proportion of participants who have achieved a ≥ 90% decrease in PSA from baseline at any time during the treatment period prior to start of new anti-cancer therapy that is confirmed by a second PSA measurement ≥4 weeks later.

Time frame
From date of start of study treatment, assessed up to approximately 24 months
2

Phase Ib: Prostate Specific Antigen 50 (PSA50) response

PSA50 response is defined as the proportion of participants who have achieved a ≥ 50% decrease in PSA from baseline at any time during the treatment period prior to the start of new anti-cancer therapy, confirmed by a second PSA measurement ≥4 weeks later.

Time frame
From date of start of study treatment, assessed up to approximately 24 months
3

Phase Ib and Phase II: Radiographic progression-free survival (rPFS)

Radiographic progression- free survival (rPFS) is defined as the time from the date of start of study treatment (Phase Ib) / randomization (Phase II) to the date of first documented radiographic disease progression using conventional imaging and Prostate Cancer Working Group 3 (PCWG3)-modified RECIST v1.1 criteria (Scher et al 2016) or death due to any cause, whichever occurs first.

Time frame
From date of start of study treatment (Phase Ib) / randomization (Phase II), assessed up to approximately 24 months
4

Phase Ib and Phase II: Overall Response Rate (ORR)

Overall Response Rate (ORR) is defined as the proportion of participants with best overall response (BOR) of confirmed complete response (CR) or partial response (PR) in soft tissue based on tumor response data and according to PCWG3-modified RECIST v1.1, in the absence of bone progression as per PCWG3.

Time frame
From date of start of study treatment (Phase Ib) / randomization (Phase II), assessed up to approximately 24 months

Other outcomes

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