A Phase II Study of AAA617 Alone and AAA617 in Combination With ARPI in Patients With PSMA PET Scan Positive CRPC

Launched by NOVARTIS PHARMACEUTICALS · Apr 27, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment called AAA617, both on its own and combined with another therapy, for men with a specific type of prostate cancer known as castration-resistant prostate cancer (CRPC) that tests positive for a certain marker called PSMA. The trial aims to find out how effective and safe this treatment is for patients who do not show signs of cancer spread on standard imaging tests like CT or MRI scans. About 120 participants between the ages of 65 to 74 will take part in this study.

To be eligible, participants must be adult men with confirmed prostate cancer who are currently receiving treatment to lower testosterone levels, either through medication or surgery. They should have signs of PSMA-positive disease but no evidence of cancer spread in traditional scans. Additionally, participants must have certain health criteria, like good organ function and a specific rate of prostate-specific antigen (PSA) growth. Those who meet these criteria can expect to receive either AAA617 alone or in combination with the other therapy, and they will be monitored closely for their response to the treatment and any side effects. It's important to note that some patients with manageable urinary issues or specific types of localized disease may still qualify, ensuring a wider range of participants can be included in this important research.

Gender

MALE

Eligibility criteria

• • Key Inclusion criteria
• • Participants must be adults ≥ 18 years of age with signed informed consent prior to participation to study
• • Histologically or cytologically confirmed prostate cancer
• • Participants must have ongoing androgen deprivation therapy with a GnRH agonist/antagonist or prior bilateral orchiectomy
• • Castrate level of serum testosterone (\< 1.7 nmol/l \[50 ng/dl\]) on GnRH agonist or antagonist therapy or after bilateral orchiectomy
• • Participants must have evidence of PSMA-positive disease as seen on a AAA517 or piflufolastat F 18 PET/CT scan at baseline as determined by Blinded Independent Central Review (BICR) based on the methodology proposed in the Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) (Eiber et al 2018). Participants with M1 disease only on PSMA PET scan are allowed to participate
• • Participants must have a negative conventional imaging for M1 disease.
• • PSA Doubling Time (PSADT) of ≤ 10 months
• • Participants must have adequate organ functions: bone marrow reserve, hepatic \& renal
• • Key Exclusion criteria
• • Prior or present evidence of metastatic disease as assessed by CT/MRI locally for soft tissue disease and whole-body radionuclide bone scan for bone disease. Exception: Participants with soft tissue pelvic disease may be eligible (e.g., participants with enlarged lymph nodes below the aortic bifurcation (N1) are eligible if the short axis of the largest lymph node is \<20 mm)
• • Unmanageable concurrent bladder outflow obstruction or urinary incontinence. Note: participants with bladder outflow obstruction or urinary incontinence, which is manageable with best available standard of care (incl. pads, drainage) are allowed
• • Active clinically significant cardiac disease; history of seizure or condition that may pre-dispose to seizure which may require treatment with surgery or radiation therapy
• • Prior therapy with: second generation anti-androgens (e.g., enzalutamide, apalutamide and darolutamide); CYP17 inhibitors (e.g., abiraterone acetate, orteronel, galeterone, ketoconazole; radiopharmaceutical agents (e.g., Strontium-89), PSMA-targeted radioligand therapy; immunotherapy (e.g., sipuleucel-T); chemotherapy, except if administered in the adjuvant/neoadjuvant setting, completed \> 2 years before randomization; any other investigational agents for CRPC; use of estrogens, 5-α reductase inhibitors (finasteride, dutasteride), other steroidogenesis inhibitors (aminoglutethimide) or first-generation anti-androgens (bicalutamide, flutamide, nilutamide, cyproterone) within 28 days before randomization; radiation therapy (external beam radiation therapy \[EBRT\] and brachytherapy within 28 days before randomization
• • Other concurrent cytotoxicity chemotherapy, immunotherapy, radioligand therapy, poly adenosine diphosphate-ribose polymerase (PARP) inhibitor, biological therapy or investigational therapy
• • Other protocol-defined inclusion/exclusion criteria may apply.