Terbium 161 PSMA in Lutetium-177 PSMA Naive Patients
brief summary
In this study it is aimed to analyze the efficacy and safety of Tb-161 PSMA I\&T in the 7.4 GBq activity in a large patient group of Lu-177 PSMA naïve mCRPC patients. 3 cycles of Tb-161 PSMA will be administered with 6 weeks periods. After each cycle a triple bed quantitative single photon emission CT (SPECT)-CT scan from vertex to thigh will be acquired 24 h after every treatment of Tb-161 PSMA. In the first cycle additional time points SPECT-CT acquisitions will be obtained for dosimetric calculations. Details of dosimetry acquisitions will be provided by dosimetry partner. Routine safety blood tests including full blood counts, liver function test, electrolytes, serum PSA, and assessment for adverse events were performed every 3 weeks during study treatment. Once the patient completed three cycles of Tb-161 PSMA, they will continue to undergo clinical review, assessment for adverse events, routine safety bloods, and PSA every 6 weeks for 48 weeks. OR to treatment will be assessed by Ga-68 PSMA PET/CT using RECIP 1.0 criteria.
detailed description
Radionuclide treatment with Lutetium-177 (Lu-177)-labelled prostate-specific membrane antigen (PSMA) has become a standard care of treatment for patients with metastatic castration-resistant prostate cancer (mCRPC). Main advantages of Lu-177 PSMA improvement of overall survival and quality of life. Progression of disease occurs most of the patients after Lu-177 PSMA treatment. For this reason, labelling of PSMA with other radionuclides such as alfa or Auger electrons emitters have been a subject of interest. The major advantage of Terbium-161 is, besides the beta-radiation similar to Lu-177, its additional emission of Auger electron. Additional energy arising from Auger electrons has a shorter distance. Thus, higher concentration of radiation affects micrometastatic deposits of prostatic cancer due to cause of double-strand DNA damage. Preclinical studies demonstrated superior anti-tumor activity of Tb-161 PSMA compared with the Lu-177 PSMA. Furthermore, safety of Tb-161 I\&T has been documented recently with VIOLET trial as the first in human study.
In this study it is aimed to analyze the efficacy and safety of Tb-161 PSMA I\&T in the 7.4 GBq activity in a large patient group of Lu-177 PSMA naïve mCRPC patients.
3 cycles of Tb-161 PSMA will be administered with 6 weeks periods. After each cycle a triple bed quantitative single photon emission CT (SPECT)-CT scan from vertex to thigh will be acquired 24 h after every treatment of Tb-161 PSMA. In the first cycle additional time points SPECT-CT acquisitions will be obtained for dosimetric calculations. Details of dosimetry acquisitions will be provided by dosimetry partner.
Routine safety blood tests including full blood counts, liver function test, electrolytes, serum PSA, and assessment for adverse events were performed every 3 weeks during study treatment. Once the patient completed three cycles of Tb-161 PSMA, they will continue to undergo clinical review, assessment for adverse events, routine safety bloods, and PSA every 6 weeks for 48 weeks.
Ga-68-PSMA and F-18-FDG PET-CT will be repeated at 8 weeks after last cycle. During cycles if any progression is observed in posttreatment SPECT/CT imaging or PSA levels, additional Ga-68-PSMA and F-18-FDG PET-CT scans will be performed. If disease progression is confirmed, then treatment will be ceased.
Patient-reported outcomes will be assessed within 3 days before cycle 1 day 1, then at 6, 12, 24, 36, and 48 weeks, using the Brief Pain Inventory-Short Form for pain, the Functional Assessment of Cancer Therapy for Prostate Cancer questionnaire for quality of life, and the Functional Assessment of Cancer Therapy-Radionuclide Therapy questionnaire for treatment-specific symptoms.
official title
Phase 2 Study of Terbium 161 PSMA in Lutetium-177 PSMA Naive mCRPC Patients