The purpose of this study is to evaluate safety and tolerability, pharmacokinetics (PK), efficacy of TRC003 injection in patients with progressive PSMA-positive mCRPC who have been treated with androgen receptor pathway inhibitor (ARPI) or taxane-based chemotherapy. We plan to recruit 90 participants who will be randomly assigned to 1 of 3 dose cohorts (30 cases per dose cohort) with up to 6 cycles of treatment in this study.
This is a prospective, randomized, open-label, phase 1/2 study on adult patients with PSMA-positive metastatic castration-resistant prostate cancer. Approximately 90 eligible participants will be enrolled and randomized 1:1:1 to three dose cohorts. The first six participants in each cohort will be assessed for dose-limiting toxicity (DLT) during the first treatment cycle. Each eligible participant will receive one of the predefined doses of TRC003 (7.40, 9.25, 11.10 MBq) by intravenous infusion every 8 weeks (±1 week) for a maximum of 6 cycles if participants benefit from the treatment. All participants in this study may undergo dose modification based on the assessment of safety or efficacy by the investigators. Any adverse events (AEs) observed or reported will be recorded. Blood and urine samples will be collected after the first administration of TRC003 on 6 participants in each cohort for pharmacokinetics (blood concentration of TRC003). 2 eligible participants of each cohort (total 6 participants) will undergo SPECT/CT for dosimetry after informed consent. All participants will be assessed PSA every 4 weeks. CT with contrast /MRI and bone scan will be evaluated every 8 weeks until proved disease progression by RECIST version 1.1 and the Prostate Cancer Clinical Trials Working Group 3 (PCWG3).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
TRC003 is a radioligand therapeutic agent indicated for the treatment of adult patients with prostate-specific membrane antigen-positive metastatic castration-resistant prostate cancer. TRC003 is a 225Ac-labeled novel molecule for targeted alpha therapy (TAT), which delivers alpha-particle radiation specifically to prostate cancer cells expressing PSMA. Inside the body, it attaches itself to PSMA on the cell surface of the prostate cancer cells and emits radiation to kill them.
Cancer Hospital, Chinese Academy of Medical Sciences, Shanxi Hospital
Taiyuan, Shanxi, China
RECRUITINGFudan University Shanghai Cancer Center
Shanghai, China
NOT_YET_RECRUITINGIncidence and severity of AEs and SAEs
Adverse events (AEs) will be assessed and graded using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) by monitoring adverse events, laboratory tests, vital signs, Electrocardiogram(ECG).
Time frame: From date of the first dose until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 60 months.
Prostate Specific Antigen response (PSA50)
The percentage of participants who achieved ≥ 50% decrease from baseline at 12 weeks after the first administration or later.
Time frame: About 12 months.
Peak concentration (Cmax)
The maximum measured concentration of TRC003 in the body after administration.
Time frame: 10 days following the first dose.
AUC0-t
Area under the concentration-time curve from time 0 to the last measurable concentration
Time frame: 10 days following the first dose.
T1/2
Time required for the drug concentration to decrease by 50%.
Time frame: 10 days following the first dose.
Absorbed dose coefficients
The ratio of absorbed dose in a target tissue to the total activity injected, representing dose delivered per unit activity.
Time frame: 10 days following the first dose.
Residence time
The total time that TRC003 remains in a target organ or the body.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 10 days following the first dose.
Effective dose
Effective dose is the total radiation dose adjusted for organ sensitivity, used to estimate the risk of radiation-induced health effects.
Time frame: 10 days following the first dose.
Prostate Specific Antigen response (PSA90)
The percentage of participants who achieved ≥ 90% decrease from baseline at 12 weeks after the first administration or later
Time frame: About 12 months.
Biochemical Progression Free Survival (bPFS)
Time to PSA progression by PCWG3 criteria (after decline from baseline: record time from start of therapy to first PSA increase that is ≥ 25% and ≥ 2 ng/mL above the nadir, and which is confirmed by a second value ≥ 3 weeks later).
Time frame: About 12 months.
Overall Response Rate (ORR)
The proportion of participants with Best Overall Response (BOR) of confirmed Complete Response (CR) or Partial Response (PR) from baseline until radiographic progression or death, whichever comes first.
Time frame: About 12 months
Disease Control Rate (DCR)
The proportion of participants with BOR of confirmed CR, PR, Stable Disease (SD) or non-CR/non-progressive disease (PD) from baseline until radiographic progression or death, whichever comes first.
Time frame: About 12 months.
Duration of Response (DoR)
Time between the date of first documented response and the date of first documented radiographic progression or death due to any cause by RECIST v1.1 and PCWG3 criteria.
Time frame: About 12 months.
Time to first radiographic Soft Tissue Progression (TTSTP)
Time to radiographic soft tissue progression by RECIST v1.1 and PCWG3 criteria.
Time frame: About 12 months.
Time to Progression (TTP)
Time to the first documented radiographic progression by RECIST v1.1 and PCWG3 criteria.
Time frame: About 12 months.
Time to first Symptomatic Skeletal Event (TTSSE)
Time to the first new symptomatic pathological bone fracture, spinal cord compression, tumor-related orthopedic surgical intervention, requirement for radiation therapy to relieve bone pain or death from any cause, whichever occurs first.
Time frame: About 12 months.
European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
A qusetionnaire to assess health-related quality of life (HRQOL) in cancer patients by patient-reported outcome (PRO) measure. The standard range of EORTC QLQ-C30 is 0-100 points. For Functional Scales, higher score means better function, better health status, higher quality of life. For Symptom Scales \& Single Symptom Items, higher score means more severe symptoms / greater burden.
Time frame: About 12 months.
Functional Assessment of Cancer Therapy - Prostate (FACT-P)
A disease-specific, patient-reported outcome (PRO) questionnaire designed to measure health-related quality of life (HRQoL) in men with prostate cancer. FACT-P Total Score range is 0-160. Higher score means better quality of life, fewer symptoms, better functional status.
Time frame: About 12 months.
Brief Pain Inventory - Short Form (BPI-SF)
A widely used, validated patient-reported outcome (PRO) tool designed to assess the severity of pain and the impact of pain on daily functioning. BPI-SF Total Score range is 0-110. Higher total score means worse overall pain and greater pain interference with daily life.
Time frame: About 12 months.