MC1R-targeted Alpha-particle Monotherapy and Combination Therapy Trial With Nivolumab in Adults With Advanced Melanoma

NCT ID: NCT05655312

Last Updated: 2026-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-01

Study Completion Date

2029-12-31

Brief Summary

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In this first-in human, phase I/IIa study, the safety and efficacy of \[212Pb\]VMT01, an alpha-particle emitting therapeutic agent targeted to melanocortin sub-type 1 receptor (MC1R) is being evaluated as a monotherapy and in combination with nivolumab in subjects with unresectable and metastatic melanoma.

Detailed Description

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This is a prospective, multi-center open-label dose-finding, dose-expansion study of \[212Pb\]VMT01 as a monotherapy or in combination with nivolumab in up to 300 subjects with histologically confirmed melanoma and a positive MC1R imaging scan with imaging agents \[203Pb\]VMT01 or \[68Ga\]VMT02.

MC1R is a receptor that is expressed on the surface of melanoma cells and therefore is an attractive therapeutic target for melanoma treatment. Lead-212 (\[212Pb\]-) based peptide-radiopharmaceuticals are an emerging class of targeted alpha-particle cancer therapies that have potential to improve delivery of a highly effective form of radiation.

This study will be conducted in 3 parts:

Part 1: Monotherapy Dose-Finding

Part 2: Combination-Therapy Dose-Finding

Part 3: Dose Expansion

Enrolled subjects in Monotherapy may receive up to 3 doses of \[212Pb\]VMT01 approximately 8 weeks apart and subjects in combination therapy may receive up to 3 doses of \[212Pb\]VMT01 along with nivolumab. Nivolumab will be administered every 4 weeks for up to 24 months.

A Dosimetry sub-set utilizing an imaging surrogate, \[203Pb\]VMT01, has been incorporated into the study in order to assess organ biodistribution and tumor uptake of the investigational products. This study will also estimate radiation dosimetry and correlate uptake of the investigation products with observed toxicities and efficacy.

Conditions

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Recurrent Melanoma (Skin) Metastatic Melanoma Melanoma Stage IV Melanoma Stage III

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Phase I/IIa First-in-Human Study of \[212Pb\]VMT01 Targeted Alpha-Particle Therapy for MC1R Positive Advanced Malignant Melanoma
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Monotherapy-Dose Finding

Enrolled subjects will be treated with \[212Pb\]VMT01 to determine optimal biological dose (OBD).

A dosimetry sub-set utilizing \[203Pb\]VMT01 has been incorporated.

Group Type EXPERIMENTAL

[203Pb]VMT01

Intervention Type DRUG

\[203Pb\]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

[212Pb]VMT01

Intervention Type DRUG

Subjects with positive uptake of \[203Pb\]VMT01 will receive a fixed dose of \[212Pb\]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Combination Therapy-Dose Finding

Enrolled subjects will be treated with \[212Pb\]VMT01 in combination with nivolumab to determine OBD.

A dosimetry sub-set utilizing \[203Pb\]VMT01 has been incorporated.

Group Type EXPERIMENTAL

[203Pb]VMT01

Intervention Type DRUG

\[203Pb\]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

[212Pb]VMT01

Intervention Type DRUG

Subjects with positive uptake of \[203Pb\]VMT01 will receive a fixed dose of \[212Pb\]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Nivolumab

Intervention Type DRUG

For all combination-therapy cohorts, 480 mg nivolumab will be administered every 4 weeks as an IV infusion.

Monotherapy - Dose Expansion

Subjects will be enrolled at previously identified recommended phase 2 dose (RP2D) for confirmation of the RP2D and regimen for the Phase 2 dose-expansion cohort.

A dosimetry sub-set utilizing \[203Pb\]VMT01 has been incorporated.

Group Type EXPERIMENTAL

[203Pb]VMT01

Intervention Type DRUG

\[203Pb\]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

[212Pb]VMT01

Intervention Type DRUG

Subjects with positive uptake of \[203Pb\]VMT01 will receive a fixed dose of \[212Pb\]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Combination Therapy - Dose Expansion

Subjects will be enrolled at previously identified RP2D for its confirmation and verification of regimen for the Phase 2 dose-expansion cohort.

A dosimetry sub-set utilizing \[203Pb\]VMT01 has been incorporated.

Group Type EXPERIMENTAL

[203Pb]VMT01

Intervention Type DRUG

\[203Pb\]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

[212Pb]VMT01

Intervention Type DRUG

Subjects with positive uptake of \[203Pb\]VMT01 will receive a fixed dose of \[212Pb\]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Nivolumab

Intervention Type DRUG

For all combination-therapy cohorts, 480 mg nivolumab will be administered every 4 weeks as an IV infusion.

Interventions

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[203Pb]VMT01

\[203Pb\]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

Intervention Type DRUG

[212Pb]VMT01

Subjects with positive uptake of \[203Pb\]VMT01 will receive a fixed dose of \[212Pb\]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Intervention Type DRUG

Nivolumab

For all combination-therapy cohorts, 480 mg nivolumab will be administered every 4 weeks as an IV infusion.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Ability to understand and willingness to provide informed consent, willingness to comply with all study procedures for the duration of the study
* Aged ≥ 18 years
* Diagnosed with unresectable Stage III or Stage IV metastatic or recurrent melanoma
* Previously progressed (radiological progression) on at least one approved systemic therapy for advanced melanoma
* Uptake of \[68Ga\]VMT02 or \[203Pb\]VMT01 by PET or SPECT imaging observed in at least one melanoma tumor site using quantitative imaging analysis compared to reference normal tissue
* Subjects on prior intravenous therapy (e.g., chemotherapy or checkpoint inhibitors), or prior oral therapy (e.g.,proto-oncogene B-RAF or mitogen-activated extracellular signal-regulated kinase inhibitors) who demonstrate MC1R positivity during screening are eligible for enrollment, provided that they undergo a wash-out period of 21 days, or 7 days, respectively, prior to Cycle 1 Day 1 treatment with \[212Pb\]VMT01.
* Presence of measurable disease by RECIST v1.1 assessed within 45 days prior to the first dose of \[212Pb\]VMT01 on Cycle 1 Day 1
* Ability to lie flat and still for up to two hours for imaging scans; moderate conscious sedation allowed if indicated
* For females of reproductive potential: agree to use of highly effective contraception and refrain from donating eggs (ova, oocytes) for the purpose of reproduction starting from screening, during treatment with \[212Pb\]VMT01 and/or nivolumab, and for at least 6 months after the last dose of \[212Pb\]VMT01 and/or nivolumab, whichever is administered last
* For males of reproductive potential: agree to use of condoms or other methods to ensure effective contraception and refrain from donating sperm starting from screening, during treatment with \[212Pb\]VMT01 and/or nivolumab, and for at least 6 months after the last dose of \[212Pb\]VMT01 and/or nivolumab, whichever is administered last
* Eastern Cooperative Oncology Group performance score of \< 2 at Screening
* Life expectancy of at least 3 months after Cycle 1 Day 1
* Satisfactory organ function determined by laboratory testing

Exclusion Criteria

* Active secondary malignancy
* Prior systematic treatment with radioactive nuclides. Subjects who had localized treatment with radioactive nuclides or imaging using radioactive imaging agents may be enrolled
* Pregnancy or breastfeeding a child
* Any serious/active/uncontrolled infection requiring parenteral antibiotics within 2 weeks before the first administration of \[212Pb\]VMT01
* Febrile illness within 48 hours of any scheduled investigational product (\[212Pb\]VMT01, \[203Pb\]VMT01, or \[68Ga\]VMT02) administration; subjects should be rescheduled \> 48 hours after resolution of fever
* Treatment with another investigational drug product (therapeutic IND agents) within the last 45 days before the first dose of \[212Pb\]VMT01 on C1D1.
* Current abuse of alcohol or illicit drugs
* Existence of any medical or social issues likely to interfere with study conductor that may cause increased risk to the subject or to others, e.g., lack of ability to follow radiation safety precautions


* Untreated central nervous system (CNS) metastasis or metastasis requiring acute therapy of any modality. Subjects must have been either off corticosteroids, or on a stable or decreasing dose of prednisone (or equivalent) for at least 2 weeks prior to the first dose of \[212Pb\]VMT01
* Subjects with an active, known, or suspected autoimmune disease
* Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications
* Acute or chronic hepatitis B (e.g., Hepatitis B surface antigen reactive), hepatitis C (e.g., HCV RNA \[qualitative\] is detected) or known history of Human Immunodeficiency Virus (HIV) with an acquired immunodeficiency syndrome
* Treatment with complementary medications (e.g., herbal supplements or traditional Chinese medicines)
* Existence of abnormal laboratory values in hematology, liver, and renal function
* Treatment with any live/attenuated vaccine within 30 days prior to the first dose of \[212Pb\]VMT01
* Any treatment-related toxicities from prior systemic immune therapy with the exception of those unlikely to re-occur with standard countermeasures
* History of allergy or hypersensitivity to nivolumab or its components
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Perspective Therapeutics

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University of California Irvine

Orange, California, United States

Site Status RECRUITING

University of Miami

Miami, Florida, United States

Site Status RECRUITING

Sarasota Memorial Hospital

Sarasota, Florida, United States

Site Status RECRUITING

University of Iowa

Iowa City, Iowa, United States

Site Status RECRUITING

University of Kentucky

Lexington, Kentucky, United States

Site Status RECRUITING

Mayo Clinic Rochester

Rochester, Minnesota, United States

Site Status RECRUITING

Saint Louis University Hospital

St Louis, Missouri, United States

Site Status RECRUITING

Washington University of St. Louis

St Louis, Missouri, United States

Site Status RECRUITING

Nebraska Cancer Specialists

Omaha, Nebraska, United States

Site Status RECRUITING

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

UPMC Hillman Cancer Center

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

University of Wisconsin Carbone Cancer Center

Madison, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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ClinicalTrials at Perspectivetherapeutics

Role: CONTACT

206-676-0900

Facility Contacts

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Research Study Line

Role: primary

877-827-8839

Sandel Cepero

Role: primary

305-243-6855

Michelle Perkalis

Role: primary

941-917-2623

Role: backup

Kellie Bodeker, RN, BSN

Role: primary

319-384-9425

Benton Patrick

Role: primary

859-323-6237

Alisha Birgin

Role: primary

507-266-9955

Chelsea Webb

Role: primary

314-617-2899

Mahsa Ghajarzadeh

Role: primary

Marlene Bridwell

Role: primary

402-691-5252

Hue Nice

Role: primary

215-728-4325

Eunice Acampado

Role: primary

412-623-1322

Cancer Connect

Role: primary

800-622-8922

Other Identifiers

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VMT01-T101

Identifier Type: -

Identifier Source: org_study_id

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