[Ac-225]-PSMA-62 Trial in Oligometastatic Hormone Sensitive and Metastatic Castration Resistant Prostate Cancer

NCT ID: NCT06229366

Last Updated: 2025-12-22

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

142 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-03

Study Completion Date

2032-12-31

Brief Summary

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ACCEL is a multicenter, open label phase Ia/Ib/II study of \[Ac-225\]-PSMA-62 in participants with prostate-specific membrane antigen (PSMA)-positive prostate cancer.

Detailed Description

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The primary aim of the phase Ia study is to evaluate the safety and tolerability of \[Ac-225\]-PSMA-62 to determine the maximum tolerated dose (MTD). The primary aim of the randomized phase Ib dose optimization is to determine the recommended phase II doses (RP2D) for patients with mCRPC and OmHSPC. The aim of the phase II study for patients with mCRPC is to evaluate the efficacy of \[Ac-225\]-PSMA-62.

Conditions

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Prostate Cancer Metastatic Castration-resistant Prostate Cancer Oligometastatic Prostate Carcinoma Hormone Sensitive Prostate Cancer

Keywords

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mCRPC OmHSPC Prostatic Neoplasms Genital Neoplasms, Male Castration Resistant Prostate Cancer Hormone Sensitive Prostate Cancer Oligometastatic Prostate Cancer [225Ac]-PSMA-62 Ac-225-PSMA-62 Actinium Radioligand Therapy Radiopharmaceuticals Urogenital Neoplasm

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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OmHSPC

Patients with prostate cancer and biochemical recurrence after definitive surgery or radiation therapy, with 1-5 PSMA-positive lesions, who have not yet initiated lifelong hormone therapy.

Group Type EXPERIMENTAL

[Ac-225]-PSMA-62 (OmHSPC)

Intervention Type DRUG

Phase Ia: Administered intravenously per dose escalation scheme. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 8-week cycle for up to 2 cycles.

Phase Ib: Administered intravenously at MTD or one dose level below MTD. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 8-week cycle, for a total of 2 cycles.

mCRPC

Patients with PSMA-positive mCRPC who have prior treatment with at least one APRI and received taxane chemotherapy (or ineligible/refused); and received a maximum of 3 prior systemic therapy regimens in the mCRPC setting.

Group Type EXPERIMENTAL

[Ac-225]-PSMA-62 (mCRPC)

Intervention Type DRUG

Phase Ia: Administered intravenously per dose escalation scheme. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 6-week cycle for up to 4 cycles.

Phase Ib: Administered intravenously at MTD or one dose level below MTD. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 6-week or 4-week cycle, for a total of 4 cycles.

Interventions

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[Ac-225]-PSMA-62 (mCRPC)

Phase Ia: Administered intravenously per dose escalation scheme. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 6-week cycle for up to 4 cycles.

Phase Ib: Administered intravenously at MTD or one dose level below MTD. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 6-week or 4-week cycle, for a total of 4 cycles.

Intervention Type DRUG

[Ac-225]-PSMA-62 (OmHSPC)

Phase Ia: Administered intravenously per dose escalation scheme. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 8-week cycle for up to 2 cycles.

Phase Ib: Administered intravenously at MTD or one dose level below MTD. Patients will receive a single dose of \[Ac-225\]-PSMA-62 on Day 1 of each 8-week cycle, for a total of 2 cycles.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate
2. ECOG performance status 0 to 1
3. Criteria specific for patients with mCRPC:

1. Previously received an androgen receptor pathway inhibitor (ARPI) and taxane-based chemotherapy (unless ineligible or refused taxane). Received a maximum of 3 prior systemic therapy regimens in the mCRPC setting
2. Progressive mCRPC at the time of consent based on at least 1 of the following criteria being met in the context of castrate levels of testosterone:

* PSA progression defined as rising PSA values at a minimum of 1-week intervals, with the last result being at least 1.0 ng/mL
* Soft-tissue progression defined as an increase ≥20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions
* Progression of bone disease defined as the appearance of two or more new lesions by bone scan
3. At least one PSMA-PET positive lesion for prostate cancer
4. Castrate circulating testosterone levels (\<1.74 nmol/L or \<50 ng/dL)
4. Criteria specific for patients with OmHSPC:

1. PSA recurrence after radical prostatectomy (RP) or definitive radiation therapy (RT), with or without adjuvant/salvage local therapy (radiation or surgery), with or without (neo)adjuvant ADT

* PSA ≥ 0.2ng/mL for patients with prior RP +/- RT, or
* PSA of ≥ 2 ng/mL above nadir for patients with only prior RT
2. 1- 5 PSMA-PET positive lesions identified outside the prostate bed or remaining gland.

Exclusion Criteria

1. Patient has received any other investigational therapeutic agents within 4 weeks or 5 half-lives (whichever is shorter) of starting the study treatment
2. Evidence of ongoing and untreated urinary tract obstruction
3. Existing Grade 1 dry mouth (xerostomia) or symptomatic Grade 1 dry eye (xerophthalmia) for any reason
4. Patient has any concurrent severe and/or uncontrolled medical conditions that could increase the patient's risk for toxicity while on the study or that could confound discrimination between disease- and study treatment-related toxicities
5. Criteria specific for patients with mCRPC:

1. Patient has received any PSMA-directed radioligand therapy (e.g., Lu-177-PSMA, Lu-177-PNT2002, Ac-225-J591)
2. Patient has received any therapeutic systemic radionuclides (e.g., radium-223, rhenium-186, strontium-89), or non-PSMA-directed therapeutic radioligands (e.g., Lu-177-Dotatate) within 5 half-lives of starting the study treatment
6. Criteria specific for patients with OmHSPC:

1. Patient has received any systemic anti-cancer therapy for prostate cancer with the exception of (neo)adjuvant ADT for management of localized disease
2. Presence of any liver metastases
3. Known presence of central nervous system metastases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eli Lilly and Company

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 8 AM - 8 PM Eastern time (UTC/GMT - 5 hours, EST)

Role: STUDY_DIRECTOR

Eli Lilly and Company

Locations

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Juravinski

Hamilton, , Canada

Site Status

Jewish General Hospital

Montreal, , Canada

Site Status

McGill University

Montreal, , Canada

Site Status

Centre Hospitalier Universite de QUEBEC

Québec, , Canada

Site Status

Hopital De Chicoutimi

Saguenay, , Canada

Site Status

Princess Margaret Cancer Centre

Toronto, , Canada

Site Status

BC Cancer Vancouver

Vancouver, , Canada

Site Status

Countries

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Canada

Other Identifiers

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J5N-OX-JJEA

Identifier Type: OTHER

Identifier Source: secondary_id

27197

Identifier Type: -

Identifier Source: org_study_id