FPI-2265 (225Ac-PSMA-I&T) for Patients With PSMA-Positive Metastatic Castration-Resistant Prostate Cancer (mCRPC)

NCT ID: NCT06402331

Last Updated: 2025-10-09

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

PHASE2

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-05

Study Completion Date

2031-01-23

Brief Summary

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This is an open-label, randomized, multicenter study of FPI-2265 (225Ac-PSMA-I\&T). Patient population is adult participants with PSMA positive mCRPC who have had previous treatment with with 177Lu-PSMA-617 or another 177Lu-PSMA radioconjugate (RC). The purpose of the study is to determine the safety and tolerability, and recommended dose and regiment of FPI-2265.

Detailed Description

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This is an open-label, randomized, multicenter study of FPI-2265 (225Ac-PSMA-I\&T). The purpose of this dose optimization study is to determine the recommended FPI-2265 dose and regimen. Conclusions will be based on safety, tolerability, and anti-tumor activity.

Screening Period: At screening, participants will be assessed for eligibility and undergo a positron emission tomography (PET)/computed tomography (CT) scan to evaluate PSMA positivity. Only participants with PSMA positive cancer and confirmed eligibility criteria will be randomized.

Participants randomized will enter the treatment period and receive investigational doses of FPI2265 according to the dose level and schedule as specified per proposed dose arm.

Part A participants will enroll 1:1:1 at three dose level/schedules, to arms 1, 2 or 3

Part B participants will enroll after completion of part A, in a 1:1 randomization scheme to arms 6 or 7.

Once Part A is fully enrolled and participants have been followed for at least 12 weeks, data from Arm 1 and 2 will be analyzed to assess the feasibility of enrolling participants to arms 4 and 5.

All participants will be monitored and assessed for efficacy response, disease progression and adverse events.

Supportive care will be allowed in all arms at the discretion of the investigator and includes available care for the eligible participant according to best institutional practice for mCRPC treatment, including androgen deprivation therapy (ADT).

Follow-up after end of treatment visit will proceed for 5 years.

5 participants will be enrolled into a dosimetry substudy (open at select sites only). Dosimetry substudy participants will be administered one dose at of FPI2265 and proceed with dosimetric assessments will be taken at a number of timepoints after dose administration.

Conditions

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Metastatic Castration-resistant Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Part A Arm 1

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part A Arm 2

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part A Arm 3

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part B Arm 4

to be utilized based on analysis of Part A

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part B Arm 5

to be utilized based on analysis of Part A

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part B Arm 6

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Part B Arm 7

Group Type EXPERIMENTAL

FPI-2265

Intervention Type DRUG

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Interventions

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FPI-2265

Investigational treatment FPI2265 is a PSMA ligand radiolabelled with 225Ac.

Other Names:

225Ac-PSMA-I\&T

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1
* Diagnosis of adenocarcinoma of prostate proven by histopathology.
* Must have had prior orchiectomy and/or ongoing androgen-deprivation therapy and a castrate level of serum/plasma testosterone
* Progressive mCRPC at time of study entry.
* Must have been previously treated with lutetium-PSMA therapy (lutetium-177 vipivotide tetraxetan or other lutetium-177-PSMA RLT). Treatment must have been completed \>6 weeks prior to the first dose of study drug.
* Participants with known BRCA mutations should have received FDA-approved therapies such as PARP inhibitors, per Investigator discretion.
* Positive PSMA PET/CT scan
* Adequate organ function
* For participants who have partners of childbearing potential: Partner and/or participant must not be planning to conceive and must use a method of birth control with adequate barrier protection deemed acceptable by the Principal Investigator during the study treatment and for six months after last study drug administration.

Exclusion Criteria

* Participants who received more than two prior lines of cytotoxic chemotherapy for CRPC.
* Participants who progress prior to administration of the 3rd cycle of prior treatment with 177Lu-PSMA therapy
* All prior treatment-related adverse events must have resolved to Grade ≤1 (CTCAE v5.0). Alopecia and stable persistent Grade 2 peripheral neuropathy may be allowed at the discretion of the Investigator.
* Participants with known, unresolved, urinary tract obstruction are excluded.
* Administration of any systemic cytotoxic or investigational therapy ≤30 days of the first dose of study treatment or five half-lives, whichever is shorter. Completion of large-field external beam radiotherapy ≤four weeks of the first dose of study treatment.
* Participants with a history of central nervous system (CNS) metastases are excluded except those who have received therapy
* Participants with any liver metastases will be excluded
* Participants with skeletal metastases presented as a superscan on a ⁹⁹ᵐTc bone scan.
* Previous or concurrent cancer that is distinct from the cancer under investigation in primary site or histology, except treated cutaneous basal cell carcinoma or squamous cell carcinoma and superficial bladder tumors. Any cancer curatively treated \>two years prior to the first dose of treatment is permitted.
* Concurrent serious (as determined by the investigator) medical conditions
* Major surgery ≤30 days prior to the first dose of study treatment.
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Fusion Pharmaceuticals Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Keith Barnett

Role: STUDY_DIRECTOR

Fusion Pharmaceuticals Inc.

Locations

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City of Hope Comprehensive Cancer Center

Duarte, California, United States

Site Status RECRUITING

Hoag Health Center Irvine

Irvine, California, United States

Site Status RECRUITING

VA Greater Los Angeles Healthcare System

Los Angeles, California, United States

Site Status RECRUITING

University of California Los Angeles

Los Angeles, California, United States

Site Status RECRUITING

UCSF School of Medicine

San Francisco, California, United States

Site Status RECRUITING

Biogenix Molecular, LLC

Miami, Florida, United States

Site Status RECRUITING

University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Site Status RECRUITING

United Theranostics

Glen Burnie, Maryland, United States

Site Status ACTIVE_NOT_RECRUITING

BAMF Health

Grand Rapids, Michigan, United States

Site Status RECRUITING

SSM Health Saint Louis University Hospital

St Louis, Missouri, United States

Site Status RECRUITING

XCancer

Omaha, Nebraska, United States

Site Status RECRUITING

New Mexico Oncology Hematology Consultants Ltd.

Albuquerque, New Mexico, United States

Site Status RECRUITING

Laura and Isaac Perlmutter Cancer Center at NYU Langone

New York, New York, United States

Site Status RECRUITING

Memorial Sloan Kettering Cancer Center - NYC

New York, New York, United States

Site Status RECRUITING

Oregon Health and Science University (OHSU, Knight Cancer Center)

Portland, Oregon, United States

Site Status RECRUITING

VA North Texas Health Care System, Nuclear Medicine Service

Dallas, Texas, United States

Site Status RECRUITING

The University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status RECRUITING

U.T. MD Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Clinical Trials Fusion Pharmaceuticals Inc.

Role: CONTACT

1 (888) 506-4215

Facility Contacts

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Jennifer Simpson

Role: primary

+ (626) 218 5087

Jessica Liu

Role: backup

+ (626) 218 0473

Gary Ulaner, MD

Role: primary

949-557-0285

Gholam Berenji, MD

Role: primary

310-268-3547

Janake Wijesuriya

Role: backup

310-977-5209

Deepu Varughese

Role: primary

+1 (310) 206 7372

Stephanie Lira

Role: backup

+310 (206) 7372

Maya Aslam

Role: primary

+1 (415) 514 8987

Lisa Kody

Role: backup

+ (310) 983 1444

Jerry Joseph, Site Administrator

Role: primary

786-791-1799

Debra OConnell-Moore

Role: primary

319-356-1693

Brandon Mancini, MD

Role: primary

Harshad Kulkarni, MD

Role: backup

Chelsea Webb, CNMT

Role: primary

(314) 617-2899

Luke Nordquist, MD

Role: primary

402-991-8468

Tony Romero

Role: backup

402-697-2229

Kimberly Demos

Role: primary

505 -317-2605

Scarlett Rodriguez

Role: primary

929-334-6980

Carol Fernandez Guerra

Role: backup

917-696-0226

MSKCC Clinical Trials Contact

Role: primary

888-906-0432

Justina Lynch

Role: primary

+ (503) 418 9737

Jessica Bhatti

Role: primary

+ (512) 341 8724

Maximillian Masuda

Role: backup

+ (214) 742 8387

Michael Fulkerson

Role: primary

214-648-5984

Virginia Bayer

Role: primary

+ (713) 517 0790

Emily Batton

Role: backup

+ (713) 563 2634

Other Identifiers

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FPI-2265-202

Identifier Type: -

Identifier Source: org_study_id

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