An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI Versus AAA617 in PSMA Positive First-line mCRPC

NCT ID: NCT06894511

Last Updated: 2025-11-12

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-11

Study Completion Date

2029-04-09

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to assess whether the combination of AAA617 (administered for 6 cycles at a dose of 7.4 GBq (200 mCi) +/- 10%) and ARPI improves radiographic progression-free survival (rPFS) or time to death compared to AAA617 alone in PSMA-positive mCRPC patients who were previously treated and progressed on ARPI in the biochemical recurrence (BCR)-non metastatic hormone sensitive prostate cancer (mHSPC), mHSPC, or non-metastatic Castration Resistant Prostate Cancer (nmCRPC) setting and have not previously received a taxane-containing regimen in the castrate resistant prostate cancer (CRPC) setting.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This prospective, open-label, multi-center, randomized phase II study will enroll adult participants with PSMA PET positive mCRPC who were previously treated and progressed on ARPI in the BCR-non mHSPC, mHSPC, or nmCRPC setting and have not previously received a taxane-containing regimen in the CRPC setting. A PSMA PET/ computed tomography (CT) scan will be done at Screening to confirm PSMA positive disease. This is a United States-based study.

Approximately 420 eligible participants will be randomized in a 1:1 ratio to one of the two treatment arms (Arm A: AAA617+ARPI vs Arm B: AAA617). The primary objective of the study is to evaluate the rPFS response in participants with metastatic CRPC, assessed by conventional imaging, treated with AAA617 in combination with ARPI and AAA617 alone. Best Supportive Care (BSC) will be allowed in both arms at the discretion of the investigator and includes available care for the eligible participants according to best institutional practice for mCRPC. Androgen deprivation therapy (ADT) is required in both arms.

A total of approximately 420 eligible participants will be randomized in a 1:1 ratio into one of two treatment arms. Participants in Arm A will receive AAA617 in combination with ARPI, while those in Arm B will receive AAA617 alone. Randomization will be stratified by type of prior ARPI (abiraterone vs other \[enzalutamide, apalutamide, or darolutamide\]) and by setting of prior ARPI (mHSPC without docetaxel vs mHSPC with docetaxel vs others \[BCR-non mHSPC or nmCRPC setting\]).

The study duration is approximately 3.5 years.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Metastatic Castration Resistant Prostate Cancer (mCRPC)

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Prostate-specific membrane antigen (PSMA) lutetium (177Lu) vipivotide tetraxetan (AAA617) Androgen Receptor Pathway Inhibitors (ARPI) Enzalutamide Abiraterone Apalutamide Darolutamide metastatic Castration Resistant Prostate Cancer (mCRPC)

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Arm A: AAA617 and ARPI

AAA617 and ARPI (Enzalutamide, Abiraterone):

* AAA617 will be administered once every 6 weeks (1 cycle) for a planned 6 cycles.
* ARPI will be administered from 14 days (+ 7 days) before first dose of AAA617 until participant is no longer clinically benefiting, or experiences unacceptable toxicity or if investigator determines that the patient should discontinue ARPI.

Group Type EXPERIMENTAL

AAA617

Intervention Type DRUG

Dose formulation: open-label vial

Dose level: 7.4 GBq (200 mCi) ± 10% Once, every 6 weeks for 6 cycles, intravenous administration

ARPI: Abiraterone

Intervention Type DRUG

Dose formulation: tablet/capsule

Dose level: 160 mg (four 40 mg or two 80 mg soft capsules) as a single daily dose, oral administration

ARPI: Enzalutamide

Intervention Type DRUG

Dose formulation: tablet

Dose level: 1000 mg daily (two 500 mg tablets or four 250 mg tablets as a single daily dose together with 5 mg oral prednisone 2 times a day, oral administration

Arm B: AAA617 alone

AAA617 alone: Control Arm B participants will receive a dose of AAA617 which will be administered once every 6 weeks (1 cycle) for a planned 6 cycles.

Group Type ACTIVE_COMPARATOR

AAA617

Intervention Type DRUG

Dose formulation: open-label vial

Dose level: 7.4 GBq (200 mCi) ± 10% Once, every 6 weeks for 6 cycles, intravenous administration

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

AAA617

Dose formulation: open-label vial

Dose level: 7.4 GBq (200 mCi) ± 10% Once, every 6 weeks for 6 cycles, intravenous administration

Intervention Type DRUG

ARPI: Abiraterone

Dose formulation: tablet/capsule

Dose level: 160 mg (four 40 mg or two 80 mg soft capsules) as a single daily dose, oral administration

Intervention Type DRUG

ARPI: Enzalutamide

Dose formulation: tablet

Dose level: 1000 mg daily (two 500 mg tablets or four 250 mg tablets as a single daily dose together with 5 mg oral prednisone 2 times a day, oral administration

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

lutetium (177Lu) vipivotide tetraxetan [177Lu]Lu-PSMA-617 177Lu-PSMA-617

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Participants must have an ECOG performance status of 0 to 2.
* Participants must have histopathological, and/or cytological confirmation of adenocarcinoma of the prostate.
* Participants must have PSMA PET positive disease using FDA approved PSMA-imaging approved agents, and eligible as determined by the sponsor's central reading rules.
* Participants must have a castrate level of serum/plasma testosterone (\< 50 ng/dL or \< 1.7 nmol/L).
* Newly diagnosed mCRPC participants who must have progression on prior ARPI in the BCR-non mHSPC, mHSPC, or nmCRPC setting.
* Participants must have progressed only once on prior second-generation ARPI (abiraterone, enzalutamide, darolutamide, or apalutamide). First generation androgen receptor inhibitor therapy (e.g. bicalutamide) is allowed but not considered as prior ARPI therapy (second generation ARPI must be the most recent therapy received).
* Participant must have been diagnosed with mCRPC with documented progressive disease after having been previously treated with ARPI in the BCR-non mHSPC, mHSPC, or nmCRPC setting as their last treatment (and did not progress on more than one ARPI), based on at least 1 of the following criteria:

* Serum/plasma PSA progression is defined as 2 increases in PSA measured at least 1 week apart. The minimal start value is 2.0 ng/mL; 1.0 ng/mL is the minimal starting value if confirmed rise in PSA is the only indication of progression as per PCWG3 guidelines.
* Soft-tissue progression defined \[PCWG3-modified RECIST v1.1 (Eisenhauer et al 2009, Scher et al 2016)\].
* Progression of bone disease: 2 new lesions; only positivity on the bone scan defines metastatic disease to bone (PCWG3 criteria \[Scher et al 2016\]).
* Participants must have ≥ 1 metastatic lesion by conventional imaging that is present at Screening/Baseline CT, MRI, or bone scan imaging obtained ≤ 28 days (about 4 weeks) prior to randomization.
* Participants must have adequate organ function:

Bone marrow reserve

* Absolute Neutrophil Count (ANC) ≥ 1.5 × 109/L
* Platelets ≥ 100 × 109/L
* Hemoglobin ≥ 9 g/dL Hepatic
* Total bilirubin \< 2 × the institutional upper limit of normal (ULN). For participants with known Gilbert's Syndrome ≤ 3 × ULN is permitted.
* Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤ 3.0 × ULN OR ≤ 5.0 × ULN for participants with liver metastases
* Albumin ≥ 2.5 g/dL Renal
* eGFR ≥ 50 mL/min/1.73m2 using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

Exclusion Criteria

* Previous treatment with any of the following within 6 weeks of randomization: Strontium-89, Samarium-153, Rhenium-186, Rhenium-188, Radium-223, hemi-body irradiation, and Lu-DOTA radioligand therapy.
* Previous PSMA-imaging RLT
* Previous treatment with taxane-based chemotherapy at mCRPC settings. Taxane exposure is allowed in the mHSPC setting if more than 12 months have elapsed since the completion of this therapy.
* Participants with a history of CNS metastases who are neurologically unstable, symptomatic, or receiving corticosteroids for the purpose of maintaining neurologic integrity.
* Symptomatic cord compression, or clinical or radiologic findings indicative of impending cord compression.
* Participant with known or suspected deleterious germline or somatic homologous recombination repair gene-mutated mCRPC, who is considered appropriate for treatment with PARP inhibitor according to the judgment of the investigator.
* History of myocardial infarction, angina pectoris, or coronary artery bypass graft (CABG) within 6 months prior to ICF signature and/or clinically active significant cardiac disease
* Concurrent serious acute or chronic nephropathy as determined by the principal investigator.
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Novartis Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Novartis Pharmaceuticals

Role: STUDY_DIRECTOR

Novartis Pharmaceuticals

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Cancer And Blood Spclsts of AZ

Casa Grande, Arizona, United States

Site Status RECRUITING

Highlands Oncology Group

Fayetteville, Arkansas, United States

Site Status RECRUITING

Hoag Memorial Hospital Presbyterian

Newport Beach, California, United States

Site Status RECRUITING

East Jefferson Hospital

Metairie, Louisiana, United States

Site Status RECRUITING

Urology Cancer Center PC

Omaha, Nebraska, United States

Site Status RECRUITING

Oregon Urology Institute

Springfield, Oregon, United States

Site Status RECRUITING

Texas Oncology P A

Bedford, Texas, United States

Site Status RECRUITING

Urology San Antonio

San Antonio, Texas, United States

Site Status RECRUITING

Virginia Cancer Specialists

Fairfax, Virginia, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Novartis Pharmaceuticals

Role: CONTACT

Phone: 1-888-669-6682

Email: [email protected]

Novartis Pharmaceuticals

Role: CONTACT

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Estrella Crystal

Role: primary

Shelly Farrow

Role: primary

Geo Raya

Role: primary

Antonia Eltit

Role: primary

Makenzie Ann Long

Role: primary

Helena McLeod

Role: primary

Carolina Hernandez

Role: primary

Manuel Hernandez

Role: primary

Hoang Anh Dinh

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

CAAA617B1US01

Identifier Type: -

Identifier Source: org_study_id