A Phase Ib/II Open-label Study of AMO959 With Lutetium (177Lu) Vipivotide Tetraxetan (AAA617) in Combination With ARPI in Adult Participants With PSMA-positive mCRPC

NCT ID: NCT07226986

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

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

123 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-16

Study Completion Date

2029-08-10

Brief Summary

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The purpose of this phase Ib/II study is to (a) in Phase Ib evaluate the safety, tolerability, and pharmacokinetics (PK) of AMO959 when given in combination with lutetium (177Lu) vipivotide tetraxetan (also known as \[177Lu\]Lu-PSMA-617 or 177Lu-PSMA-617 and hereafter referred to as AAA617) with an androgen receptor pathway inhibitor (ARPI) in participants with metastatic castration resistant prostate cancer (mCRPC) who have failed one prior ARPI and with or without prior taxane exposure, and (b) in Phase II evaluate the preliminary efficacy of AMO959 in combination with AAA617 and ARPI in participants with mCRPC who have failed one prior ARPI, but who have not yet been exposed to taxane treatment.

Detailed Description

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This study will consist of two phases:

1. The escalation phase (Ib) will consist of provisionally three dose level cohorts of 3-6 participants investigating the safety, tolerability, and to determine the recommended dose for expansion (RDE) of AMO959 with standard dose of AAA617 +/- ARPI (abiraterone or enzalutamide). Initially AMO959 monotherapy will be administered, and then AMO959 will be given along with AAA617 in the same participants. Dose escalation meetings (DEMs) will occur when all participants in a dose level cohort have completed the DLT evaluation period or have experienced a DLT prior to the end of the evaluation period.
2. The Phase II will follow with 25 participants per arm randomized in a 1:1:1 ratio treated at the RDE(s) of AMO959 along with AAA617 and ARPI (abiraterone or enzalutamide) and AAA617 and ARPI (abiraterone or enzalutamide).

Conditions

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PSMA-positive Metastatic Castration Resistant Prostate Cancer (mCRPC) With Prior Exposure to One Prior ARPI Who Are Candidates for Taxane-based Chemotherapy

Keywords

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PSMA-positive metastatic castration resistant prostate cancer AMO959 Lutetium (177Lu) vipivotide tetraxetan Androgen Receptor Pathway Inhibitor (ARPI) dose escalation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase 1b: Doublet

Participants will receive AMO959 BID for first 14 days followed by AAA617+AMO959 every 6 weeks for a maximum of 6 cycles.

Group Type EXPERIMENTAL

AMO959

Intervention Type DRUG

DNA Damage Response inhibitor

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Phase 1b: Triplet

Participants will receive AAA617 on day 1 followed by AMO959 BID (days 2-15), repeated every 6 weeks, for a maximum of 6 cycles with an ARPI (abiraterone or enzalutamide) administered continuously starting on day 1.

Group Type EXPERIMENTAL

AMO959

Intervention Type DRUG

DNA Damage Response inhibitor

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Enzalutamide

Intervention Type DRUG

Androgen receptor pathway inhibitor

Abiraterone

Intervention Type DRUG

Androgen receptor pathway inhibitor

Phase 1b: Food Effect

Participants will receive a single dose of AMO959 on Day 1 (fed), followed by 2-day washout, then AMO959 BID (fasted) for 14 days followed by 2-day washout and AAA617+AMO959 (fasted) every 6 weeks for a maximum of 6 cycles.

Group Type EXPERIMENTAL

AMO959

Intervention Type DRUG

DNA Damage Response inhibitor

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Phase II: Arm 1

Participants will receive AAA617 on day 1 followed by AMO959 BID (days 2-15), repeated every 6 weeks, for a maximum of 6 cycles with an ARPI (abiraterone or enzalutamide administered continuously starting on day 1.

Group Type EXPERIMENTAL

AMO959

Intervention Type DRUG

DNA Damage Response inhibitor

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Enzalutamide

Intervention Type DRUG

Androgen receptor pathway inhibitor

Abiraterone

Intervention Type DRUG

Androgen receptor pathway inhibitor

Phase II: Arm 2

Participants will receive AAA617 on day 1 followed by AMO959 BID (days 2-15), repeated every 6 weeks, for a maximum of 6 cycles with an ARPI (abiraterone or enzalutamide) administered continuously starting on day 1.

Group Type EXPERIMENTAL

AMO959

Intervention Type DRUG

DNA Damage Response inhibitor

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Enzalutamide

Intervention Type DRUG

Androgen receptor pathway inhibitor

Abiraterone

Intervention Type DRUG

Androgen receptor pathway inhibitor

Phase II: Arm 3

Participants will receive AAA617 every 6 weeks for a maximum of 6 cycles, with ARPI (abiraterone or enzalutamide) administered continuously starting on day 1.

Group Type EXPERIMENTAL

AAA617

Intervention Type RADIATION

PSMA-targeted radiopharmaceutical

Enzalutamide

Intervention Type DRUG

Androgen receptor pathway inhibitor

Abiraterone

Intervention Type DRUG

Androgen receptor pathway inhibitor

Interventions

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AMO959

DNA Damage Response inhibitor

Intervention Type DRUG

AAA617

PSMA-targeted radiopharmaceutical

Intervention Type RADIATION

Enzalutamide

Androgen receptor pathway inhibitor

Intervention Type DRUG

Abiraterone

Androgen receptor pathway inhibitor

Intervention Type DRUG

Other Intervention Names

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BY1298 BY101298 Pluvicto [177Lu]Lu-PSMA-617

Eligibility Criteria

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Inclusion Criteria

* Signed informed consent must be obtained prior to participation in the study.
* Participants must be adults ≥ 18 years of age.
* Participants must have an ECOG performance status of 0 to 2.
* Participants must have histologically confirmed adenocarcinoma of the prostate. Participants with other histology (e.g. neuroendocrine, intraductal subtype) are not eligible.
* Phase Ib: Prior exposure of up to 1 line of taxane-based chemotherapy is permissible. Phase II: Participants must not have received taxane-based chemotherapy in mCRPC setting (allowed in mHSPC setting).
* Participants must have PSMA-PET positive disease assessed by using a PSMA imaging agent that is approved as per protocol and are eligible as determined by the sponsor's central reading rules.
* Castration level of testosterone (\< 50 ng/dL), and/or use of concomitant ADT
* Participant must have been diagnosed with mCRPC with documented progressive disease while on treatment with ARPI in mHSPC or earlier 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).

Exclusion Criteria

* Concurrent local (radiation therapy to the prostate with curative intent or other prostate antineoplastic ablative procedures) or systemic (hormonal ablation, chemotherapy, immunotherapy, , RLTs) antineoplastic treatments, or within 28 days of enrollment (Phase Ib) or randomization (Phase II)
* Prior treatment with any RLT or PSMA-targeted agents (approved or investigational)
* Any other investigational agents within 28 days prior to first dose of any study treatment
* Concurrent serious medical conditions that may interfere with study procedures or followup
* Participants with a history of CNS metastases must have received therapy (surgery, whole brain radiation therapy, stereotactic radiosurgery) and be neurologically stable, asymptomatic, and not taking corticosteroids for the purpose of maintaining neurologic integrity.
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Novartis Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Novartis Pharmaceuticals

Role: STUDY_DIRECTOR

Novartis Pharmaceuticals

Central Contacts

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Novartis Pharmaceuticals

Role: CONTACT

Phone: 1-888-669-6682

Email: [email protected]

Novartis Pharmaceuticals

Role: CONTACT

Phone: +41613241111

Email: [email protected]

Other Identifiers

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2025-521859-23-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

CAMO959A12103

Identifier Type: -

Identifier Source: org_study_id