This phase II trial studies how well prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scans (in combination with bone scans) work in selecting patients for Ra-223 radiation therapy that have castration-resistant prostate cancer that has spread from where it first started (primary site) to the bones (bone metastasis). Ra-223 is a type of therapy that emits radiation. Radiation gives off energy which can kill tumor cells and other cells that may support the tumor cells. Ra-223 is given by infusion into the veins, where it is absorbed by the bones. PSMA PET is a type of scan used to detect prostate cancer tumors. PSMA is a radioactive tracer that binds to a specific protein that is found on prostate tumor cells. The PSMA tracer shows the areas on the PET scan where tumor cells are active. A PET scan uses a special camera to detect the energy given off from radioactive tracers (such as PSMA) to make detailed pictures of areas where the tracer accumulates in the body. The PET scan is often combined with a magnetic resonance imaging (MRI) or computed tomography (CT) scan, which helps to map the locations where PSMA has accumulated. PSMA PET scans may be able to select patients that will benefit the most from Ra-223 treatment.
Additional locations may be listed on ClinicalTrials.gov for NCT05924672.
Locations matching your search criteria
United States
California
San Francisco
University of California San FranciscoStatus: Active
Contact: Thomas A. Hope
Phone: 415-353-9437
PRIMARY OBJECTIVE:
I. To determine the PSA50 response rate of patients treated with radium Ra 223 dichloride (Ra-223).
SECONDARY OBJECTIVES:
I. To determine the median overall survival (mOS) of patients treated with Ra-223.
II. To determine the PSA30 response rate of patients treated with Ra-223.
III. To determine the time to the first skeletal symptomatic event.
IV. To characterize the safety profile of Ra-223 treatment.
V. To compare the lesion based PSMA PET response based on sodium fluoride (NaF) PET/technetium Tc-99m medronate (MDP) single photon emission computed tomography (SPECT) uptake.
EXPLORATORY OBJECTIVES;
I. To compare the PSA response stratified by PSMA PET tumor volume.
II. To determine the location of progression by location.
III. Safety on subsequent treatment with PSMA radioligand therapy (RLT).
OUTLINE:
Patients undergo NaF PET/CT or MDP scan within 45 days prior to cycle 1 day 1. Patients then receive standard of care (SOC) Ra-223 intravenously (IV) on day 1 of each cycle. Treatment repeats every 28 days for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients then undergo PSMA PET/CT over 45-60 minutes between 30-60 days after the last dose of Ra-223. Patients also undergo collection of blood samples during screening, on day 1 of every Ra-223 cycle, and at 30 days after the last dose of Ra-223. Patients may also undergo NaF PET/CT or MDP scans during Ra-223 treatment as clinically indicated, and/or CT scans during screening and Ra-223 treatment as clinically indicated.
After completion of Ra-223 treatment, patients are followed up at 30 days, and then every 3-6 months.
Lead OrganizationUniversity of California San Francisco
Principal InvestigatorThomas A. Hope
