Background:
Biochemically recurrent prostate cancer (BCR) occurs when prostate-specific antigen (PSA)
levels in the blood rise after surgery or radiation. BCR affects 30,000 to 50,000 men
each year. Researchers want to know if a drug (N-803) alone or combined with a vaccine
(ETBX-071) can reduce PSA in BCR prostate cancer after radiation.
Objective:
To test a study drug alone and combined with a vaccine in people with BCR prostate cancer
who have been treated with targeted radiation to areas of recurrent prostate cancer in
the past.
Eligibility:
People aged 18 years and older with BCR prostate cancer who have previously undergone
treatment with stereotactic body radiation therapy (SBRT).
Design:
Participants will be screened. They will have a physical exam with blood tests. They will
have tests of their heart and kidney function. They will have 3 different imaging scans
of their tumors.
N-803 is injected under the skin of the abdomen. ETBX-071 is injected under the skin of
thigh.
Participants will be divided into 2 groups: 1 group will get N-803 alone; 1 group will
get both N-803 and ETBX-071.
The drug or drugs will be given on the first day of 21-day treatment cycles. Participants
will have 8 treatment cycles.
Participants will have a follow-up visit 3 weeks after their last dose of the study
drugs. Blood tests and all 3 imaging scans will be repeated.
Follow-up visits will continue every 4 to 8 weeks for 5 years. These visits will include
a positron emission tomography (PET) scan every 6 months.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT07686380.
Background:
- Biochemical recurrence (BCR) denotes rising prostate serum antigen (PSA) and
negative computed tomography (CT) and Tc99 bone scan following radical prostatectomy
and/or definitive local radiation.
- Beyond local salvage radiation options, the management of BCR has not been clearly
defined.
- As BCR is an asymptomatic stage of disease which can take years to progress to overt
metastatic disease, treatment for this stage should have minimal side effects and
only be for a limited duration of time.
- The advent of prostate-specific membrane antigen (PSMA)-based imaging has driven
stereotactic body radiation therapy (SBRT) in BCR despite lack of robust evidence.
- Further study is required to ascertain the role of SBRT in BCR.
- Due to the presence of only microscopic disease, BCR may be the ideal stage of the
disease to evaluate immunotherapy.
- Previous studies in the GMB have demonstrated that vaccine can lead to delayed
declines in PSA.
- N-803 is an IL-15 superagonist which increases the number of natural killer (NK) and
CD8 T cells without expanding regulatory T-cells. The net effect is to increase the
inflammatory milieu of the tumor microenvironment and this is FDA approved for the
treatment of superficial bladder cancer. There is clinical evidence of the activity
of N-803 in prostate cancer.
- The ETBX-071 is an adenoviral-based vaccine against PSA.
- We have previously demonstrated the effects of vaccine in BCR. N-803 has
demonstrated preclinical synergy with vaccine and has also been associated with PSA
declines in a combination immunotherapy trial in metastatic prostate cancer.
Objectives:
-To estimate efficacy of N-803 alone or with ETBX-071 vaccine, each administered for 6
months, in participants with biochemically recurrent prostate cancer following PSA
progression after SBRT
Eligibility:
- Biochemically recurrent prostate cancer, defined as PSA over 0.8 ng/ml following
radical prostatectomy or >= 2 ng/ml above the nadir following definitive
radiotherapy.
- No evidence of soft tissues disease on CT scan and bone metastasis on technetium-99m
(Tc99) bone scan.
- PSA rise of at least 25% of nadir following prior SBRT treatment for recurrent
prostate cancer
- Eastern Cooperative Oncology Group (ECOG) performance score 0-1.
- No active or organ-threatening autoimmune disease.
Design:
- This is an open-label phase 2 study in which all participants have received prior
SBRT and experienced subsequent PSA progression.
- Participants will be randomized between two treatments: N-803 for 6 months versus
N-803 with ETBX-071 vaccine for 6 months.
Lead OrganizationNational Cancer Institute
Principal InvestigatorMelissa Abel