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

About

Brief Summary

This is an open-label, randomized, multicenter study of FPI-2265 (225Ac-PSMA-I&T). The dose optimization Phase 2 part will be investigating the safety, tolerability, and anti-tumor activity of novel dosing regimens of FPI-2265 in participants with PSMA-positive mCRPC who have been previously treated with 177Lu-PSMA-617 or another 177Lu-PSMA radioligand therapy (RLT).

Primary Purpose

Treatment

Study Type

Interventional

Phase

Phase 2/Phase 3

Eligibility

Gender

Male

Healthy Volunteers

No

Minimum Age

18 Years

Maximum Age

N/A

Key Inclusion Criteria:

Ability to understand and sign an approved informed consent form (ICF) and comply with all protocol requirements.
Phase 2: 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.
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.

Key Exclusion Criteria:

Participants who received more than two prior lines of cytotoxic chemotherapy for CRPC.
Phase 2: participants who progress within two cycles 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 from the Phase 2 segment of the study.
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.