Phase 1b Study of 177Lu-TLX250 and Peposertib for Treating CAIX-Expressing Advanced Solid Tumors
Led by Telix Pharmaceuticals (Innovations) Pty Limited · Updated on 2024-05-01
36
Participants Needed
5
Research Sites
104 weeks
Total Duration
AI-Summary
What this Trial Is About
Researchers are studying the combination of two treatments, 177Lu-TLX250 and peposertib, in patients who have solid tumors that express carbonic anhydrase IX CAIX. This open-label, single-arm study includes a dose escalation phase to find the best dose combination, followed by a dose expansion phase to further evaluate the treatment. The study focuses on patients with advanced or metastatic solid tumors that have progressed despite standard therapies and includes specific groups such as those with metastatic or non-resectable clear cell renal cell carcinoma ccRCC.
In the first phase, patients receive one of three radioactive doses of 177Lu-TLX250 intravenously on day 1 of each 84-day cycle, combined with peposertib taken orally twice daily from days 4 to 21 of the same cycle. This phase involves small groups to identify the maximum tolerated dose. In the second phase, larger groups receive the recommended dose determined from phase one. Additionally, a diagnostic test involves a single intravenous administration of 89Zr-TLX250 followed by PETCT or PETMRI scans to assess tumor uptake.
Participants will undergo treatment for up to three 84-day cycles or until disease progression or unacceptable side effects occur. They will have regular safety assessments including laboratory tests, vital signs, ECGs, and monitoring for adverse events over the first 42 days. Disease impact will be evaluated using the ECOG performance scale at several time points. After treatment, follow-up visits occur every three months for up to two years to monitor survival, tumor response, and progression. Blood samples will also be collected to check for immune responses to the treatment.
CONDITIONS
Brief Title
Combination of 177Lu-TLX250 and Peposertib in Patients With Carbonic Anhydrase IX -Expressing Solid Tumors
Research Team
M
MEDICAL DIRECTOR, MD
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Histologically confirmed advanced or metastatic solid tumor progressed on or after standard therapies and not eligible for surgery or standard care
At least one measurable lesion on CT/MRI with corresponding CAIX positivity shown by 89Zr-TLX250 uptake
CAIX positivity in at least 75% of total lesion volume (intensity at least 1.5 times normal liver uptake)
ECOG performance status of 0 or 1
Adequate organ function at screening
Life expectancy of at least 6 months
You will not qualify if you...
Prior treatment with 177Lu-TLX250 or any CAIX-targeted therapy
Known allergy to peposertib, girentuximab labeled with zirconium or lutetium, study medication ingredients, or similar proteins/antibodies
Received any radionuclide therapy within 10 half-lives before consent
Chemotherapy, radiation, biological therapy, or investigational treatment within 28 days before study therapy
More than 2 prior lines of cytotoxic chemotherapy or severe blood count problems during last therapy
Unable to stop medications or supplements strongly affecting CYP3A4/5, CYP2C9, or CYP2C19 enzymes
Unable to discontinue H2-blockers or proton-pump inhibitors at least 5 days before treatment
Receiving therapeutic anticoagulation or platelet aggregation inhibitors
Having 5 or more bone metastases, bulky pelvic/femoral tumors over 3 cm, or vertebral spine metastases involving more than 3 vertebrae
Severe other medical conditions or infections that pose risk or affect protocol compliance
Need for other anti-cancer treatments outside study medications (supportive care allowed)
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person) for diagnostic test and eligibility assessments
Treatment
Duration - Up to 3 cycles of 84 days each
Participants receive combination treatment with 177Lu-TLX250 intravenously on Day 1 and peposertib orally twice daily on Days 4-21 of each 84-day cycle, for up to 3 cycles or until disease progression or unacceptable toxicity.
3 treatment cycles with visits on Day 1, Day 29, Day 57 of each cycle
Follow-up
Duration - Up to 24 months after last treatment
Participants are monitored for safety and treatment outcomes including overall survival, tumor response, and progression-free survival after treatment completion.
Visits every 3 months ± 2 weeks for up to 24 months
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SEQUENTIAL
Primary Purpose
TREATMENT
Number of Arms
1
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Published Research Related To This Trial
DNA-Dependent Protein Kinase Inhibitor Peposertib Enhances Efficacy of 177Lu-Based Radioimmunotherapy in Preclinical Models of Prostate and Renal Cell Carcinoma.
Cameron N Johnstone, Laura D Osellame, Zhipeng Cao...