MC1R-targeted Alpha-particle Monotherapy and Combination Therapy Trial With Nivolumab in Adults With Advanced Melanoma

Study Purpose

In this first-in human, phase I/IIa study, the safety and efficacy of [212Pb]VMT01, an alpha-particle emitting therapeutic agent targeted to melanocortin sub-type 1 receptor (MC1R) is being evaluated as a monotherapy and in combination with Nivolumab in subjects with unresectable and metastatic melanoma.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years - 90 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Ability to understand and willingness to provide informed consent, willingness to comply with all study procedures for the duration of the study.
  • - Aged ≥ 18 years.
  • - Diagnosed with unresectable Stage III or Stage IV metastatic melanoma.
  • - Previously progressed (clinical or radiological progression) on at least one approved first-line therapy for metastatic melanoma.
  • - Uptake of [68Ga]VMT02 or [203Pb]VMT01 by PET or SPECT imaging observed in at least one melanoma tumor site using quantitative imaging analysis compared to reference normal tissue.
  • - Subjects on prior intravenous therapy (e.g., chemotherapy or checkpoint inhibitors), or prior oral therapy (e.g.,proto-oncogene B-RAF or mitogen-activated extracellular signal-regulated kinase inhibitors) who demonstrate MC1R positivity during screening are eligible for enrollment, provided that they undergo a wash-out period of 21 days, or 7 days, respectively, prior to Cycle 1 Day 1 treatment with [212Pb]VMT01.
  • - Presence of measurable disease by RECIST v1.1 assessed within 30 days prior to the first dose of [212Pb]VMT01 on Cycle 1 Day 1.
  • - Ability to lie flat and still for up to two hours for imaging scans; moderate conscious sedation allowed if indicated.
  • - For females of reproductive potential: agree to use of highly effective contraception and refrain from donating eggs (ova, oocytes) for the purpose of reproduction starting from screening, during treatment with [212Pb]VMT01 and/or nivolumab, and for at least 6 months after the last dose of [212Pb]VMT01 and/or nivolumab, whichever is administered last.
  • - For males of reproductive potential: agree to use of condoms or other methods to ensure effective contraception and refrain from donating sperm starting from screening, during treatment with [212Pb]VMT01 and/or nivolumab, and for at least 6 months after the last dose of [212Pb]VMT01 and/or nivolumab, whichever is administered last.
  • - Eastern Cooperative Oncology Group performance score of < 2 at Screening.
  • - Life expectancy of at least 3 months after Cycle 1 Day 1.
  • - Satisfactory organ function determined by laboratory testing.

Exclusion Criteria:

  • - Active secondary malignancy.
  • - Prior systematic treatment with radioactive nuclides.
Subjects who had localized treatment with radioactive nuclides or imaging using radioactive imaging agents may be enrolled.
  • - Pregnancy or breastfeeding a child.
  • - Any serious/active/uncontrolled infection requiring parenteral antibiotics within 2 weeks before the first administration of [212Pb]VMT01.
  • - Febrile illness within 48 hours of any scheduled investigational product ([212Pb]VMT01, [203Pb]VMT01, or [68Ga]VMT02) administration; subjects should be rescheduled > 48 hours after resolution of fever.
  • - Treatment with another investigational drug product (therapeutic IND agents) within the last 45 days before the first dose of [212Pb]VMT01 on C1D1.
  • - Current abuse of alcohol or illicit drugs.
  • - Existence of any medical or social issues likely to interfere with study conductor that may cause increased risk to the subject or to others, e.g., lack of ability to follow radiation safety precautions.
Additional exclusion criteria for subjects who will receive combination therapy with nivolumab:
  • - Untreated central nervous system (CNS) metastasis or metastasis requiring acute therapy of any modality.
Subjects must have been either off corticosteroids, or on a stable or decreasing dose of prednisone (or equivalent) for at least 2 weeks prior to the first dose of [212Pb]VMT01.
  • - Concurrent malignancy requiring treatment or history of prior malignancy active within 2 years prior to the first dose of [212Pb]VMT01.
  • - Subjects with an active, known, or suspected autoimmune disease.
  • - Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications.
  • - Acute or chronic hepatitis B (e.g., Hepatitis B surface antigen reactive), hepatitis C (e.g., HCV RNA [qualitative] is detected) or known history of Human Immunodeficiency Virus (HIV) with an acquired immunodeficiency syndrome.
  • - Treatment with complementary medications (e.g., herbal supplements or traditional Chinese medicines) - Existence of abnormal laboratory values in hematology, liver, and renal function.
  • - Treatment with any live/attenuated vaccine within 30 days prior to the first dose of [212Pb]VMT01.
  • - Any treatment-related toxicities from prior systemic immune therapy with the exception of those unlikely to re-occur with standard countermeasures.
- History of allergy or hypersensitivity to nivolumab or its components

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT05655312
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1/Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Perspective Therapeutics
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Melanoma (Skin), Metastatic Melanoma, Melanoma Stage IV, Mucosal Melanoma, Melanoma Stage III
Additional Details

This is a prospective, multi-center open-label dose-escalation, dose-expansion study of [212Pb]VMT01 as a monotherapy or in combination with Nivolumab in up to 264 subjects with histologically confirmed melanoma and a positive MC1R imaging scan with imaging agents [203Pb]VMT01 or [68Ga]VMT02. MC1R is a receptor that is expressed on the surface of melanoma cells and therefore is an attractive therapeutic target for melanoma treatment. Lead-212 ([212Pb]-) based peptide-radiopharmaceuticals are an emerging class of targeted alpha-particle cancer therapies that have potential to improve delivery of a highly effective form of radiation. This study will be conducted in 3 parts: Part 1: Monotherapy Dose-Escalation: [212Pb]VMT01 is administered alone in escalating doses to determine the Maximum Tolerated radioactivity Dose (MTD), Maximum Feasible radioactivity Dose (MFD), and potential recommended Phase 2 doses (RP2Ds) Part 2: Combination-Therapy Dose-Escalation: [212Pb]VMT01 and Nivolumab are administered in escalating doses to determine MTD, MFD, and RP2Ds. Part 3: Dose Expansion: This part will enroll subjects in monotherapy and combination-therapy expansion cohorts based on the identified MTD, MFD, and RP2D for the selection of [212Pb]VMT01 alone and [212Pb]VMT01-Nivolumab combination doses for further clinical development. Enrolled subjects in Monotherapy part may receive up to 3 doses of [212Pb]VMT01 approximately 8 weeks apart and subjects in combination therapy may receive nivolumab every 4 weeks for up to 24 months. A Dosimetry sub-study utilizing an imaging surrogate, [203Pb]VMT01, has been incorporated into the study in order to assess organ biodistribution and tumor uptake of the investigational products. This study will also estimate radiation dosimetry and correlate uptake of the investigation products with observed toxicities and efficacy.

Arms & Interventions

Arms

Experimental: Monotherapy-Dose Escalation

Enrolled subjects will be treated with increasing doses of [212Pb]VMT01 (up to 15 mCi) to determine MTD, MFD, and RP2D. Up to 32 subjects will be enrolled. A dosimetry sub-study utilizing [203Pb]VMT01 has been incorporated into Monotherapy Dose-Escalation arm.

Experimental: Combination Therapy-Dose Escalation

Enrolled subjects will be treated with increasing radioactive doses of [212Pb]VMT01 (up to 15 mCi) in combination with nivolumab to determine MTD, MFD, and RP2D. A dosimetry sub-study utilizing [203Pb]VMT01 has been incorporated into Combination Therapy-Dose Escalation.

Experimental: Monotherapy - Dose Expansion

Up to 2 monotherapy expansion cohorts of up to 25 subjects will be enrolled at previously identified RP2D to confirm the RP2D and regimen for the Phase 2 dose-expansion cohort. A dosimetry sub-study utilizing [203Pb]VMT01 has been incorporated into Monotherapy-Dose Expansion.

Experimental: Combination Therapy - Dose Expansion

Up to 2 Combination Therapy expansion cohorts of up to 25 subjects will be enrolled at RP2Ds previously identified to confirm the RP2D and regimen for the Phase 2 dose-expansion cohort. A dosimetry sub-study utilizing [203Pb]VMT01 has been incorporated into Combination Therapy-Dose Expansion. Once the RP2D and regimen for the Phase 2 dose-expansion cohort is confirmed, up to 100 subjects will be enrolled to confirm the efficacy and safety of the RP2D and regimen.

Interventions

Drug: - [203Pb]VMT01

[203Pb]VMT01 is administered intravenous (IV) as an imaging agent for SPECT/CT

Drug: - [212Pb]VMT01

Subjects with positive uptake of [203Pb]VMT01 will receive a fixed dose of [212Pb]VMT01 administered IV every 8 weeks starting at Cycle 1 Day 1.

Drug: - Nivolumab

For all combination-therapy cohorts, 480 mg nivolumab will be administered every 4 weeks as an IV infusion.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Biogenix Molecular, Miami, Florida

Status

Recruiting

Address

Biogenix Molecular

Miami, Florida, 33165

Site Contact

Milka Vina

[email protected]

786-791-1799

University of Iowa, Iowa City, Iowa

Status

Recruiting

Address

University of Iowa

Iowa City, Iowa, 52242

Site Contact

Kristin West,, RN, BSN

[email protected]

319-394-5489

University of Kentucky, Lexington, Kentucky

Status

Recruiting

Address

University of Kentucky

Lexington, Kentucky, 40536

Site Contact

Yvonne O Taul

[email protected]

859-323-2354

Mayo Clinic Rochester, Rochester, Minnesota

Status

Recruiting

Address

Mayo Clinic Rochester

Rochester, Minnesota, 55905

Saint Louis University Hospital, Saint Louis, Missouri

Status

Recruiting

Address

Saint Louis University Hospital

Saint Louis, Missouri, 63110

Site Contact

Chelsea Webb

[email protected]

314-617-2899

Washington University of St. Louis, Saint Louis, Missouri

Status

Recruiting

Address

Washington University of St. Louis

Saint Louis, Missouri, 63110

Site Contact

John Crandall

[email protected]

314-747-5561

Nebraska Cancer Specialists, Omaha, Nebraska

Status

Recruiting

Address

Nebraska Cancer Specialists

Omaha, Nebraska, 68130

Fox Chase Cancer Center, Philadelphia, Pennsylvania

Status

Recruiting

Address

Fox Chase Cancer Center

Philadelphia, Pennsylvania, 19111

UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania

Status

Recruiting

Address

UPMC Hillman Cancer Center

Pittsburgh, Pennsylvania, 15232

Site Contact

Samantha Demko

[email protected]

412-623-1400

Madison, Wisconsin

Status

Recruiting

Address

University of Wisconsin Carbone Cancer Center

Madison, Wisconsin, 53792

Site Contact

Cancer Connect

[email protected]

800-622-8922

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