New bispecific antibody treatment for advanced prostate cancer

First in Human Study to Evaluate the Safety, Tolerability and Preliminary Efficacy of the Bispecific PSMAxCD3 Antibody CC-1 in Patients with Castration Resistant Prostate Carcinoma

This study is testing a new treatment for advanced prostate cancer to see if a special antibody can help patients whose cancer hasn't responded to other therapies.

Quick facts

• Phase: Phase 1
• Study type: Interventional
• Enrollment: 86 (estimated)
• Ages: 18 Years and up
• Sex: Male
• Sponsor: University Hospital Tuebingen (Academic / other)
• Drugs / interventions: tocilizumab, chemotherapy, blinatumomab, CART, immunotherapy
• Locations: 2 sites (Tübingen, Baden-Wurttemberg and 1 other locations)
• Trial ID: NCT04104607 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the safety and efficacy of CC-1, a bispecific antibody targeting prostate-specific membrane antigen (PSMA) and CD3, in patients with castration-resistant metastatic prostate cancer (CRPC) who have failed third-line therapy. The study aims to determine the maximally tolerated dose of CC-1 while using tocilizumab to mitigate side effects. By binding to both cancer cells and tumor vessels, CC-1 is designed to enhance anti-cancer activity and improve immune response. The trial consists of a dose-escalation phase to assess the drug's safety profile and therapeutic potential.

Who should consider this trial

Good fit: Ideal candidates for this study are adult males with castration-resistant prostate cancer who have undergone at least three lines of therapy.

Not a fit: Patients with prostate cancer who have not yet undergone third-line therapy or those with other significant health issues may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new effective option for patients with advanced prostate cancer who have limited treatment alternatives.

How similar studies have performed: While there have been advancements in immunotherapeutics for other cancers, this specific bispecific antibody approach in CRPC is novel and has not been extensively tested in prior studies.

Eligibility criteria

Inclusion Criteria:

Patients with CRPC will be included in this clinical trial. Patients must meet all of the following inclusion criteria to be eligible for enrolment into the study:

* Existence of a written informed consent
* Patient is able to understand and comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations
* CRPC after third line therapy
* Life expectance of \> 3 months
* At least one measurable lesion that can be accurately assessed at baseline by CT or MRI and is suitable for repeated assessment
* Eastern Cooperative Oncology Group Performance (ECOG) Status ≤ 2
* Patient aged ≥ 18, no upper age limit
* Male patients with partners of child-bearing potential, who are sexually active, must agree to the use of two highly effective forms of contraception. This should be started from the signing of the informed consent and continue throughout period of taking study treatment for 3 months after last dose of study drug.
* Adequate bone marrow, renal, and hepatic function defined by laboratory tests within 14 days prior to study treatment:

  * Hemoglobin ≥ 10 g/dl
  * Neutrophil count ≥ 1,500/mm3
  * Platelet count ≥ 100,000/μl
  * Bilirubin ≤ 1.5 x upper limit of normal (ULN)
  * ALT and AST ≤ 2.5 x ULN
  * Alkaline phosphatase ≤ 2.5 x ULN
  * PT-INR/PTT ≤ 1.5 x ULN
  * Creatine kinase ≤ 2.5 x ULN
  * Serum creatinine ≤ 1.5 mg/dl or creatinine clearance ≥ 60 ml/min

Exclusion Criteria:

Patients fulfilling any of the following criteria cannot be enrolled in the trial:

* Other malignancy within the last 5 years except: adequately treated non-melanoma skin cancer
* Concurrent or previous treatment within 30 days in another interventional clinical trial with an investigational anticancer therapy
* Persistent toxicity (≥Grade 2 according to Common Terminology Criteria for Adverse Events \[CTCAE\] version 5.0) caused by previous cancer therapy, excluding alopecia and neurotoxicity (≤ 2 grade)
* Clinical signs of active infection (\>Grade 2 according to CTCAE version 5.0)
* History of HIV infection
* Immunocompromised patients
* Active or chronic viral hepatitis (HBV or HCV)
* History of autoimmune disease
* History of relevant CNS pathology or current relevant CNS pathology (e.g. seizure, paresis, aphasia, cerebrovascular ischemia/hemorrhage, severe brain injuries, dementia, Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis, coordination or movement disorder) Epilepsy requiring pharmacologic treatment
* Therapeutic anticoagulation therapy
* Major surgery within 4 weeks of starting study treatment. Patients must have recovered from any effects of major surgery.
* Patients receiving any systemic chemotherapy or radiotherapy within 2 weeks prior to study treatment or a longer period depending on the defined characteristics of the agents used
* Heart failure NYHA III/IV
* Severe obstructive or restrictive ventilation disorder
* Known history of GI-perforation
* Pre-existing HAHA
* Known intolerance to CC-1, tocilizumab or other immunoglobulin drug products as well as hypersensitivity to any of the excipients present in the respective drug products (CC-1, tocilizumab)

Where this trial is running

Tübingen, Baden-Wurttemberg and 1 other locations

• University Hospital Tuebingen — Tübingen, Baden-Wurttemberg, Germany (Recruiting)
• University hospital Heidelberg — Heidelberg, BadenWuerttemberg, Germany (Not_yet_recruiting)

Study contacts

• Principal investigator: Helmut R Salih, Prof. — KKE Translational Immunology, University Hospital Tübingen
• Study coordinator: Helmut R Salih, Prof.

Conditions Castration-Resistant Prostatic Cancer; PSMA; Resistant Prostate Cancer; PSMAxCD3; CC-1