Metastatic Castration-Resistant Prostate CancerPhase 3SPLASHNCT04647526
Study Evaluating mCRPC Treatment Using PSMA [Lu-177]-PNT2002 Therapy After Second-line Hormonal Treatment
A Phase 3 study testing [Lu-177]-PNT2002, Abiraterone and Enzalutamide in people with Metastatic Castration-Resistant Prostate Cancer, run by POINT Biopharma, a wholly owned subsidiary of Eli Lilly and Company at 54 sites in 6 countries.
Trial summary
The purpose of this study is to evaluate the efficacy and safety of [Lu-177]-PNT2002 in patients with metastatic castration-resistant prostate cancer who have progressed following treatment with androgen receptor axis-targeted therapy (ARAT). Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Metastatic Castration-Resistant Prostate Cancer
- What is being tested?
- [Lu-177]-PNT2002, Abiraterone and Enzalutamide
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 455 participants
- Where
- 54 sitesin 6 countries
- Study dates
- 25 Feb 2021to Mar 2028
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Men only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male aged 18 years or older.
- Histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate.
- Ineligible or averse to chemotherapeutic treatment options.
- Patients must have progressive mCRPC at the time of consent based on at least 1 of the following criteria:
- Serum/plasma PSA progression defined as increase in PSA greater than 25% and >2 ng/mL above nadir, confirmed by progression at 2 time points at least 3 weeks apart.
- Soft-tissue progression defined as an increase ≥20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or a new lesion.
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- Progression of bone disease defined as the appearance of two or more new lesions by bone scan.
- Progression on previous treatment with one ARAT (abiraterone or enzalutamide or darolutamide or apalutamide) in either the CSPC or CRPC setting.
- PSMA-PET scan (i.e., 68Ga-PSMA-11 or 18F-DCFPyL) positive as determined by the sponsor's central reader.
- Castrate circulating testosterone levels (<1.7 nmol/L or <50 ng/dL).
- Adequate organ function, independent of transfusion:
- Bone marrow reserve:
- i. White blood cell (WBC) count ≥2.5 × 10^9/L OR absolute neutrophil count (ANC) ≥1.5 × 10^9/L.
- ii. Platelets ≥100 × 10^9/L.
- iii. Hemoglobin ≥8 mmol/L.
- Liver function:
- i. Total bilirubin ≤1.5 × institutional upper limit of normal (ULN). For patients with known Gilbert's syndrome, ≤3 × ULN is permitted.
- ii. ALT or AST ≤3.0× ULN.
- Renal function:
- i. Serum/plasma creatinine ≤1.5 × ULN or creatinine clearance ≥50 mL/min based on Cockcroft-Gault formula (for patients in France, serum/plasma creatinine ≤1.5 × ULN or CrCl ≥60 mL/min based on Cockcroft-Gault formula).
- Albumin ≥30 g/L.
- Human immunodeficiency virus-infected patients who are healthy and have a low risk of acquired immunodeficiency syndrome-related outcomes are included in this trial.
- For patients who have partners who are pregnant or of childbearing potential: a condom is required along with a highly effective contraceptive method during the study and for 6 months after last study drug administration. Such methods deemed highly effective include a) combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation, b) progestogen-only hormonal contraception associated with inhibition of ovulation, c) intrauterine device (IUD), d) intrauterine hormone-releasing system (IUS), e) bilateral tubal occlusion, f) vasectomy, g) true sexual abstinence: when this is in line with the preferred and usual lifestyle of the subject [periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), declaration of abstinence for the duration of exposure to IMP, and withdrawal are not acceptable methods of abstinence].
- Willing to initiate ARAT therapy (either enzalutamide or abiraterone), pre-specified by investigator, if randomized to Treatment Arm B.
- ECOG performance status 0 to 1.
- Willing and able to comply with all study requirements and treatments (including 177Lu PNT2002) as well as the timing and nature of required assessments.
- Signed informed consent.
Who cannot join
- Patients are excluded from the study if any of the following criteria apply:
- If noted in pathology report, prostate cancer with known significant (>10% present in cells) sarcomatoid or spindle cell or neuroendocrine components. Any small cell component in the cancer should result in exclusion.
- Prior treatment for prostate cancer ≤28 days prior to randomization, with the exclusion of first-line local external beam, ARAT, luteinizing hormone-releasing hormone (LHRH) therapy, or non-radioactive bone-targeted agents.
- Any prior cytotoxic chemotherapy for CRPC (e.g., cabazitaxel or docetaxel); chemotherapy for hormone-sensitive prostate cancer (HSPC) is allowed if the last dose was administered >1 year prior to consent.
- Prior treatment with systemic radionuclides (e.g. radium-223, rhenium-186, strontium 89).
- Prior immuno-therapy, except for sipuleucel-T.
Show all 26Show fewer
- Prior PSMA-targeted radioligand therapy, e.g., Lu-177-PSMA-617, I 131-1095.
- Prior poly ADP ribose polymerase (PARP) inhibitor for prostate cancer.
- Patients who progressed on 2 or more lines of ARATs.
- Patients receiving bone-targeted therapy (e.g. denosumab, zoledronic acid) not on stable doses for at least 4 weeks prior to randomization.
- Administration of an investigational agent ≤60 days or 5 half-lives, whichever is shorter, prior to randomization.
- Major surgery ≤30 days prior to randomization.
- Estimated life expectancy <6 months as assessed by the principal investigator.
- Presence of liver metastases >1 cm on abdominal imaging.
- A superscan on bone scan defined as a bone scan that demonstrates markedly increased skeletal radioisotope uptake relative to soft tissues in association with absent or faint genitourinary tract activity.
- Dose escalation or initiation of opioids for cancer-related pain ≤30 days prior to consent up to and including randomization.
- Known presence of central nervous system metastases.
- Contraindications to the use of planned ARAT therapy, [Ga-68]-PSMA-11, [F-18]-DCFPyL or [Lu-177]-PNT2002 therapy, including but not limited to the following:
- Hypersensitivity to [Ga-68]-PSMA-11, [F-18]-DCFPyL or [Lu-177]-PNT2002 excipients (Diethylenetriaminepentaacetic acid (DTPA), Sodium ascorbate, Lascorbic acid, Sodium gentisate, HCl, Sodium hydroxide).
- Recent myocardial infarction or arterial thrombotic events (in the past 6 months) or unstable angina (in the past 3 months), bradycardia or left ventricular ejection fraction measurement of < 50%.
- History of seizures in patients planned to receive enzalutamide.
- Active malignancy other than low-grade non-muscle-invasive bladder cancer and non-melanoma skin cancer.
- Concurrent illness that may jeopardize the patient's ability to undergo study procedures.
- Serious psychological, familial, sociological, or geographical condition that might hamper compliance with the study protocol and follow-up schedule. Patients that travel need to be capable of repeated visits even if they are on the control arm.
- Symptomatic cord compression, or clinical or radiologic findings indicative of impending cord compression.
- Concurrent serious (as determined by the investigator) medical conditions, including, but not limited to, New York Heart Association class III or IV congestive heart failure (see 12.1 Appendix 1), unstable ischemia, uncontrolled symptomatic arrhythmia, history of congenital prolonged QT syndrome, uncontrolled infection, known active hepatitis B or C, or other significant co-morbid conditions that in the opinion of the investigator would impair study participation or cooperation.
Trial locations and contacts
54 sites in 6 countries.
54 sites in 6 countries
United States33 sites
New Mexico Oncology Hematology Consultants Ltd., New Mexico Cancer Center
Albuquerque, New Mexico, 87109
University of Michigan Hospitals
Ann Arbor, Michigan, 48109
University of Colorado Hospital
Aurora, Colorado, 80045
University of Maryland Greenebaum Cancer Center
Baltimore, Maryland, 21201
Tri-State Urologic Services
Cincinnati, Ohio, 45212
Dallas VA Medical Center, Nuclear Medicine Service
Dallas, Texas, 75216
UT Southwestern Medical Center
Dallas, Texas, 75390
Karmanos Cancer Center
Detroit, Michigan, 48201
Astera Cancer Care
East Brunswick, New Jersey, 08816
Excel Diagnostics & Nuclear Oncology Center
Houston, Texas, 77402
University of Iowa Hospitals and Clinics
Iowa City, Iowa, 52242
Greater Dayton Cancer Center
Kettering, Ohio, 45409
University of Kentucky Chandler Medical Center
Lexington, Kentucky, 40536
Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute
Los Angeles, California, 90048
VA Greater Los Angeles Healthcare System
Los Angeles, California, 90073
University of California Los Angeles, Nuclear Medicine Clinic
Los Angeles, California, 90095
Carolina Urologic Research Center
Myrtle Beach, South Carolina, 29572
Vanderbilt-Ingram Cancer Center
Nashville, Tennessee, 37232
Tulane University Medical Center
New Orleans, Louisiana, 70112
New York Presbyterian Hospital/Weill Cornell Medical Center
New York, New York, 10065
Hoag Memorial Hospital Presbyterian
Newport Beach, California, 92663
Urology Cancer Center, PC
Omaha, Nebraska, 68130
UC Irvine Chao Family Comprehensive Cancer Center
Orange, California, 92868
Stanford Cancer Institute
Palo Alto, California, 94305
Perelman Center for Advanced Medicine
Philadelphia, Pennsylvania, 19104
Fox Chase Cancer Center
Philadelphia, Pennsylvania, 19111
Swedish Cancer Institute Research
Seattle, Washington, 98104
VA St. Louis Health Care System
St Louis, Missouri, 63106
Saint Louis University Hospital
St Louis, Missouri, 63110
Washington University School of Medicine
St Louis, Missouri, 63110
H. Lee Moffitt Cancer Center & Research Institute
Tampa, Florida, 33612
Chesapeake Urology Associates (CUA) P.A.
Towson, Maryland, 21204
Arizona Institute of Urology (AIU) - Tucson
Tucson, Arizona, 85704
Canada8 sites
Nova Scotia Health Authority
Halifax, Nova Scotia, B3H 2Y9
London Health Sciences Center - Victoria Hospital
London, Ontario, N6A 5W9
CHUM - University Hospital of Montreal
Montreal, Quebec, H2X 3E4
Jewish General Hospital
Montreal, Quebec, H3T 1E2
CHU of Quebec - Laval University
Québec, Quebec, G1R 2J6
Sunnybrook Research Institute, Odette Cancer Center
Toronto, Ontario, M4N 3M5
Princess Margaret Cancer Centre
Toronto, Ontario, M5G 2M9
BC Cancer - Vancouver
Vancouver, British Columbia, V5Z 4E6
France6 sites
Center Jean Perrin, Department of Medical Oncology
Clermont-Ferrand, 63011
Claude Huriez Hospital
Lille, 59037
Leon Berard Center
Lyon, 69373
La Timone Hospital, Nuclear Medicine Department
Marseille, 13385
Montpellier Cancer Institute, Department of Nuclear Medicine
Montpellier, 34298
Tenon Hospital, Department of Medical Oncology
Paris, 75020
Netherlands3 sites
St. Antonius Hospital
Nieuwegein
Radboud University Medical Center (Radboudumc)
Nijmegen
Erasmus University Medical Center Rotterdam
Rotterdam, 3015 GD
Sweden2 sites
Sahlgrenska University Hospital
Gothenburg, 41345
Norrlands University Hospital, Department of Radiation Sciences, Oncology
Umeå
United Kingdom2 sites
Charing Cross Hospital, Department of Medical Oncology
London
Royal Marsden NHS Foundation Trust - Institute of Cancer Research
Sutton
About this study
Official title: A Phase 3, Open-Label, Randomized Study Evaluating Metastatic Castrate Resistant Prostate Cancer Treatment Using PSMA [Lu-177]-PNT2002 Therapy After Second-line Hormonal Treatment (SPLASH)
The purpose of this study is to evaluate the efficacy and safety of [Lu-177]-PNT2002 in patients with metastatic castration-resistant prostate cancer who have progressed following treatment with androgen receptor axis-targeted therapy (ARAT).
Read the detailed description
The primary objective of the study is to determine the efficacy of [Lu-177]-PNT2002 ([Lu-177]-PSMA-I\&T) versus abiraterone or enzalutamide in delaying radiographic progression in patients with mCRPC.
The study consists of 3 phases: Dosimetry, Randomized Treatment, and Long term Follow up.
The study will commence with a 25-patient safety and dosimetry lead-in (Part 1) and proceed to a randomization treatment phase in approximately 390 patients (Part 2). Patients in Part 2 will be randomized in a 2:1 ratio to receive either [Lu-177]-PNT2002 (Arm A), or enzalutamide or abiraterone (Arm B). Patients in Arm B who experience radiographic progression per central review and meet protocol defined eligibility, may crossover to receive [Lu-177]-PNT2002. After final overall survival (OS) analysis, all patients will continue to be followed through Continued Access, including long-term follow-up (LTFU) for at least 5 years from the first therapeutic dose, death, or loss to follow up (Part 3).
Only patients that meet PSMA PET avidity criteria per central review will be eligible for this study.
- Being tested
- [Lu-177]-PNT2002, Abiraterone, Enzalutamide
- Keywords
- PSMA, mCRPC, Prostate cancer, 177Lu-PSMA, radioligand therapy, PSMA-I&T, SPLASH
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
[Lu-177]-PNT2002Drug
Also called [Lu-177]-PSMA-I&T, LY4187525
Participants randomized to Arm A will receive 6.8 GBq (±10%) of [Lu-177]-PNT2002 every 8 weeks for 4 cycles
AbirateroneDrug
Abiraterone (1000 mg orally once daily with: 5 mg twice daily prednisone or 0.5 mg once daily dexamethasone)
EnzalutamideDrug
Enzalutamide (160 mg orally once daily)
| Study group | Role | What they receive |
|---|---|---|
| Lead-in Dosimetry Phase: [Lu-177]-PNT2002 | Experimental | Participants received 6.8 gigabecquerels (GBq) (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. Receives: Drug: [Lu-177]-PNT2002 |
| Randomization Phase: [Lu-177]-PNT2002 (Arm A) | Experimental | Participants received 6.8 GBq (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. Receives: Drug: [Lu-177]-PNT2002 |
| Randomization Phase: Abiraterone or Enzalutamide (Arm B) | Active comparator | Participants received either of below treatments until radiographic progression.
* Enzalutamide 160 milligram (mg) orally once daily (or)
* Abiraterone 1000 mg orally once daily coadministered with prednisone 5 mg orally twice daily or dexamethasone 0.5 mg orally once daily.
Participants who experienced radiographic progression per Blinded Independent Central Review (BICR) (or after final overall survival (OS), per local investigator-assessment), had not started an intervening treatment, and had no uncontrolled adverse events (AEs) were eligible to consent to cross over to receive 6.8 GBq (±10%) of [Lu-177]-PNT2002 intravenous infusion every 8 weeks for 4 cycles. Receives: Drug: [Lu-177]-PNT2002; Drug: Abiraterone; Drug: Enzalutamide |
| Pharmacokinetic (PK) Extension Phase: [Lu-177]-PNT2002 | Experimental | Participants received 6.8 GBq (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. Receives: Drug: [Lu-177]-PNT2002 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Randomization Phase: Radiographic Progression-Free Survival (rPFS)
- rPFS, as assessed by blinded independent central review (BICR), is the time from the randomization date to progression on soft tissue per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) or confirmed progression on bone lesions by Prostate Cancer Working Group 3 (PCWG3) criteria, or death from any cause.
- The date of disease progression is the date of the scan for the first objectively documented progressive disease (PD) per RECIST v1.1 or PCWG3. PD is defined as a ≥20% increase in the sum of the diameters of target lesions (≥5 mm absolute), with reference being the smallest sum in the study, or unequivocal progression of non-target lesions, or appearance of new lesions.
- Participants who do not progress, including those who started new anticancer therapy, withdrew from the study, or were lost to follow-up without disease progression, were censored at the last valid assessment for RECIST v1.1 or PCWG3.
Measured: From the randomization date to the first documented progressive disease or death from any cause (up to 23 months)
Secondary outcomes (5)
Randomization Phase: Percentage of Participants With Objective Response Rate (ORR)
- ORR, as assessed by BICR, is the best confirmed overall tumor response of complete response (CR) or partial response (PR) as per RECIST v1.1 ( in the absence of confirmed progression on bone scan assessed by PCWG3).
- CR is a disappearance of all target and non-target lesions. Any pathological lymph nodes (whether target or non-target) must have a reduction in the short axis to <10 millimeters (mm).
- PR is at least a 30% decrease in the sum of diameters of target lesions (taking as reference the baseline sum diameters), without progression of non-target lesions or appearance of new lesions.
Measured: Randomization until measured progressive disease (up to 23 months)
Randomization Phase: Duration of Response
Duration of Response, as assessed by BICR, is the time from the date of first documented confirmed CR or PR as per RECIST v1.1 (in the absence of confirmed progression on bone scan assessed by PCWG3) to the date of first documented radiographic progression or death in the absence of progression. Participants who have attained CR or PR as the best overall response, did not have progressive disease, and did not die will be censored.
Measured: From the date of first CR or PR to disease progression or death (up to 16.3 months)
Randomization Phase: Percentage of Participants With Prostate-Specific Antigen (PSA) Response Rate
The PSA response rate, as per the PCWG3 criteria, is the percentage of participants achieving a ≥50% decrease in PSA from baseline to the lowest post-baseline PSA result, confirmed by a second PSA assessment conducted at least 3 weeks later.
Measured: From the randomization up to 23 months
Randomization Phase: Biochemical Progression-Free Survival (bPFS)
bPFS is the time from the date of randomization to the date of the first PSA increase from baseline ≥25% and ≥2 nanograms per milliliter (ng/mL) above nadir confirmed by a second PSA measurement defining progression ≥3 weeks later, as per PCWG3, or death from any cause in the absence of progression. Participants who do not progress or die including those who withdraw from the study or are lost to follow-up will be censored at the time of last valid PSA measurement.
Measured: From the randomization up to 23 months
Overall Survival
Time from the date of randomization until death due to any cause.
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Dec 2020
- Study start25 Feb 2021
- Primary completion1 Nov 2023
- Study completionMar 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Metastatic Castration-Resistant Prostate CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 455 participants (actual)
Sponsor and investigators
- Lead sponsor
- POINT Biopharma, a wholly owned subsidiary of Eli Lilly and Company
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Jessica Jensen, Study director, Eli Lilly and Company
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04647526
- Sponsor's protocol ID
- 27232
- Other IDs
- J5T-OX-JXCA, PBP-301, 2021-002641-15, 2024-515604-39-00
- Acronym
- SPLASH
- Status last verified
- Dec 2025
- First submitted
- 23 Nov 2020
- Last updated
- 13 Jan 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Baum RP, Kulkarni HR, Schuchardt C, Singh A, Wirtz M, Wiessalla S, Schottelius M, Mueller D, Klette I, Wester HJ. 177Lu-Labeled Prostate-Specific Membrane Antigen Radioligand Therapy of Metastatic Castration-Resistant Prostate Cancer: Safety and Efficacy. J Nucl Med. 2016 Jul;57(7):1006-13. doi: 10.2967/jnumed.115.168443. Epub 2016 Jan 21.
PubMed 26795286Hansen AR, Probst S, Beauregard JM, Viglianti BL, Michalski JM, Tagawa ST, Sartor O, Tutrone RF, Oz OK, Courtney KD, Delpassand ES, Nordquist LT, Osman MM, Chi KN, Sparks R, George N, Hawley SM, Wu W, Jensen JD, Fleshner NE. Initial clinical experience with [177Lu]Lu-PNT2002 radioligand therapy in metastatic castration-resistant prostate cancer: dosimetry, safety, and efficacy from the lead-in cohort of the SPLASH trial. Front Oncol. 2025 Jan 7;14:1483953. doi: 10.3389/fonc.2024.1483953. eCollection 2024.
PubMed 39839782American College of Nuclear Medicine (ACNM) 2022 ACNM Annual Meeting AbstractsJanuary 27-29, 2022 Virtual Meeting. Clin Nucl Med. 2023 Feb 3:e246-e277. doi: 10.1097/RLU.0000000000004535. Online ahead of print. No abstract available.
PubMed 36735603
Study at a glance
From the registry record, last updated by the sponsor on 13 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Open-Label, Randomized Study Evaluating Metastatic Castrate Resistant Prostate Cancer Treatment Using PSMA [Lu-177]-PNT2002 Therapy After Second-line Hormonal Treatment (SPLASH)
- ClinicalTrials.gov ID
- NCT04647526
- Acronym / sponsor ID
- SPLASH / 27232
- Keywords
- PSMA, mCRPC, Prostate cancer, 177Lu-PSMA, radioligand therapy, PSMA-I&T, SPLASH
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 455 participants (actual)
- Lead sponsor
- POINT Biopharma, a wholly owned subsidiary of Eli Lilly and CompanyIndustry (pharma, biotech, devices)
- Study start
- 25 Feb 2021 (actual)
- Primary completion
- 1 Nov 2023 (actual)
- Study completion
- Mar 2028 (estimated)
- First posted
- 1 Dec 2020 (actual)
- Results
- Posted 13 Jan 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the efficacy and safety of [Lu-177]-PNT2002 in patients with metastatic castration-resistant prostate cancer who have progressed following treatment with androgen receptor axis-targeted therapy (ARAT).
Detailed description
The primary objective of the study is to determine the efficacy of [Lu-177]-PNT2002 ([Lu-177]-PSMA-I\&T) versus abiraterone or enzalutamide in delaying radiographic progression in patients with mCRPC.
The study consists of 3 phases: Dosimetry, Randomized Treatment, and Long term Follow up.
The study will commence with a 25-patient safety and dosimetry lead-in (Part 1) and proceed to a randomization treatment phase in approximately 390 patients (Part 2). Patients in Part 2 will be randomized in a 2:1 ratio to receive either [Lu-177]-PNT2002 (Arm A), or enzalutamide or abiraterone (Arm B). Patients in Arm B who experience radiographic progression per central review and meet protocol defined eligibility, may crossover to receive [Lu-177]-PNT2002. After final overall survival (OS) analysis, all patients will continue to be followed through Continued Access, including long-term follow-up (LTFU) for at least 5 years from the first therapeutic dose, death, or loss to follow up (Part 3).
Only patients that meet PSMA PET avidity criteria per central review will be eligible for this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Lead-in Dosimetry Phase: [Lu-177]-PNT2002 | Experimental | Drug: [Lu-177]-PNT2002Participants received 6.8 gigabecquerels (GBq) (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. |
| Randomization Phase: [Lu-177]-PNT2002 (Arm A) | Experimental | Drug: [Lu-177]-PNT2002Participants received 6.8 GBq (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. |
| Randomization Phase: Abiraterone or Enzalutamide (Arm B) | Active comparator | Drug: [Lu-177]-PNT2002, Drug: Abiraterone, Drug: EnzalutamideParticipants received either of below treatments until radiographic progression. * Enzalutamide 160 milligram (mg) orally once daily (or) * Abiraterone 1000 mg orally once daily coadministered with prednisone 5 mg orally twice daily or dexamethasone 0.5 mg orally once daily. Participants who experienced radiographic progression per Blinded Independent Central Review (BICR) (or after final overall survival (OS), per local investigator-assessment), had not started an intervening treatment, and had no uncontrolled adverse events (AEs) were eligible to consent to cross over to receive 6.8 GBq (±10%) of [Lu-177]-PNT2002 intravenous infusion every 8 weeks for 4 cycles. |
| Pharmacokinetic (PK) Extension Phase: [Lu-177]-PNT2002 | Experimental | Drug: [Lu-177]-PNT2002Participants received 6.8 GBq (±10%) of [Lu-177]-PNT2002 by intravenous infusion every 8 weeks for 4 cycles. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (27 listed)
- Male aged 18 years or older.
- Histological, pathological, and/or cytological confirmation of adenocarcinoma of the prostate.
- Ineligible or averse to chemotherapeutic treatment options.
- Patients must have progressive mCRPC at the time of consent based on at least 1 of the following criteria:
- Progression on previous treatment with one ARAT (abiraterone or enzalutamide or darolutamide or apalutamide) in either the CSPC or CRPC setting.
Key exclusion criteria (26 listed)
- If noted in pathology report, prostate cancer with known significant (>10% present in cells) sarcomatoid or spindle cell or neuroendocrine components. Any small cell component in the cancer should result in exclusion.
- Prior treatment for prostate cancer ≤28 days prior to randomization, with the exclusion of first-line local external beam, ARAT, luteinizing hormone-releasing hormone (LHRH) therapy, or non-radioactive bone-targeted agents.
- Any prior cytotoxic chemotherapy for CRPC (e.g., cabazitaxel or docetaxel); chemotherapy for hormone-sensitive prostate cancer (HSPC) is allowed if the last dose was administered >1 year prior to consent.
- Prior treatment with systemic radionuclides (e.g. radium-223, rhenium-186, strontium 89).
- Prior immuno-therapy, except for sipuleucel-T.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| [Lu-177]-PNT2002Also: [Lu-177]-PSMA-I&T, LY4187525Participants randomized to Arm A will receive 6.8 GBq (±10%) of [Lu-177]-PNT2002 every 8 weeks for 4 cycles | Drug | Lead-in Dosimetry Phase: [Lu-177]-PNT2002, Pharmacokinetic (PK) Extension Phase: [Lu-177]-PNT2002, Randomization Phase: Abiraterone or Enzalutamide (Arm B), Randomization Phase: [Lu-177]-PNT2002 (Arm A) |
| AbirateroneAbiraterone (1000 mg orally once daily with: 5 mg twice daily prednisone or 0.5 mg once daily dexamethasone) | Drug | Randomization Phase: Abiraterone or Enzalutamide (Arm B) |
| EnzalutamideEnzalutamide (160 mg orally once daily) | Drug | Randomization Phase: Abiraterone or Enzalutamide (Arm B) |
Primary outcome
Randomization Phase: Radiographic Progression-Free Survival (rPFS)
Time frame: From the randomization date to the first documented progressive disease or death from any cause (up to 23 months)
* rPFS, as assessed by blinded independent central review (BICR), is the time from the randomization date to progression on soft tissue per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) or confirmed progression on bone lesions by Prostate Cancer Working Group 3 (PCWG3) criteria, or death from any cause. * The date of disease progression is the date of the scan for the first objectively documented progressive disease (PD) per RECIST v1.1 or PCWG3. PD is defined as a ≥20% increase in the sum of the diameters of target lesions (≥5 mm absolute), with reference being the smallest sum in the study, or unequivocal progression of non-target lesions, or appearance of new lesions. * Participants who do not progress, including those who started new anticancer therapy, withdrew from the study, or were lost to follow-up without disease progression, were censored at the last valid assessment for RECIST v1.1 or PCWG3.
5 secondary outcomes
Randomization Phase: Percentage of Participants With Objective Response Rate (ORR)
Time frame: Randomization until measured progressive disease (up to 23 months)
Randomization Phase: Duration of Response
Time frame: From the date of first CR or PR to disease progression or death (up to 16.3 months)
Randomization Phase: Percentage of Participants With Prostate-Specific Antigen (PSA) Response Rate
Time frame: From the randomization up to 23 months
Randomization Phase: Biochemical Progression-Free Survival (bPFS)
Time frame: From the randomization up to 23 months
Overall Survival
Time frame: 5 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jan 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 26795286Baum RP, Kulkarni HR, Schuchardt C, Singh A, Wirtz M, Wiessalla S, Schottelius M, Mueller D, Klette I, Wester HJ. 177Lu-Labeled Prostate-Specific Membrane Antigen Radioligand Therapy of Metastatic Castration-Resistant Prostate Cancer: Safety and Efficacy. J Nucl Med. 2016 Jul;57(7):1006-13. doi: 10.2967/jnumed.115.168443. Epub 2016 Jan 21.
- Derived from this study: PubMed 39839782Hansen AR, Probst S, Beauregard JM, Viglianti BL, Michalski JM, Tagawa ST, Sartor O, Tutrone RF, Oz OK, Courtney KD, Delpassand ES, Nordquist LT, Osman MM, Chi KN, Sparks R, George N, Hawley SM, Wu W, Jensen JD, Fleshner NE. Initial clinical experience with [177Lu]Lu-PNT2002 radioligand therapy in metastatic castration-resistant prostate cancer: dosimetry, safety, and efficacy from the lead-in cohort of the SPLASH trial. Front Oncol. 2025 Jan 7;14:1483953. doi: 10.3389/fonc.2024.1483953. eCollection 2024.
- Derived from this study: PubMed 36735603American College of Nuclear Medicine (ACNM) 2022 ACNM Annual Meeting AbstractsJanuary 27-29, 2022 Virtual Meeting. Clin Nucl Med. 2023 Feb 3:e246-e277. doi: 10.1097/RLU.0000000000004535. Online ahead of print. No abstract available.
- 1400P - Efficacy and safety of 177Lu-PNT2002 prostate-specific membrane antigen (PSMA) therapy in metastatic castration resistant prostate cancer (mCRPC): Initial results from SPLASHLink provided by the sponsor.
- ESMO 2024: Efficacy of 177Lu-PNT2002 in PSMA-Positive mCRPC Following Progression on an Androgen-Receptor Pathway Inhibitor (SPLASH)Link provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jessica Jensen study director
Eli Lilly and Company
54 sites in 6 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing [Lu-177]-PNT2002, Abiraterone and Enzalutamide in people with Metastatic Castration-Resistant Prostate Cancer, run by POINT Biopharma, a wholly owned subsidiary of Eli Lilly and Company at 54 sites in 6 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 27 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 13 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 54 sites in United States, Canada, France, Netherlands, Sweden and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 13 Jan 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Randomization Phase: Radiographic Progression-Free Survival (rPFS) (time frame: From the randomization date to the first documented progressive disease or death from any cause (up to 23 months)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04647526, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2026.