Metastatic Prostate CancerPhase 3NCT04876651
The Present Study Aims to Compare Patients Who Receive the Investigational Product (177Lu-DOTA-rosopatamab) Plus Standard of Care, in Comparison to Standard of Care Only
A Phase 3 study testing 177Lu-DOTA-rosopatamb in people with Metastatic Prostate Cancer, run by Telix Pharmaceuticals (Innovations) Pty Ltd at 6 sites in 2 countries.
Trial summary
This multinational, multicenter, prospective, randomized, controlled, open label Phase 3 study is designed to investigate and confirm the benefits and risks associated with the PSMA-targeted antibody, 177Lu DOTA rosopatamab administered together with Standard of Care (SoC), as compared to the best SoC alone. Read more about this study
- Who is it for?
- Ages 18 years and older, men only
- Conditions the study is for
- Metastatic Prostate Cancer
- What is being tested?
- 177Lu-DOTA-rosopatamb
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 16 participants
- Where
- 6 sitesin 2 countries
- Study dates
- 29 Aug 2023to 1 Jul 2025
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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
- Be a male, at least 18 years old, with metastatic adenocarcinoma of the prostate defined by histological / pathological confirmation of PC.
- Be of ECOG Performance Status 0, 1, or 2 and have an estimated life expectancy of ≥6 months.
- Have metastatic disease (≥1 metastatic lesions present on baseline CT, MRI, or bone scan imaging).
- Have castration-resistant PC (defined as disease progressing despite castration by orchiectomy or ongoing use of luteinizing hormone-releasing hormone [LHRH]) and must have a castrate level of serum/plasma testosterone (<50 ng/dL or <1.7 nmol/L).
- In the mCRPC setting, must have received a minimum of 12 weeks of prior therapy with a NAAD, either enzalutamide or abiraterone plus prednisone.
- Should have received one line of prior taxane therapy or have refused or be ineligible for taxanes
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- Have a disease that is progressing at study entry, despite a castrate testosterone level (<50 ng/dL or <1.7 nmol/L), by the demonstration of at least one of the following:
- Rising PSA values done in sequence at least 1 week apart and with a minimal starting value of 2.0 ng/mL.
- Progressive disease or new lesion(s) in the viscera or lymph nodes as per RECIST1.1 or in bone as per Prostate Cancer Working Group 3 [PCWG3; Scher et al., 2016]). Any ambiguous results are to be confirmed by other imaging modality (e.g., CT or MRI scan).
- Have disease that is PSMA positive, as demonstrated by a 68Ga-PSMA11 PET/CT scan and confirmed as eligible by the Sponsor's central reader (patient must have at least one site of metastatic disease with SUVmax ≥1.5 times the SUV of normal liver). If the disease meets the criteria for PSMA positivity, but there is one or more soft tissue lesion of ≥ 2 cm that is not PSMA positive, then the patient is to be excluded on the grounds that there is substantial disease which might not respond to the therapy.
- Must have recovered to ≤ Grade 2 from all clinically significant toxicities related to prior therapies (i.e., surgery, local radiotherapy, NAAD, chemotherapy, etc.).
- Can be receiving a bisphosphonate or denosumab regimen provided that the patient has been receiving and tolerating this treatment for ≥30 days prior to randomization.
- Have adequate organ function at Screening:
- Bone marrow: i. Platelets ≥150×109/L. ii. Absolute neutrophil count >1.5×109/L. iii. Hemoglobin ≥10g/dL (no red blood cell transfusion in the previous 4 weeks).
- Liver function: i. Total bilirubin < 1.5×the upper limit of normal (ULN). For patients with known Gilbert's Syndrome <3×ULN is permitted. ii. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) <3×ULN OR <5×ULN for patients with liver metastases. c. Renal function: i. Serum/plasma creatinine <1.5×ULN or creatinine clearance ≥50 mL/min determined using the Cockcroft \& Gault formula.
- Have the capacity to understand the study and be able and willing to comply with all protocol requirements.
- Patients must comply with the radiation protection rules (including hospital admissions and isolation) that are used by the treating institution in order to protect their contacts and the general public, especially if a female partner of the patient is or could be pregnant.
- Must agree to practice adequate precautions to prevent pregnancy in a partner and to avoid potential problems associated with radiation exposure to the unborn child (Refer to Clinical Trials Facilitation Group, 2020: Recommendations related to contraception and pregnancy testing in clinical trials Version 1.1, CTFG, 2020).
Who cannot join
- Are unable to understand or are unwilling to sign a written informed consent document or to follow investigational procedures in the opinion of the Investigator.
- Have PC associated with pathological findings consistent with small cell or any histology other than adenocarcinoma of the prostate. If there are minor elements of neuroendocrine histology, this is acceptable.
- Uncontrolled pain.
- Diagnosed with other malignancies that are expected to alter life expectancy or may interfere with disease assessment. However, patients with a prior history of malignancy that has been adequately treated and who have been disease-free for more than 3 years are eligible, as are patients with adequately treated non-melanoma skin cancer, and superficial bladder cancer.
- Are at increased risk of hemorrhage or bleeding, or with a recent history of a thrombolytic event (e.g., deep vein thrombosis [DVT]/ pulmonary embolism [PE]) and have been administered long-term anti-coagulant or anti-platelet agents.
- Have received prior treatment with monoclonal antibody (mAb) J591 or HuJ591 or any other PSMA targeted therapy.
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- Have known allergies, hypersensitivity, or intolerance to the investigational drug or its excipients.
- Have received prior systemic anti-cancer therapy (e.g., chemotherapy, immunotherapy, or biological therapy) and/or radiation therapy within 4 weeks of randomization OR if any significant AEs have not resolved to National Cancer Institute (NCI) AE Criteria ≤2; OR are receiving other concurrent cytotoxic chemotherapy, immunotherapy, radioligand therapy, or investigational therapy.
- Have received prior treatment with radioisotopes, including but not limited to: 89Strontium, 153Samarium, 186Rhenium, 188Rhenium, 223Radium, or hemi-body irradiation within 6 months prior to randomization.
- Have received other investigational therapy within 4 weeks of randomization.
- Have known brain metastases or hepatic metastases.
- Have a history of seizure and/or stroke within past 6 months.
- Have clinical or radiologic findings indicative of impending cord compression or experience symptomatic cord compression.
- Have a serious active or sub-clinical infection or angina pectoris (New York Heart Association [NYHA] Class III or IV), significantly prolonged QT interval or other serious illness(es) involving the cardiac, respiratory, central nervous system, renal, hepatic or hematological organ systems, which might impair the ability to complete this study or could interfere with determination of causality of any adverse effects experienced in this study, or which require treatment that could interact with study treatment, particularly with enzalutamide.
- Have received treatment with any PARP inhibitors (i.e., Olaparib) or with any platinum based anti-neoplastic drugs.
- Have a known alteration in breast cancer genes (BRCA) BRCA1, BRCA2, or Ataxia Telangiectasia Mutated Gene (ATM) gene and are eligible to receive Olaparib therapy according to their institution's SoC
Trial locations and contacts
6 sites in 2 countries.
6 sites in 2 countries
Australia5 sites
Monash Health
Clayton, Victoria, 3168
Austin Health
Melbourne, Victoria, 3083
'GenesisCare Murdoch'
Murdoch, Western Australia, 6150
Westmead Hospital
Westmead, New South Wales, 2145
Princess Alexandra Hospital
Woolloongabba, Queensland, 4102
About this study
Official title: A Multinational, Multicenter, Prospective, Randomized, Controlled, Open Label Phase 3 Study With Best Standard of Care With and Without 177Lu-DOTA-rosopatamab for Patients With PSMA Expressing Metastatic Castration-resistant Prostate Cancer Progressing Despite Prior Treatment With a Novel Androgen Axis Drug
This multinational, multicenter, prospective, randomized, controlled, open label Phase 3 study is designed to investigate and confirm the benefits and risks associated with the PSMA-targeted antibody, 177Lu DOTA rosopatamab administered together with Standard of Care (SoC), as compared to the best SoC alone. The phase 3 will be conducted in patients with metastatic castration-resistant PC (mCRPC) that expresses PSMA and has progressed despite prior treatment with a novel androgen axis drug (NAAD).
Read the detailed description
This multinational, multicenter, prospective, randomized, controlled, open label Phase 3 study is designed to investigate and confirm the benefits and risks associated with 177Lu DOTA rosopatamab administered together with SoC, as compared to the best SoC alone, in patients with PSMA-positive, metastatic castration-resistant PC (mCRPC) that has progressed despite prior treatment with a novel androgen axis drug (NAAD).
PSMA positivity will be defined by gallium-68 labeled PSMA-11 (68Ga-PSMA-11) positron emission tomography/computerized tomography (PET/CT) as at least one site of metastatic disease with intensity significantly greater than normal liver (i.e., standardized uptake value [SUV] max at least 1.5 times SUV of normal liver.
Approximately 392 eligible adult male will be part of this study. 387 patients will be randomized to one of two groups in a 2:1 ratio to receive one of the treatments below. 5 participants in New Zealand will be enrolled into a sub-study.
- Group A: Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC
- Group B: Best SoC.
In parallel to this, 5 participants in New Zealand site, will be enrolled into a sub-study to investigate the biodistribution, pharmacokinetics and dosimetry of 177Lu-DOTA-TLX591(m17). Participants will receive two doses of 177Lu-DOTA-TLX591(m17), 14 days apart.
Screening procedures will take up to 28 days prior to enrollment and randomization. Only patients with PSMA-positive metastatic PC and meeting all other inclusion/exclusion criteria were randomized in a 2:1 ratio to Group A or B OR allocated to Sub-study in New Zealand.
Participants in Group A or B will participate in the study for up to 5 years. During this period the participants will undergo imaging procedures approximately every 6-8 weeks until progression.
Participants in the sub-study will participate in the study up to 23 days. During this period participants will receive two doses of 177Lu-DOTA-TLX591(m17), 14 days apart, and undergo SPECT/CT imaging and blood collection for Pharmacokinetics at days 1,2,5,8, 13 and 15.
For all patients, the best SoC will be determined by the Principal Investigator (PI) and the medication will be provided until progression.
- Conditions
- Metastatic Prostate Cancer
- Being tested
- 177Lu-DOTA-rosopatamb, Standard of Care
- Keywords
- prostate cancer, 177Lu-DOTA-TLX591, progression free survival, overall survival, safety, gallium-68 labeled PSMA-11 (68Ga-PSMA-11) PET/CT Scan, novel androgen axis drug
- Medical subject headings
- Prostatic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
177Lu-DOTA-rosopatambOther
Also called 177Lu-TLX591
Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC
Standard of CareDrug
enzalutamide or abiraterone [+ prednisone/prednisolone)] or docetaxel
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best Standard of Care Receives: Other: 177Lu-DOTA-rosopatamb |
| Group B | Active comparator | Participants will receive the Standard of Care Receives: Drug: Standard of Care |
| Biodistribution and Dosimetry Sub-Study | Experimental | Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best Standard of Care Receives: Other: 177Lu-DOTA-rosopatamb |
What is being measured
The primary outcome is the main question the study is designed to answer.
Comparison of radiographic progression-free survival (rPFS)
Radiographic progression-free survival (rPFS) defined as the time from randomization to disease progression confirmed by central independent radiology review according to RECIST 1.1 (for soft tissue disease) and/or PCWG3 criteria (for bone disease), or death (whichever occurs first).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Secondary outcomes (24)
Overall survival
Overall survival (OS), determined from randomization, until death from any cause
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Tumour objective response rate (ORR)
Tumor response in terms of objective response rate (ORR) (malignant soft tissue response and overall radiological response [malignant soft tissue response by RECIST 1.1 and overall radiological response by RECIST 1.1 and PCWG3]).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Time to a first Symptomatic Skeletal Event (SSE)
Time to a first SSE, defined as the use of external beam radiation to relieve bone pain, or occurrence of a new symptomatic pathological fracture (vertebral or non-vertebral), or occurrence of spinal cord compression, or tumor-related orthopedic surgical intervention
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Progression-free survival
PFS defined as the time from randomization to disease progression confirmed by radiology, clinical or PSA progression, or death (whichever occurs first).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Assessment of AEs graded by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0, vital signs (systolic and diastolic blood pressures, respiratory rate, pulse rate, and body temperature), ECGs, and evaluation of laboratory parameters (biochemistry, hematology, coagulation, and urinalysis).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Adverse events of special interest (AESI)
Assessment of any Grade 4 hematological abnormalities and bleeding events and Symptomatic skeletal events (SSE), defined as the use of external beam radiation to relieve bone pain, or occurrence of a new symptomatic pathological fracture (vertebral or non-vertebral), or occurrence of spinal cord compression, or tumor-related orthopedic surgical intervention.
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by ECOG
Quality of Life is to be evaluated using the Eastern Cooperative Oncology Group (ECOG) Performance Scale- From 0 (fully active) to 5 (dead).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by FACT-P
The Functional Assessment of Cancer Therapy-Prostate (FACT-P) evaluates the physical well-being, social/family well-being, emotional well-being and functional well-being), the results range from "not at all" to "Very much"
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by BPI-SF
The Brief Pain Inventory - Short Form (BPI-SF) where the results vary from 1-4 (mild pain), 5-6 (Moderate pain) and 7-10 (severe pain)
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by EQ-5D-5L
The EQ-5D-5L where the results vary from 1 (no problems) to 5 (extreme problems/unable to do)
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by EORTC/QQ-C30
The European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) questionnaire - result is calculated from the mean of 13 of the 15 QLQ-C30 scales (Physical Functioning+ Role Functioning+ Social Functioning+ Emotional Functioning+ Cognitive Functioning+ Fatigue+ Pain+ Nausea_Vomiting+ Dyspnoea+ Sleeping Disturbances+ Appetite Loss+ Constipation+ Diarrhoea) ranging from "not at all" to "Very much"
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Assessment of changes in prostate specific antigen (PSA)
Percentage change from baseline in PSA level, PSA response, and PSA response duration
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Time to radiographic soft tissue progression (TTSTP)
Time to radiographic soft tissue progression (TTSTP) defined as time from randomization to radiographic soft tissue progression according to RECIST 1.1 (for soft tissue disease).
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Biochemical response as indicated by PSA levels, lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) levels
Percentage change from baseline in PSA level, PSA response, and PSA response duration and percentage change from baseline in blood LDH/ALP levels.
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Development of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
A blood test to check if antibodies are formed against the study drug, and how much of the antibodies is formed and if it is enough to neutralize the study drug. ADA can reduce or neutralise the drug's effectiveness as the body tries to neutralize the drug.
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Titer of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
The concentration (ug/mL) of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Duration of positiveness in the development of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
In case of DA positiveness, this will analise how long the ADA positiveness is measured in the study samples.
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Neutralizing anti-drug antibodies (NAb) to 177Lu-DOTA-TLX591
How many study samples have been positive (rate) for neutralizing anti-drug antibodies (NAb) to 177Lu-DOTA-TLX591. NAb can neutralize the biological drugs and decrease the drug's efficacy and increase its clearance, resulting in patient secondary unresponsiveness.
Measured: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
To determine whole body biodistribution (BD) of administered activity 177Lu-DOTATLX591(m17)
Evaluate whole body and organs imagining positivity for administered 177Lu-DOTATLX591 (m17)
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
To determine organ radiation dosimetry of tracer levels of administered activity 177Lu-DOTATLX591(m17)
Evaluate organs absorbed radiation doses of administered 177Lu-DOTATLX591 in PSMA expressing tumours as determined by suitable tumour-to-heathy tissue ratios and residence times.
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
To determine pharmacokinetics (PK) of administered activity 177Lu-DOTATLX591
Measure whole blood radioactive concentration at each timepoint to determine the radiation PK curve.
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate comparability of whole body biodistribution dosimetry of the 177Lu-DOTA-TLX591
Qualitative comparison measured in SUV (Standardized Uptake Value) of whole-body biodistribution between 177Lu-DOTA-TLX591 from ProstACT-SELECT participants (NCT04786847) and this study's participants
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate comparability of organ uptake dosimetry of the 177Lu-DOTA-TLX591
Qualitative comparison measured in SUV (Standardized Uptake Value) of organ uptake between 177Lu-DOTA-TLX591 from ProstACT-SELECT participants (NCT04786847) and this study's participants
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate organ radiation dosimetry comparability of the 177Lu-DOTA-TLX591
Qualitative comparison of organ dosimetry from ProstACT-SELECT participants (NCT04786847) and 177Lu-DOTA-TLX591 (m17 allotype)
Measured: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2021
- Study start29 Aug 2023
- Primary completion1 Jul 2025
- Study completion1 Jul 2025
Why it stopped: Telix is conducting a separate Phase 3 clinical trial - ProstACT Global NCT06520345- to expedite the development and approval process under an IND. Consequently, this necessitates the closure of the current 177Lu-TLX591-002 Phase 3 trial.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Metastatic 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
- Model description
- Approximately 387 eligible patients will be randomized to one of two groups in a 2:1 ratio to receive one of the following treatments: * Group A: Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC * Group B: Best SoC. Additionally, up to 10 patients, in New Zealand only, will be recruited for evaluation of biodistribution and dosimetry of 177Lu- DOTA-TLX591(m17 allotype) in combination with the SoC. These patients will receive two single intravenous (IV) injections of 76 mCi (±10%) each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA-TLX591 (m17), given 14 days apart, plus best SoC (abiraterone/prednisolone or enzalutamide or docetaxel). After the first dose, the patients will undergo single-photon emission computerized tomography/computerized tomography (SPECT/CT).
- Masking
- None (open label)
- Enrolment
- 16 participants (actual)
Sponsor and investigators
- Lead sponsor
- Telix Pharmaceuticals (Innovations) Pty Ltd
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04876651
- Sponsor's protocol ID
- 177Lu-TLX591-002
- Status last verified
- Feb 2026
- First submitted
- 3 May 2021
- Last updated
- 20 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multinational, Multicenter, Prospective, Randomized, Controlled, Open Label Phase 3 Study With Best Standard of Care With and Without 177Lu-DOTA-rosopatamab for Patients With PSMA Expressing Metastatic Castration-resistant Prostate Cancer Progressing Despite Prior Treatment With a Novel Androgen Axis Drug
- ClinicalTrials.gov ID
- NCT04876651
- Acronym / sponsor ID
- 177Lu-TLX591-002
- Conditions
- Metastatic Prostate Cancer
- Keywords
- prostate cancer, 177Lu-DOTA-TLX591, progression free survival, overall survival, safety, gallium-68 labeled PSMA-11 (68Ga-PSMA-11) PET/CT Scan, novel androgen axis drug
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Telix is conducting a separate Phase 3 clinical trial - ProstACT Global NCT06520345- to expedite the development and approval process under an IND. Consequently, this necessitates the closure of the current 177Lu-TLX591-002 Phase 3 trial.
- Enrolment
- 16 participants (actual)
- Lead sponsor
- Telix Pharmaceuticals (Innovations) Pty LtdIndustry (pharma, biotech, devices)
- Study start
- 29 Aug 2023 (actual)
- Primary completion
- 1 Jul 2025 (actual)
- Study completion
- 1 Jul 2025 (actual)
- First posted
- 6 May 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This multinational, multicenter, prospective, randomized, controlled, open label Phase 3 study is designed to investigate and confirm the benefits and risks associated with the PSMA-targeted antibody, 177Lu DOTA rosopatamab administered together with Standard of Care (SoC), as compared to the best SoC alone. The phase 3 will be conducted in patients with metastatic castration-resistant PC (mCRPC) that expresses PSMA and has progressed despite prior treatment with a novel androgen axis drug (NAAD).
Detailed description
This multinational, multicenter, prospective, randomized, controlled, open label Phase 3 study is designed to investigate and confirm the benefits and risks associated with 177Lu DOTA rosopatamab administered together with SoC, as compared to the best SoC alone, in patients with PSMA-positive, metastatic castration-resistant PC (mCRPC) that has progressed despite prior treatment with a novel androgen axis drug (NAAD).
PSMA positivity will be defined by gallium-68 labeled PSMA-11 (68Ga-PSMA-11) positron emission tomography/computerized tomography (PET/CT) as at least one site of metastatic disease with intensity significantly greater than normal liver (i.e., standardized uptake value [SUV] max at least 1.5 times SUV of normal liver.
Approximately 392 eligible adult male will be part of this study. 387 patients will be randomized to one of two groups in a 2:1 ratio to receive one of the treatments below. 5 participants in New Zealand will be enrolled into a sub-study.
- Group A: Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC
- Group B: Best SoC.
In parallel to this, 5 participants in New Zealand site, will be enrolled into a sub-study to investigate the biodistribution, pharmacokinetics and dosimetry of 177Lu-DOTA-TLX591(m17). Participants will receive two doses of 177Lu-DOTA-TLX591(m17), 14 days apart.
Screening procedures will take up to 28 days prior to enrollment and randomization. Only patients with PSMA-positive metastatic PC and meeting all other inclusion/exclusion criteria were randomized in a 2:1 ratio to Group A or B OR allocated to Sub-study in New Zealand.
Participants in Group A or B will participate in the study for up to 5 years. During this period the participants will undergo imaging procedures approximately every 6-8 weeks until progression.
Participants in the sub-study will participate in the study up to 23 days. During this period participants will receive two doses of 177Lu-DOTA-TLX591(m17), 14 days apart, and undergo SPECT/CT imaging and blood collection for Pharmacokinetics at days 1,2,5,8, 13 and 15.
For all patients, the best SoC will be determined by the Principal Investigator (PI) and the medication will be provided until progression.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Approximately 387 eligible patients will be randomized to one of two groups in a 2:1 ratio to receive one of the following treatments: * Group A: Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC * Group B: Best SoC. Additionally, up to 10 patients, in New Zealand only, will be recruited for evaluation of biodistribution and dosimetry of 177Lu- DOTA-TLX591(m17 allotype) in combination with the SoC. These patients will receive two single intravenous (IV) injections of 76 mCi (±10%) each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA-TLX591 (m17), given 14 days apart, plus best SoC (abiraterone/prednisolone or enzalutamide or docetaxel). After the first dose, the patients will undergo single-photon emission computerized tomography/computerized tomography (SPECT/CT).
| Arm | Type | Receives |
|---|---|---|
| Group A | Experimental | Other: 177Lu-DOTA-rosopatambTwo single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best Standard of Care |
| Group B | Active comparator | Drug: Standard of CareParticipants will receive the Standard of Care |
| Biodistribution and Dosimetry Sub-Study | Experimental | Other: 177Lu-DOTA-rosopatambTwo single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best Standard of Care |
Who may qualify
- Ages
- 18 years and older
- Sex
- Male only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (18 listed)
- Be a male, at least 18 years old, with metastatic adenocarcinoma of the prostate defined by histological / pathological confirmation of PC.
- Be of ECOG Performance Status 0, 1, or 2 and have an estimated life expectancy of ≥6 months.
- Have metastatic disease (≥1 metastatic lesions present on baseline CT, MRI, or bone scan imaging).
- Have castration-resistant PC (defined as disease progressing despite castration by orchiectomy or ongoing use of luteinizing hormone-releasing hormone [LHRH]) and must have a castrate level of serum/plasma testosterone (<50 ng/dL or <1.7 nmol/L).
- In the mCRPC setting, must have received a minimum of 12 weeks of prior therapy with a NAAD, either enzalutamide or abiraterone plus prednisone.
Key exclusion criteria (16 listed)
- Are unable to understand or are unwilling to sign a written informed consent document or to follow investigational procedures in the opinion of the Investigator.
- Have PC associated with pathological findings consistent with small cell or any histology other than adenocarcinoma of the prostate. If there are minor elements of neuroendocrine histology, this is acceptable.
- Uncontrolled pain.
- Diagnosed with other malignancies that are expected to alter life expectancy or may interfere with disease assessment. However, patients with a prior history of malignancy that has been adequately treated and who have been disease-free for more than 3 years are eligible, as are patients with adequately treated non-melanoma skin cancer, and superficial bladder cancer.
- Are at increased risk of hemorrhage or bleeding, or with a recent history of a thrombolytic event (e.g., deep vein thrombosis [DVT]/ pulmonary embolism [PE]) and have been administered long-term anti-coagulant or anti-platelet agents.
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 |
|---|---|---|
| 177Lu-DOTA-rosopatambAlso: 177Lu-TLX591Two single intravenous (IV) injections of 76 mCi each (equivalent to a 45 mCi/m2 dose in a standard 1.7m2 individual) of 177Lu-DOTA- rosopatamab, given 14 days apart, plus best SoC | Other | Biodistribution and Dosimetry Sub-Study, Group A |
| Standard of Careenzalutamide or abiraterone [+ prednisone/prednisolone)] or docetaxel | Drug | Group B |
Primary outcome
Comparison of radiographic progression-free survival (rPFS)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Radiographic progression-free survival (rPFS) defined as the time from randomization to disease progression confirmed by central independent radiology review according to RECIST 1.1 (for soft tissue disease) and/or PCWG3 criteria (for bone disease), or death (whichever occurs first).
24 secondary outcomes
Overall survival
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Tumour objective response rate (ORR)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Time to a first Symptomatic Skeletal Event (SSE)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Progression-free survival
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Adverse events of special interest (AESI)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by ECOG
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by FACT-P
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by BPI-SF
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by EQ-5D-5L
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Health-related quality of life by EORTC/QQ-C30
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Assessment of changes in prostate specific antigen (PSA)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Time to radiographic soft tissue progression (TTSTP)
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Biochemical response as indicated by PSA levels, lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) levels
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Development of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Titer of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Duration of positiveness in the development of anti-drug antibodies (ADA) to 177Lu-DOTA-TLX591
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
Neutralizing anti-drug antibodies (NAb) to 177Lu-DOTA-TLX591
Time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab
To determine whole body biodistribution (BD) of administered activity 177Lu-DOTATLX591(m17)
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
To determine organ radiation dosimetry of tracer levels of administered activity 177Lu-DOTATLX591(m17)
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
To determine pharmacokinetics (PK) of administered activity 177Lu-DOTATLX591
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate comparability of whole body biodistribution dosimetry of the 177Lu-DOTA-TLX591
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate comparability of organ uptake dosimetry of the 177Lu-DOTA-TLX591
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Demonstrate organ radiation dosimetry comparability of the 177Lu-DOTA-TLX591
Time frame: Day 1 to day 23 after two administrations of 177Lu-DOTA-rosopatamab
Results and safety
The study was stopped early (reason given: Telix is conducting a separate Phase 3 clinical trial - ProstACT Global NCT06520345- to expedite the development and approval process under an IND. Consequently, this necessitates the closure of the current 177Lu-TLX591-002 Phase 3 trial.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Feb 2026.
- Individual participant dataSharing planned: No
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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.
The record lists no contact. Use the official record to reach the sponsor.
6 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing 177Lu-DOTA-rosopatamb in people with Metastatic Prostate Cancer, run by Telix Pharmaceuticals (Innovations) Pty Ltd at 6 sites in 2 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 18 inclusion and 16 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: stopped early, as of the sponsor's last update on 20 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 6 sites in Australia, New Zealand. 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?
The study was stopped early (reason given: Telix is conducting a separate Phase 3 clinical trial - ProstACT Global NCT06520345- to expedite the development and approval process under an IND. Consequently, this necessitates the closure of the current 177Lu-TLX591-002 Phase 3 trial.). Results are not available in the source record.
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?
Comparison of radiographic progression-free survival (rPFS) (time frame: Day 1 to 5 years after two administrations of 177Lu-DOTA-rosopatamab). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 20 Feb 2026.