Unknown Cancer NIHR-supported project Brain & Nervous System

Bayer 22143 - A Phase 1 open-label, first-in-human, multicenter study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of actinium-225-macropa-pelgifatamab (BAY 3546828) in participants with advanced metastatic castration-resistant prostate

In plain English

AI plain-English summary

A new radioactive drug homes in on prostate cancer cells and delivers a short-range radiation blast designed to kill them while sparing surrounding healthy tissue. This matters because advanced metastatic castration-resistant prostate cancer (mCRPC) has few effective treatment options once standard therapies stop working. The drug, 225Ac-pelgi, targets a protein called PSMA that sits on the surface of prostate cancer cells. Its radioactive payload, actinium-225, emits radiation that travels only a very short distance, so it kills the cells it binds to without damaging neighbours. In this first-in-human trial, participants receive the drug once every six weeks for up to four cycles. The study tracks safety, how the drug moves through the body, how much reaches tumours, and whether it shrinks cancer. A substudy uses gamma imaging to map the drug’s distribution and the radiation dose delivered to tumour sites. If the drug proves safe and effective, it could offer a new treatment line for men with few remaining options. The approach—using targeted radiation to destroy cancer cells from within—could also be adapted for other cancers that display specific surface markers.

View original technical description
The study treatment actinium-225-macropa-pelgifatamab (also called 225Ac-pelgi or BAY 3546828) is a new type of treatment under development for patients with mCRPC who have already received available treatments or have few treatment options available. It works by binding to a protein on the surface of the cancer cells called prostate specific membrane antigen (PSMA). As it gives off a type of radioactivity that travels a very short distance, it kills the nearby (cancer) cells that express PSMA. Participants in this study will take the study treatment 225Ac-pelgi once in a period of 6 weeks called a cycle. Each participant will have 4 of these treatment cycles if the participant benefits from the treatment. Each participant will be in the study for up to nearly six years, including a first test (screening) phase of a maximum of 28 days, up to 12 months of treatment depending on the participant’s benefit, and a follow-up phase of 60 months after the end of treatment. In addition, a sub study during the dose escalation part will gather information on the distribution of the study treatment in the body, the proportion that binds to the cancer cells, and the resulting radiation at the tumor site. During the study, the study team will do physical examinations, check vital signs such as blood pressure, heart rate, and body temperature, take blood, and urine samples, examine heart health using echocardiogram and electrocardiogram, take tumour samples, track 225Ac-pelgi in the body using gamma imaging (only selected sites), check the tumour status using PET (positron emission tomography), CT (computed tomography) or MRI (magnetic resonance imaging) and bone scans, and ask questions about the impact of the disease on the participants’ wellbeing and activities of daily life (Eastern Cooperative Oncology Group Performance status.

Researchers

Anuradha Jayaram (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

A Phase 1 open-label, first-in-human, multicenter study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of actinium-225-macropa-pelgifatamab (BAY 3546828) in participants with advanced metastatic castration-resistant prostate cancer (mCRPC)
A Phase 1 open-label, first-in-human, multicenter study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of actinium-225-macropa-pelgifatamab (BAY3546828)in participants with advanced metastatic castration-resistant prostate cancer (mCRPC)
A Phase 1 open-label, first-in-human, multi-center study to evaluate the safety, tolerability, pharmacokinetics, and antitumor activity of 225Ac-PSMA-Trillium in participants with advanced metastatic castration-resistant prostate cancer (mCRPC)
ACT-RESoLUTE - A multi-site, prospective, open-label Phase I/II trial of Actinium (225Ac) rhPSMA-10.1 to evaluate safety and anti-tumour activity in men with metastatic castrate-resistant prostate cancer (mCRPC) including those who have previously responded to Lutetium-PSMA
A multi-site, prospective, open-label Phase I/II trial of Actinium (225Ac) rhPSMA 10.1 to evaluate safety and anti-tumour activity in men with metastatic castrate-resistant prostate cancer (mCRPC) who have previously responded to Lutetium-PSMA.

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