MC1R-targeted Alpha-particle Therapy Trial in Adults With Advanced Melanoma

Perspective Therapeutics

Status and phase

Enrolling

Phase 2

Phase 1

Conditions

Mucosal Melanoma

Melanoma Stage IV

Melanoma Stage III

Melanoma, Uveal

Melanoma (Skin)

Metastatic Melanoma

Treatments

Drug: [212Pb]VMT01

Drug: [203Pb]VMT01

Study type

Interventional

Funder types

Industry

Identifiers

NCT05655312

VMT01-T101

Details and patient eligibility

About

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 in patients with unresectable and metastatic melanoma.

Full description

This is a prospective, multi-center open-label dose escalation, dose expansion study of [212Pb]VMT01 in up to 52 subjects with histologically confirmed melanoma and a positive MC1R imaging scan ([203Pb]VMT01 or [68Ga]VMT02).

MC1R is a receptor that is expressed on the surface of melanoma cells. As such MC1R represents a potentially useful means of targeting therapeutics to melanoma. Lead-212 ([212Pb]-) based peptide-radiopharmaceuticals are an emerging class of targeted alpha-particle cancer therapies which have the potential to improve delivery of a highly effective form of radiation.

Patients may be eligible to receive up to 3 administrations of [212Pb]VMT01 approximately 8 weeks apart.

The first part of the study is an dose-escalation study to determine the Maximum Tolerated radioactivity Dose (MTD) or Maximum Feasible radioactivity Dose (MFD) following a single administration of [212Pb]VMT01.

The second part of the study is a dose expansion based on the identified MTD/MFD for the selection of [212Pb]VMT01 dose(s) for further clinical development.

A dosimetry sub-study utilizing the SPECT imaging surrogate, [203Pb]VMT01, has been incorporated into the study in order to assess normal organ biodistribution, tumor uptake of the investigational products, to estimate radiation dosimetry, and to correlate uptake of the investigation products with observed toxicities and efficacy.

Enrollment

52 estimated patients

Sex

All

Ages

18 to 90 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Ability to understand and willingness to provide informed consent, willingness to comply with all study procedures for the duration of the study
Male or female, aged ≥ 18 years
Diagnosed with Stage IV metastatic melanoma, or unresectable Stage III
Previously progressed (clinical or radiological progression) on at least one prior 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., BRAF or MEK inhibitors) who demonstrate MC1R positivity during screening are eligible for enrollment, provided that they undergo a wash-out period of 21 days, or 14 days, respectively, prior to Day 1 treatment with [212Pb]VMT01.
Presence of measurable disease by RECIST v1.1 criteria assessed within 30 days prior to the start of 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: use of highly effective contraception for at least one month prior to screening, and agreement to use such a method during study participation and for an additional four weeks after the last administration of an investigational product
For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner during study participation and for an additional four weeks after the last administration of an investigational product
ECOG performance score of < 2 at Screening
Life expectancy of at least 3 months
Evidence of sufficient organ function as determined by all of the following:

Oxygen saturation > 90% on room air eGFR > 50 mL/min/1.73m2 by CKD-EPI equation Complete blood count with differential, within 7 calendar days prior to therapy and off Growth Factors White blood cells (WBC) > 2500/mm3 Hemoglobin (Hgb) > 9.0 g/dL Platelets > 60,000/mm3 Absolute Neutrophil Count (ANC) > 1,250/mm3

The comprehensive metabolic panel, within seven calendar days prior to Day 1, demonstrating values within the site's upper limit of normal (ULN), with the following exceptions:

Alanine aminotransferase (ALT) < 3x ULN Aspartate aminotransferase (AST) < 3x ULN Alkaline phosphatase (ALP) < 2.5x ULN

Exclusion criteria

Active secondary malignancy
Prior treatment (for any reason) with radioactive nuclides; however, imaging tracers are acceptable
Pregnancy or breastfeeding a child
Active infection
Brain metastasis requiring acute therapy of any modality (i.e., surgical or external beam radiotherapy) within two weeks of enrollment or clinical instability, including signs or symptoms of brain edema. Subjects must demonstrate stable or decreasing brain metastasis by a noninvasive imaging scan and must be off steroids or on decreasing doses prior to enrollment.
Treatment with another investigational drug product (therapeutic IND agents) within the last 30 days.
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

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Sequential Assignment

Masking

None (Open label)

52 participants in 2 patient groups

Dose Escalation

Experimental group

Description:

Dose Escalation to determine MTD/MFD among 4 different dose levels in up to 32 patients receiving up to 3 administrations of \[212Pb\]VMT01 approximately 8 weeks apart. The second part of the study is a dose expansion based on the identified MTD/MFD for the selection of \[212Pb\]VMT01 dose(s) in up to 20 additional subjects for further clinical development. A dosimetry sub-study utilizing \[203Pb\]VMT01 has been incorporated into the study.

Treatment:

Drug: [203Pb]VMT01

Drug: [212Pb]VMT01

Dose Expansion with RPh2D

Experimental group

Description:

Up to 20 patients with advanced or metastatic melanoma

Treatment:

Drug: [212Pb]VMT01