Protocol of a prospective, multicentre phase I study to evaluate the safety, tolerability and preliminary efficacy of the bispecific PSMAxCD3 antibody CC-1 in patients with castration-resistant prostate carcinoma

Introduction Prostate cancer is the second most common cancer in men worldwide. When the disease becomes resistant to androgen-deprivation therapy, treatment options are sparse. To address the high medical need in castration-resistant prostate cancer (CRPC), we generated a novel PSMAxCD3 bispecific...

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Main Authors: Heitmann, Jonas S. (Author) , Walz, Juliane S. (Author) , Pflügler, Martin (Author) , Kauer, Joseph (Author) , Schlenk, Richard Friedrich (Author) , Jung, Gundram (Author) , Salih, Helmut R. (Author)
Format: Article (Journal)
Language:English
Published: October 16, 2020
In: BMJ open
Year: 2020, Volume: 10, Issue: 10, Pages: 1-9
ISSN:2044-6055
DOI:10.1136/bmjopen-2020-039639
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1136/bmjopen-2020-039639
Verlag, lizenzpflichtig, Volltext: https://bmjopen.bmj.com/content/10/10/e039639
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Author Notes:Jonas S. Heitmann, Juliane S. Walz, Martin Pflügler, Joseph Kauer, Richard F. Schlenk, Gundram Jung, Helmut R. Salih

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520 |a Introduction Prostate cancer is the second most common cancer in men worldwide. When the disease becomes resistant to androgen-deprivation therapy, treatment options are sparse. To address the high medical need in castration-resistant prostate cancer (CRPC), we generated a novel PSMAxCD3 bispecific antibody termed CC-1. CC-1 binds to prostate-specific membrane antigen that is expressed on prostate cancer cells and tumour vessels, thereby allowing a dual anticancer effect. - Methods and analysis This first in human clinical study is a prospective and multicentre trial which enrols patients with metastatic CRPC after failure of established third-line therapy. CC-1 is applied after prophylactic interleukin-6 receptor blockade with tocilizumab (once 8 mg/kg body weight). Each patient receives at least one cycle of CC-1 over a time course of 7 days in an inpatient setting. If clinical benefit is observed, up to five additional cycles of CC-1 can be applied. The study is divided in two parts: (1) a dose escalation phase with intraindividual dose increase from 28 µg to the target dose of 1156 µg based on a modified fast titration design by Simon et al to determine safety, tolerability and the maximum tolerated dose (MTD) as primary endpoints and (2) a dose expansion phase with additional 14 patients on the MTD level of part (1) to identify first signs of efficacy. Secondary endpoints compromise overall safety, tumour response, survival and a translational research programme with, among others, the analysis of CC-1 half-life, the induced immune response, as well as the molecular profiling in liquid biopsies. - Ethics and dissemination The PSMAxCD3 study was approved by the Ethics Committee of The University Hospital Tübingen (100/2019AMG1) and the Paul-Ehrlich-Institut (3684/02). Clinical trial results will be published in peer-reviewed journals. - Trial registration numbers ClinicalTrials.gov Registry (NCT04104607) and ClinicalTrials.eu Registry (EudraCT2019-000238-20). 
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