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Schedule De-Escalation of 177Lu-PSMA-617 for the Treatment of Metastatic Castrate Resistant Prostate Cancer

Is NCT06200103 recruiting? Yes, currently enrolling (May 2026). This Phase 2 trial studies Lutetium Lu 177 Vipivotide Tetraxetan for castration-resistant prostate carcinoma.

Phase 2RecruitingMayo ClinicNCT06200103Data as of May 2026

Treatment: Lutetium Lu 177 Vipivotide TetraxetanThis phase II trial studies how to improve the usage of Lu 177 vipivotide tetraxetan (177Lu-prostate-specific membrane antigen \[PSMA\]-617) for treating patients with castration-resistant prostate cancer that has spread from where it first started (primary site), to other places in the body (metastatic) utilizing a treatment pause after 5 cycles of therapy versus standard continuous treatment for 6 cycles. Lutetium is a radioligand therapy (RLT). RLT uses a small molecule (in this case 177Lu-PSMA-617) that carries a radioactive component to destroy tumor cells. When lutetium is injected into the body, it attaches to the PSMA receptor found on tumor cells. After lutetium attaches to the PSMA receptor, its radiation component destroys the tumor cell. Giving 177Lu-PSMA-617 for 5 cycles versus 6 cycles may better treat patients with metastatic castrate resistant prostate cancer.

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Extracted eligibility criteria

Cancer type

Prostate Cancer

Biomarker criteria

Required: FOLH1 overexpression (miPSMA score >= 2 on PET)

PSMA positive metastatic castration resistant prostate cancer (68Ga and 18F PSMA PET will be considered equivalent for eligibility), defined by molecular imaging prostate specific membrane antigen (miPSMA) score >= 2 on Mayo PET report

Required: FOLH1 imaging-defined avidity (lesions with uptake equal to or above liver on cycle 1 post therapy SPECT)

Lesions with uptake equal to or above liver on cycle 1 post therapy SPECT

Required: FOLH1 imaging-defined avidity (no lesions with SUV max above mean SUV of 2cm ROI in central right hepatic lobe (near-complete response on post-therapy SPECT))

Near-complete response on post-therapy SPECT following any of cycles 2-5 of 177Lu PSMA-617. Near-complete response will be defined as no lesions with SUV max above the mean standard uptake value (SUV) of a representative 2cm spherical region of interest in the central right hepatic lobe, as determined by a nuclear medicine trained radiologist

Required: FOLH1 imaging-defined avidity (PSMA avid lesions on PSMA PET (miPSMA score >= 2 following first progression))

PSMA avid lesions on PSMA PET (miPSMA score >= 2 following first progression)

Disease stage

Required: Stage IVB

Metastatic disease required

Lab requirements

Blood counts

Hemoglobin (Hgb) ≥ 8 g/dL; Platelets ≥ 75,000/mm^3; Neutrophils ≥ 100/mm^3

Kidney function

eGFR < 50 mL/min *BSA using Cockcroft-Gault formula OR Creatinine ≤ 1.5 x upper limit of normal

Liver function

AST or ALT ≤ 3 x upper limit of normal

Hemoglobin (Hgb) ≥ 8 g/dL; Platelets ≥ 75,000/mm^3; Neutrophils ≥ 100/mm^3; eGFR < 50 mL/min *body surface area (BSA) using Cockcroft-Gault formula OR Creatinine ≤ 1.5 x upper limit of normal; AST or ALT ≤ 3 x upper limit of normal

Structured fields extracted by AI. May contain errors — verify against the official protocol.

US trial sites

  • Mayo Clinic in Rochester · Rochester, Minnesota

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