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The aim of this study is to evaluate the efficacy of SHR-1701 in combination with SBRT in patients with metastatic castration-resistant prostate cancer. Dr. Yao Zhu from Fudan University Shanghai Cancer Center is the co-leading PI of this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Radiotherapy plus immunotherapy group | Experimental | Stereotactic body radiotherapy on targeted metastasis determined by MDT + SHR1701 30mg/kg IV every 3 weeks (Q3W) for 2 cycles, then SHR1701 alone Q3W until progression |
|
| Radiotherapy alone group | Active Comparator | Stereotactic body radiotherapy on targeted metastasis determined by MDT |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SHR-1701 + SBRT | Combination Product | Stereotactic body radiotherapy on targeted metastasis determined by MDT + SHR1701 30mg/kg IV every 3 weeks (Q3W) for 2 cycles, then SHR1701 alone Q3W until progression |
| Measure | Description | Time Frame |
|---|---|---|
| Radiographic Progression-Free Survival (rPFS) | Description: Defined as bone disease progression (occurrence of two or more new lesions on bone scan) per PCWG3, or soft tissue/clinical progression per RECIST v1.1. | From randomization to radiographic progression or death (up to 24 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) | The proportion of patients with a best overall response of Complete Response (CR) or Partial Response (PR), as assessed by RECIST v1.1 and PCWG3 criteria. | From randomization until progression (up to 24 months) |
| PSA Response Rate |
| Measure | Description | Time Frame |
|---|---|---|
| Immune Microenvironment Analysis | Evaluation of the immune microenvironment in peripheral blood and tumor lesions | up to 24 months |
Inclusion Criteria:
Age: 18 to 80 years old.
Diagnosis: Histologically or cytologically confirmed adenocarcinoma of the prostate, clinically staged as metastatic prostate cancer based on conventional imaging (bone scan or CT/MRI).
Biopsy: Whenever possible, patients should undergo a pre-treatment image-guided biopsy of a lesion; alternatively, archived biopsy tissue obtained within 30 days prior to enrollment is acceptable.
Prior Therapy: Failure of at least one prior next-generation hormone therapy (NHT), such as abiraterone acetate, rezivilutamide, enzalutamide, apalutamide, or darolutamide.
Chemotherapy History: Prior treatment with docetaxel, or documentation of intolerance to or refusal of chemotherapy.
Disease Progression: Evidence of disease progression defined by: PSA progression: At least two consecutive increases in PSA levels, measured at least 1 week apart, with a screening PSA value ≥ 1 ng/mL; OR Radiographic progression in soft tissue per RECIST v1.1 (with or without PSA progression); OR Bone progression per PCWG3 criteria (occurrence of ≥ 2 new bone lesions on bone scan).
Castration Status: Maintenance of effective and continuous luteinizing hormone-releasing hormone analog (LHRHa) therapy throughout the study period, or prior bilateral orchidectomy; serum testosterone must be maintained at castrate levels (< 50 ng/dL).
Performance Status: ECOG Performance Status score of 0 to 2.
Life Expectancy: ≥ 6 months.
Hematologic Function: Absolute neutrophil count (ANC) ≥ 1.5 ×10^9/L; Platelets ≥ 75 ×10^9/L; Hemoglobin ≥ 90 g/L; White blood cell (WBC) count ≥ 3.0 ×10^9/L.
Hepatic Function (Transaminases): Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤ 2.5 × upper limit of normal (ULN); for patients with liver metastases, ALT/AST ≤ 5 × ULN.
Hepatic Function (Bilirubin): Total bilirubin ≤ 1.5 × ULN, or total bilirubin > 1.5
× ULN if direct bilirubin ≤ ULN.
Coagulation Function: INR ≤ 1.5, Activated partial thromboplastin time (APTT) ≤ 1.5 × ULN, and Prothrombin time (PT) < ULN + 4 seconds.
Cardiac Function: Left ventricular ejection fraction (LVEF) ≥ 50%; QTc < 450 ms for males; serum potassium ≥ 3.5 mmol/L.
Blood Pressure: Systolic BP < 160 mmHg and diastolic BP < 95 mmHg; patients with stable BP after appropriate clinical management are eligible.
Renal Function: Serum creatinine ≤ 1.5 × ULN and creatinine clearance ≥ 50 mL/min.
Contraception: Sexually active patients with ejaculatory potential must agree to use effective contraception and refrain from sperm donation from the first dose until 3 months after the last dose of study treatment.
Informed Consent: Ability to understand and willingness to sign a written Informed Consent Form (ICF).
Compliance: Ability to comply with the study visit schedule and other protocol requirements.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yao Zhu | Contact | 13816751347 | zhuyao@fudan.edu.cn | |
| XuDong Ni | Contact | 19946234803 | xdni18@fudan.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fujian Cancer Hospital | Recruiting | Fujian | China |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C000723862 | SHR-1701 |
| D016634 | Radiosurgery |
| ID | Term |
|---|---|
| D011878 | Radiotherapy |
| D013812 | Therapeutics |
| D013238 | Stereotaxic Techniques |
| D019635 | Neurosurgical Procedures |
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| SBRT | Radiation | Stereotactic body radiotherapy on targeted metastasis determined by MDT |
|
The proportion of patients achieving a ≥ 50% reduction in serum PSA from baseline, confirmed by a second measurement at least 3 weeks later. |
| From randomization until progression (up to 24 months) |
| PSA Progression-Free Survival (PSA-PFS) | Defined according to PCWG3 criteria as: (1) For patients with a decline from baseline: A ≥ 25% increase in PSA and an absolute increase of ≥ 2 ng/mL above the nadir, confirmed by a second measurement at least 3 weeks later; (2) For patients without a decline from baseline: A ≥ 25% increase in PSA and an absolute increase of ≥ 2 ng/mL from baseline after at least 12 weeks of intervention. Subjects with PSA progression alone in the absence of symptomatic or radiographic progression may continue treatment at the investigator's discretion if clinical benefit is perceived. | From randomization until progression (up to 24 months) |
| Overall Survival (OS) | Defined as the time from enrollment to death from any cause. | From randomization until death (up to 24 months) |
| Safety and Tolerability | The National Cancer Institute-Common Terminology Criteria for Adverse Events version 5 (NCI-CTCAE v5) is widely accepted in the community of oncology research as the leading rating scale for adverse events. This scale, divided into 5 grades (1 = "mild", 2 = "moderate", 3 = "severe", 4 = "life-threatening", and 5 = "death") determined by the investigator, will make it possible to assess the severity of the disorders. | up to 24 months |
| Fudan University Shanghai Cancer Center | Recruiting | Shanghai | China |
|
| Fudan University Shanghai Cancer Center Xiamen Branch | Recruiting | Xiamen | China |
|
| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D013514 |
| Surgical Procedures, Operative |
| D008919 | Investigative Techniques |