This study tests a new treatment for men with high-risk prostate cancer who can't havesurgery. The treatment combines three experimental drugs and radiation therapy.Researchers will track how well the treatment works and how safe it is. The study willlast about five years.
This study (ResQ110B-PROS, IND 027158) is a Phase 2, open-label clinical trial designed
to assess the safety and efficacy of a novel, multi-component treatment strategy for men
with high-risk prostate cancer who are unsuitable for prostatectomy. The experimental
treatment combines three investigational products with standard external beam radiation
therapy (EBRT). The study is interventional, not observational.
The Investigational Products:
N-803 (nogapendekin alfa inbakicept): A soluble complex of an IL-15 variant bound to a
human IL-15 receptor alpha subunit/human IgG1 Fc fusion protein. It acts as a growth and
activation factor for NK cells and effector and memory T cells, aiming to stimulate the
immune system's response to the cancer. Administered subcutaneously (SC).
ETBX-071 (hAd5 [E1-, E2b-, E3-]-PSA): A replication-defective human adenovirus serotype 5
(hAd5) vector modified to encode human prostate-specific antigen (PSA). This acts as a
cancer vaccine, designed to generate an immune response targeting PSA-expressing prostate
cancer cells. Administered subcutaneously (SC).
M-CENK (cytokine-induced memory-like NK cells): Autologous natural killer (NK) cells
expanded and modified ex vivo using a cytokine cocktail (IL-12, IL-15, and IL-18) to
enhance their cytotoxic activity and persistence. These cells are administered
intravenously (IV).
Treatment Regimen:
The study employs a staged treatment approach:
Screening and Baseline Assessments: Participants undergo screening to confirm
eligibility, including PSMA-PET scans, genomic testing, and PSA level assessment.
Baseline assessments are collected before starting treatment.
Apheresis: Autologous peripheral blood mononuclear cells (MNCs) are collected from
participants for the generation of M-CENK cells.
Pre-Radiation Immunotherapy: Participants receive N-803, ETBX-071, and M-CENK according
to a specified schedule over a 6-week period. A targeted biopsy is performed before
radiation.
Radiation Therapy (EBRT): Participants undergo EBRT (either a standard 2-week course or
an extended 9-week course, as determined by the investigator).
Post-Radiation Immunotherapy: Following radiation, participants receive N-803, ETBX-071,
and M-CENK for four 6-week cycles. Androgen deprivation therapy (ADT) may be initiated 6
months after completing radiotherapy.
Follow-up: Participants are followed for up to 5 years after the end of treatment (EOT).
Endpoints:
Primary: Complete pathologic response (CPR) after pre-radiation immunotherapy and PSA30
response at EOT after post-radiation immunotherapy.
Secondary: Clinical pathologic response, time to recurrence interval (TTRI), and safety.
Exploratory: Quality of life (QoL), sexual function, immune responses (including changes
in immune subsets and antigen-specific responses), tumor microenvironment (TME), and
circulating tumor DNA (ctDNA).
Study Population and Duration:
The study plans to enroll up to 20 participants. The total study duration is up to 303
weeks, including treatment and 5 years of follow-up.
Drug: N-803 (IL-15 Superagonist)
Administered subcutaneously (SC) both before and after radiation therapy. The specific
dosing schedule varies slightly depending on the cohort.
Drug: ETBX-071 (PSA-based Oncolytic Virus)
Administered subcutaneously (SC) before and after radiation therapy. The specific dosing
schedule varies slightly depending on the cohort.
Drug: M-CENK (Activated NK Cells)
Administered intravenously (IV) before and after radiation therapy, also with variations
in the timing and dosing across different cohorts.
Radiation: External Beam Radiation Therapy (EBRT)
This is a standard treatment administered to all participants. The specific dose and
schedule (40 Gy in 5 fractions over 2 weeks or up to 9 weeks) are determined by the
investigator based on clinical judgment.
Radiation: Androgen Deprivation Therapy (ADT)
May be used in conjunction with the other therapies. The specific type and duration of
ADT are at the investigator's discretion, and it may be initiated up to 6 months after
the completion of radiotherapy. This treatment is not part of the experimental treatment
regimen.
Radiation: Post-radiation immunotherapy
The post-radiation immunotherapy phase in the ResQ110B-PROS study involves the continued
administration of N-803, ETBX-071, and M-CENK, but with a specific schedule and after the
completion of radiation therapy.
The inclusion criteria:
- Age: ≥18 years old.
- Ability to understand and provide informed consent: Participants must be able to
understand the study and provide written informed consent fulfilling all relevant
Institutional Review Board (IRB) or Independent Ethics Committee (IEC) guidelines.
- Histologically confirmed prostate adenocarcinoma: A diagnosis confirmed through a
pathology report or a clinical course consistent with the disease, as determined by
a local pathologist, if a pathology specimen is unavailable.
- ECOG performance status: 0 or 1 (fully active or restricted in strenuous activity
but ambulatory).
- Life expectancy: >5 years.
- Germline testing: Must have germline testing completed at the time of initial
diagnosis and, if applicable, at recurrence.
- No evidence of distant metastasis: No evidence of soft tissue disease metastasis
(visceral or lymph nodes) on CT/MRI scan.
- No active or organ-threatening autoimmune disease: Participants must not have an
active or organ-threatening autoimmune disease.
- High-risk or very high-risk prostate cancer: Based on 2024 NCCN guidelines: PSA >20
ng/mL or Gleason Grade Group ≥4 or ≥cT3a.
- Adequate hematologic and organ function: Defined by specific laboratory values (ANC,
lymphocyte count, platelet count, hemoglobin, INR/aPTT, AST, ALT, alkaline
phosphatase) obtained within 14 days prior to baseline, with specific exceptions
stated in the protocol for participants with liver or bone metastases or those with
known Gilbert disease.
- Ability to attend study visits and return for adequate follow-up.
- Agreement to practice effective contraception: Non-sterile males must agree to use
effective contraception (condom, vasectomy, or other barrier methods) for up to 7
months after treatment.
Exclusion Criteria:
- Prior treatment for prostate cancer: Participants who have undergone any prior
surgical, cryotherapy, or high-intensity focused ultrasound treatment for prostate
cancer are excluded.
- Prior hormonal therapy: Prior orchiectomy or hormonal therapy (GnRH agonists, NSAA)
is an exclusion criterion.
- Prior treatment with androgen receptor (AR) inhibitors: Prior treatment with
first-generation (bicalutamide, flutamide, nilutamide, cyproterone acetate) or
second-generation (enzalutamide, apalutamide, or darolutamide) AR inhibitors is an
exclusion criterion.
- Organ transplantation: Receipt of any organ transplantation (excluding those not
requiring immunosuppression, such as corneal or hair transplants) excludes
participants from the study.
- Chronic systemic corticosteroid use: Chronic administration (>14 days) of systemic
corticosteroids within 28 days of study treatment initiation excludes participants.
However, minimal systemic absorption (inhaled steroids, nasal sprays, topical
agents) is permitted.
- Active autoimmune disease: Active autoimmune diseases (Addison's disease,
Hashimoto's thyroiditis, systemic lupus erythematosus, Sjögren syndrome,
scleroderma, myasthenia gravis, Goodpasture syndrome, or active Grave's disease)
exclude participants. However, a history of autoimmunity that did not require
systemic immunosuppression and did not threaten vital organ function is permitted.
- Use of medications affecting PSA: Use of medications known to alter PSA levels
(5-alpha reductase inhibitors, phytoestrogens, saw palmetto) within 28 days before
study treatment initiation excludes participants.
- Major surgery: Major surgery within 28 days of study treatment initiation excludes
participants.
- Systemic therapy: Systemic therapy (including any investigational therapy) within 28
days of study treatment initiation is an exclusion criterion.
- Allergic reactions: A history of allergic reactions to compounds with similar
chemical or biologic composition to the study drugs excludes participants.
- Clinically significant cardiovascular/cerebrovascular disease: This includes
cerebral vascular accident/stroke, myocardial infarction, or unstable angina,
congestive heart failure, or uncontrolled hypertension within specific timeframes
before study enrollment.
- Serious intercurrent medical illness: Any serious intercurrent medical illness that
could interfere with treatment participation.
- Active infections: Active HIV, hepatitis B (positive HBsAg), or hepatitis C
infections exclude participation.
- Live attenuated vaccine administration: Administration of a live, attenuated vaccine
within 3 weeks prior to study entry or anticipated during the study.
- Inability or unwillingness to comply: Participants assessed by the investigator as
unable or unwilling to comply with the study requirements are excluded.
Not Provided
Joseph Ward
3236933913
joseph.ward@immunitybio.com
Deana Martz
323.493.6386
Deana.martz@immunitybio.com
Bruce Brown, Study Chair
ImmunityBio, Inc.