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177Lu-PSMA-617 + niraparib + abiraterone acetate + prednisone

Development stage: Unknown
Lead developer: Baptist Health South Florida
Modality: Small Molecules, Antibody-Radionuclide Conjugates → Antibody Conjugates → Antibody-Based Therapeutics
Administration: Intravenous, Oral

Overview

This investigational combination therapy is being evaluated in the Phase 1/2 LUNAAR trial (NCT05567952) for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The regimen integrates three distinct therapeutic modalities: radioligand therapy with 177Lu-PSMA-617 (Pluvicto), which delivers targeted beta-particle radiation to cells expressing prostate-specific membrane antigen (PSMA); PARP inhibition with niraparib, which disrupts DNA repair mechanisms; and androgen biosynthesis inhibition with abiraterone acetate (administered as a fixed-dose combination with niraparib, known as Akeega). Prednisone is included to manage the mineralocorticoid effects of abiraterone. This multi-pronged approach aims to enhance anti-tumor activity by combining targeted radiation with the inhibition of DNA damage response and androgen receptor signaling pathways. The study is sponsored by Baptist Health South Florida.

Brand names: PluvictoAkeega
Other names: Lutetium Lu 177 vipivotide tetraxetan + niraparib + abiraterone acetate + prednisone177Lu-PSMA-617 + Niraparib/Abiraterone + Prednisone

Targets

GR (Glucocorticoid receptor)PSMA (Prostate-specific membrane antigen)CYP17A1 (Steroid 17-alpha-hydroxylase/C17,20 lyase)PARP1 (Poly (adp-ribose) polymerase 1)Pol II (RNA polymerase II elongation factors)

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