Vorinostat and 177Lu-PSMA-617 for PSMA-Low Metastatic Prostate Cancer

This study is looking at how well a drug called vorinostat works when given with 177Lu-PSMA-617 for men with metastatic castration-resistant prostate cancer (mCRPC). This is prostate cancer that has spread to other parts of the body and is no longer responding to treatments that lower testosterone. You may be able to join if your prostate cancer has low levels of a protein called PSMA (prostate-specific membrane antigen), as shown by a special PET scan. The main goal of this study is to see if vorinostat can help increase the PSMA levels in your cancer cells. This study is currently unclear on its recruitment status and plans to enroll 15 participants.

Study design
This is an interventional study. It plans to enroll 15 male participants.
What's involved
You would take vorinostat daily for 28 days, then receive gallium Ga 68 gozetotide and have a PET scan. You may also receive 177Lu-PSMA-617 every 6 weeks for up to 6 cycles, and have various scans and blood tests.
Compensation
Not stated in the trial record.
Follow-up
After treatment, you would be followed up every 8 weeks for 6 months, then every 12 weeks for up to 2 years.

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NCT06145633

Vorinostat and 177Lu-PSMA-617 for the Treatment of PSMA-Low Metastatic Castration-Resistant Prostate Cancer

Recruiting
PHASE2All AgesInterventionalTreatment
Fred Hutchinson Cancer Center
~15 participants
Updated 2026-08-06 on ClinicalTrials.gov
What's tested:Biopsy ProcedureBiospecimen CollectionBone ScanComputed TomographyFludeoxyglucose F-18Gallium Ga 68 Gozetotide

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Proportion of patients who convert from prostate-specific membrane antigen (PSMA) low to PSMA high
Measured over Up to 40 weeks
Castration-Resistant Prostate Carcinoma
Metastatic Prostate Adenocarcinoma
Stage IVB Prostate Cancer AJCC v8
1 sites across 1 states
Washington1
  • Michael Schweizer · PRINCIPAL_INVESTIGATOR · Fred Hutch/University of Washington Cancer Consortium

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Eligibility criteria

Inclusion

Documented histologically confirmed adenocarcinoma of the prostate.
Patient must have evidence of castration resistant prostate cancer as evidenced by PSA progression (per Prostate Cancer Working Group 3 \[PCWG3\] criteria) and a castrate serum testosterone level (i.e., ≤ 50 mg/dL).
PSMA SUVmean \< 10 as determined by 68Ga-PSMA-11 PET.
Patients must have received a next-generation androgen receptor-signaling inhibitor (e.g. abiraterone, enzalutamide, apalutamide, darolutamide). There must be at least a 2-week washout period after stopping these agents. Patients should be weaned off steroids at least 1 week prior to starting treatment.
Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
At least one lesion (measurable and/or non-measurable) that can be accurately assessed at baseline by CT and/or bone scan and is suitable for repeated assessment.
Hemoglobin ≥ 10 g/dL (measured within 28 days prior to administration of study treatment)
Absolute neutrophil count (ANC) ≥ 1.5 x 10\^9/L (measured within 28 days prior to administration of study treatment)
Platelet count ≥ 100 x 10\^9/L (measured within 28 days prior to administration of study treatment)
Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) (measured within 28 days prior to administration of study treatment)
Aspartate aminotransferase (AST) and alanine transaminase (ALT) ≤ 2.5 x ULN, unless liver metastases are present in which case they must be ≤ 5 x ULN (measured within 28 days prior to administration of study treatment) . For patients with known Gilbert's Syndrome they must be ≤ 3 x ULN (measured within 28 days prior to administration of study treatment)
Calculated creatinine clearance ≥ 50 mL/min (using Cockcroft-Gault formula) (measured within 28 days prior to administration of study treatment)
Patients and their partners, who are sexually active and of childbearing potential must agree to the use of two highly effective forms of contraception in combination throughout the period of taking study treatment and for 3 months after last dose of study drug to prevent pregnancy in a partner.
Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations.

Exclusion

Evidence of serious and/or unstable pre-existing medical, psychiatric or other condition that could interfere with patient safety or provision of informed consent to participate in this study.
Evidence of metastatic neuroendocrine/small cell prostate cancer (NEPC). Note: baseline biopsy is not required but is strongly encouraged if a patient is found to have an FDG-positive/PSMA-negative lesion on baseline imaging.
Patients receiving any systemic therapy (aside from an luteinizing hormone-releasing hormone \[LHRH\] analogue) or radiotherapy within 2 weeks prior to study treatment.
Any previous treatment with an HDAC inhibitor (including valproic acid) or 177Lu-PSMA-617.
Persistent toxicities (CTCAE grade \>2) from prior cancer therapy, excluding alopecia and stable neuropathy.
Patients considered a poor medical risk due to a serious, uncontrolled medical disorder or active, uncontrolled infection. Examples include, but are not limited to uncontrolled seizure disorder, unstable spinal cord compression, superior vena cava syndrome, or any psychiatric disorder that prohibits obtaining informed consent.
Patients who are known to be serologically positive for human immunodeficiency virus (HIV) and a CD4 count \< 200.
Patients with known active hepatitis (i.e. Hepatitis B or C). Prior Hep C infection is allowed as long as polymerase chain reaction (PCR) is negative.
Major surgery within 2 weeks of starting study treatment and patients must have recovered from any effects of any major surgery.
Patients unable to swallow orally administered medication and patients with gastrointestinal disorders likely to interfere with absorption of the study medication.
Deep vein thrombosis or pulmonary embolism diagnosed within the past six months.
Active use of coumarin-derived anticoagulant medication (i.e. warfarin).
Serious cardiac disorder, including but not limited to uncontrolled ventricular arrhythmia, recent (within 12 months) myocardial infarction, resting electrocardiogram (ECG) indicating Fridericia's corrected QT interval prolongation \> 500ms, or congenital long QT syndrome.
  • Proportion of patients who convert from prostate-specific membrane antigen (PSMA) low to PSMA highUp to 40 weeks

    Will be calculated as the percentage with 95% confidence interval (CI) of the total number of patients who had PSMA-high expression on re-assessment gallium Ga 68 gozetotide (68Ga)-PSMA-11 positron emission tomography (PET).