47 Participants Needed

BAT + Radium-223 for Prostate Cancer

(BAT-RAD Trial)

Recruiting at 2 trial locations
RS
AM
AM
Overseen ByAmber Michalik, BA
Age: 18+
Sex: Male
Trial Phase: Phase 2
Sponsor: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Must be taking: Zoledronic acid, Denosumab
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a combination of two treatments for men with a specific type of advanced prostate cancer that has spread to the bones and resists standard hormone therapy. The study examines whether Bipolar Androgen Therapy (BAT), which involves fluctuating testosterone levels, combined with Radium-223, a radioactive treatment targeting bone cancer, can help manage the disease. Men whose prostate cancer continues to grow despite treatments to lower testosterone and who have bone metastases may be suitable for this trial. As a Phase 2 trial, this research measures the treatment's effectiveness in an initial, smaller group, offering a chance to contribute to important advancements in prostate cancer care.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you must continue taking bone health agents like zoledronic acid or denosumab during the study. If you are on warfarin, you cannot participate, but other anticoagulants are allowed.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Radium-223 is usually well-tolerated by patients with advanced prostate cancer that has spread to the bones. One study found it effective and safe, with most side effects being manageable.

Bipolar Androgen Therapy (BAT), which involves altering testosterone levels, is also under investigation for safety and effectiveness. While researchers continue to gather information on BAT's safety, they are currently testing its combination with Radium-223.

As this is a Phase 2 trial, earlier studies provide some evidence of safety, but more data is needed to confirm how well the combination is tolerated. Participants should consider this when deciding to join the trial.12345

Why do researchers think this study treatment might be promising for prostate cancer?

Researchers are excited about Bipolar Androgen Therapy (BAT) combined with Radium-223 for prostate cancer because this combination offers a unique approach compared to traditional treatments like androgen deprivation therapy or chemotherapy. Unlike standard therapies that focus solely on reducing testosterone levels to slow cancer growth, BAT involves alternating high and low doses of testosterone, potentially sensitizing cancer cells to radiation. Additionally, Radium-223 targets bone metastases, which are common in advanced prostate cancer, by emitting radiation directly at cancer cells in the bones, minimizing damage to surrounding healthy tissue. This dual approach could provide a more effective and targeted attack on prostate cancer, particularly for those with bone metastases.

What evidence suggests that BAT plus Radium-223 could be an effective treatment for prostate cancer?

Research has shown that Bipolar Androgen Therapy (BAT) can be effective for aggressive prostate cancer. BAT involves administering high doses of testosterone, which may benefit prostate cancer cells unresponsive to standard hormone treatments. Studies have found that BAT is generally well-tolerated and may be particularly effective depending on previous treatments.

Radium-223 has been proven to extend the lives of men with metastatic castration-resistant prostate cancer (mCRPC). It specifically targets cancer that has spread to the bones, a common occurrence in prostate cancer, and can help delay or improve bone-related symptoms. One study demonstrated that Radium-223 increased survival time and reduced bone problems, making it a valuable treatment option for mCRPC. In this trial, participants will receive both BAT and Radium-223, offering a promising approach to managing this type of prostate cancer.678910

Who Is on the Research Team?

SD

Samuel Denmeade, M,D

Principal Investigator

Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital

PI

Pedro Isaacsson Velho, M,D

Principal Investigator

Moinhos de Vento Hospital

Are You a Good Fit for This Trial?

Men with advanced prostate cancer that has spread to the bones and is resistant to hormone therapy can join. They should have tried hormone-blocking treatments, but only one newer drug like abiraterone or enzalutamide. No recent chemo for mCRPC, no major health issues unrelated to cancer, and they must not be using strong painkillers like morphine.

Inclusion Criteria

I am fully active or can carry out light work.
I can provide tissue samples for genetic testing.
My PSA levels have increased and I have new bone or soft tissue cancer lesions.
See 10 more

Exclusion Criteria

I have had chemotherapy for advanced prostate cancer or any reason in the last year, but not within the last 6 months if it was for early-stage or hormone-sensitive prostate cancer.
I use strong painkillers like oxycodone for my cancer pain. Weak painkillers like tramadol are okay.
I have a serious health condition that is not well-controlled.
See 9 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Radium-223 at a dose of 55 kBq/kg IV every 28 days for 6 cycles, plus Testosterone Cypionate 400mg IM every 28 days, until progression or unacceptable toxicity

6 months
6 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

24 months

Open-label extension (optional)

Participants may opt into continuation of treatment long-term

Long-term

What Are the Treatments Tested in This Trial?

Interventions

  • Bipolar Androgen Therapy (BAT)
  • Radium-223
Trial Overview The trial tests a combination of high-dose testosterone injections (BAT) and Radium-223 (RAD), a radioactive drug targeting bone metastases. Participants will receive these treatments every 28 days for up to six cycles, monitoring for disease progression or unacceptable side effects.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Bipolar Androgen Therapy in addition to RADium-223 (RAD)Experimental Treatment2 Interventions

Bipolar Androgen Therapy (BAT) is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Bipolar Androgen Therapy for:
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Approved in European Union as Bipolar Androgen Therapy for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Lead Sponsor

Trials
578
Recruited
33,600+

Bayer

Industry Sponsor

Trials
2,291
Recruited
25,560,000+
Founded
1863
Headquarters
Leverkusen, Germany
Known For
Pharmaceutical Innovations
Top Products
Aspirin, Aleve, Yaz, Nexavar

Bill Anderson

Bayer

Chief Executive Officer since 2023

BSc in Chemical Engineering from the University of Texas, MSc in Chemical Engineering and Management from MIT

Michael Devoy profile image

Michael Devoy

Bayer

Chief Medical Officer since 2014

MD, PhD

Published Research Related to This Trial

In a Phase II trial involving 36 patients with metastatic castration-resistant prostate cancer (mCRPC), the combination of bipolar androgen therapy (BAT) and the PARP inhibitor olaparib resulted in a 31% PSA50 response rate at 12 weeks, indicating significant efficacy in reducing prostate-specific antigen levels.
The treatment also demonstrated a median progression-free survival of 13 months, with clinical benefits observed regardless of the presence of homologous recombination repair (HRR) gene mutations, suggesting that this therapy could be effective for a broad range of patients.
Bipolar androgen therapy plus olaparib in men with metastatic castration-resistant prostate cancer.Schweizer, MT., Gulati, R., Yezefski, T., et al.[2023]
Bipolar androgen therapy (BAT) is a safe treatment option for asymptomatic men with metastatic castration-resistant prostate cancer, showing no symptomatic disease progression during treatment.
BAT has demonstrated the ability to produce sustained responses in 30%-40% of patients and can resensitize them to future antiandrogen therapies, making it a promising strategy for managing resistant prostate cancer.
Bipolar androgen therapy (BAT): A patient's guide.Denmeade, S., Antonarakis, ES., Markowski, MC.[2022]
In a study of 114 men with metastatic castration-resistant prostate cancer (mCRPC), 19% achieved significant PSA reductions (≥70%) after treatment with bipolar androgen therapy (BAT), indicating its potential efficacy.
All patients who responded deeply to BAT had mutations in the TP53 gene or homologous recombination DNA repair genes, suggesting that BAT may be particularly beneficial for those with DNA repair deficiencies.
Molecular and Clinical Characterization of Patients With Metastatic Castration Resistant Prostate Cancer Achieving Deep Responses to Bipolar Androgen Therapy.Markowski, MC., Kachhap, S., De Marzo, AM., et al.[2022]

Citations

Clinical Efficacy of Bipolar Androgen Therapy in Men with ...Our data suggest that BAT may induce clinically meaningful responses in aggressive-variant prostate cancers with a more favorable safety profile ...
Study Details | NCT06305598 | Bipolar Androgen Therapy ...This phase I trial tests the change in androgen receptor sensitivity, side effects and effectiveness of bipolar androgen therapy, using testosterone, ...
ASCO GU 2025: Extreme Bipolar Androgen Therapy ...Prostate cancer cells can develop resistance to androgen ablation through an adaptive marked upregulation of androgen receptors over time in ...
Bipolar androgen therapy plus nivolumab for patients with ...Cyclic high-dose testosterone administration, known as bipolar androgen therapy (BAT), is a treatment strategy for patients with metastatic castration- ...
A Multicohort Open-label Phase II Trial of Bipolar Androgen ...BAT is well tolerated in metastatic castration-resistant prostate cancer patients. The type of prior AR-targeted therapy might affect response to BAT as well as ...
Bipolar Androgen Therapy (BAT) and Radium-223 (RAD ...This is a single-arm, multicenter open label, international, phase II study of Bipolar Androgen Therapy (BAT) plus Radium-223 (RAD) in men with metastatic ...
Bipolar Androgen Therapy (BAT) and Radium-223 (RAD) ...Histologically documented adenocarcinoma of the prostate confirmed by pathology report from prostate biopsy or a radical prostatectomy specimen.
A new era for radium-223? Optimizing treatment by ...Radium-223 dichloride is a calcium-mimetic agent that targets bone lesions, disrupting the vicious circle between tumor cells and the bone microenvironment, and ...
Bipolar Androgen Therapy and Radium-223 for the ...Giving bipolar androgen therapy with testosterone cypionate, and radium-223 may kill more tumor cells in patients with metastatic castration-resistant prostate ...
10.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38924042/
Real-world safety and effectiveness of radium-223 in ...223 Ra provides a well-tolerated and effective treatment for Taiwanese patients with mCRPC and bone metastases.
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