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Prostate Cancer Metastatic to BonePhase 1/2NCT07917390

ALT-100 Monoclonal Antibody (mAb) in Bone-Predominant Metastatic Androgen Pathway Modulation Resistant (APMR) Prostate Cancer -- The ALTAR-100 Trial

A Phase 1/2 study testing ALT-100 in people with Prostate Cancer Metastatic to Bone, run by University of Florida.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Aqualung Therapeutics Corporation has developed ALT-100, a humanized murine monoclonal antibody (mAb) that specifically targets and neutralizes extracellular nicotinamide phosphoribosyltransferase (eNAMPT) and prevents activation of a dysregulated proinflammatory signaling cascade. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Prostate Cancer Metastatic to Bone
What is being tested?
ALT-100
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
No sites listed yet
Study dates
Jan 2027to Aug 2028
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male, age ≥ 18 years
  • Prostate cancer, histologically confirmed or presumed on the basis of clinical, biochemical, and/or radiographic findings.
  • Metastatic disease confined to bone and lymph nodes, with bone metastases predominant, documented on conventional imaging (CT/MRI and bone scan). Measurable soft tissue disease is not required.
  • Androgen pathway modulation-resistant (APMR) disease per Prostate Cancer Working Group 4 (PCWG4) with progression on at least one prior androgen receptor pathway inhibitor documented as any of the following:
  • Serum PSA progression defined as 2 consecutive increases in PSA over a previous reference value measured at least 1 week prior. The minimal start value is 2.0 ng/mL,
  • Soft tissue progression defined as an increase ≥20% in the sum of the diameter (SOD) (short axis for nodal lesions and long axis for non-nodal lesions) of all target lesions based on the smallest SOD since treatment started or the appearance of one or more new lesions or unequivocal progression of existing non-target lesions,
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  • For PSMA-PET: Two new PSMA-avid lesions, or
  • Progression of bone disease defined by the appearance of ≥2 new bone lesions on bone scan per PCWG4 criteria
  • Ongoing androgen deprivation therapy (ADT) with a Gonadotropin-releasing hormone analogue, or prior bilateral orchiectomy, with serum testosterone <50 ng/dL
  • ECOG performance status 0-2
  • Life expectancy ≥6 months
  • Adequate organ and marrow function defined as:
  • ANC ≥1,500/µL
  • Platelets ≥100,00/µL
  • Hemoglobin ≥9.0 g/dL without transfusion within 14 days
  • Total bilirubin ≤1.5 x ULN (≤ 3 x ULN for Gilbert's)
  • AST and ALT ≤3 x ULN
  • Creatinine clearance ≥30 mL/min
  • Concurrent bone-modifying agent (including, but not limited to denosumab or bisphosphonates such as zoledronic acid or pamidronate), permitted but not required. If receiving one, it must have been at a stable dose and scheduled for ≥8 weeks before C1D1.
  • Written informed consent obtained from the subject and the subject agrees to comply with all the study-related procedures.
  • Subjects with partners of child-bearing potential must agree to use physician-approved contraceptive methods (e.g., abstinence, condoms, vasectomy) throughout the study and should avoid conceiving children for 6 months following the last dose of study drug.

Who cannot join

  • Visceral metastases, including liver, lung, adrenal, brain or peritoneal disease. Lymph node involvement is permitted
  • Known pure small cell or neuroendocrine prostate carcinoma
  • Radium-223 within 6 months of C1D1
  • External beam radiotherapy to a bone lesion within 4 weeks of C1D1 or radiotherapy planned during the DLT window of 30 days after first dose of ALT-100.
  • Impending skeletal-related event requiring immediate radiotherapy or surgical intervention or untreated spinal cord compression
  • Chemotherapy, investigational therapy, or any systemic anticancer therapy other than ADT within 4 weeks or 5 half-lives of C1D1, whichever is shorter
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  • Prior exposure to any extracellular nicotinamide phosphoribosyltransferase (eNAMPT)-directed or toll-like receptor 4 (TLR4)-directed therapeutic agent.
  • Known hypersensitivity to a monoclonal antibody, or prior grade ≥3 infusion-related reaction to a biologic
  • Active infection requiring systemic therapy at C1D1
  • Known HIV infection, or known active hepatitis B or hepatitis C, that is uncontrolled or requires a change in therapy. Testing is not required at screening
  • Cardiovascular or thromboembolic disease that, in the investigator's judgment, is uncontrolled or would place the patient at undue risk on study
  • Chronic systemic immunosuppressive therapy at doses that in the investigator's judgement would place the patient at undue infection risk
  • Active osteonecrosis of the jaw, or invasive dental procedure planned during the DLT window of 30 days after first dose of ALT-100
  • Another malignancy requiring active treatment, except non-melanoma skin cancer or adequately treated in situ disease
  • Any condition that in the investigator's judgement would compromise safety or protocol compliance
  • Administration of a vaccine containing live virus within 30 days prior to the first dose of trial treatment. Note: Most flu vaccines are killed viruses, with the exception of the intra-nasal vainer (Flu-Mist) which is an attenuated live virus and therefore prohibited for 30 days prior to first dose.
  • Prisoners or subjects who are involuntarily incarcerated, or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Alexandra Leggett contact

352-273-9785

agmueller@ufl.edu

About this study

Aqualung Therapeutics Corporation has developed ALT-100, a humanized murine monoclonal antibody (mAb) that specifically targets and neutralizes extracellular nicotinamide phosphoribosyltransferase (eNAMPT) and prevents activation of a dysregulated proinflammatory signaling cascade.

Pre-clinical and clinical information from acute respiratory distress syndrome and prostate cancer studies show a novel treatment option for the patients with androgen pathway modulator-resistant (APMR) prostate cancer and bone metastases. Secreted eNAMPT drives prostate cancer progression, and a humanized eNAMPT-neutralizing antibody prevented aggressive disease in preclinical models by Sun et al. The anti-fibrotic activity of the eNAMPT-neutralizing antibody acts on type I collagen turnover-the same biology as osteoblastic bone metastasis.

Read more

Bone-predominant androgen pathway modulator-resistant (APMR) prostate cancer is a common clinical problem. Treatment options are often limited after progression on ADT and androgen receptor pathway inhibitors. The bone microenvironment itself is still largely untargeted. No eNAMPT-directed therapy has been tested in any oncology population, and no trial has asked whether eNAMPT/toll-like receptor 4 (TLR4) blockade can modify the osseous tumor microenvironment in humans. This trial would test a first-in-class agent aimed at the bone microenvironment rather than at the tumor alone, in a setting where most available therapies offer short-lived benefit.

This study will evaluate the safety, tolerability and efficacy of the use of ALT-100 for treatment of bone-predominant metastatic androgen pathway modulation resistant prostate cancer. The recommended phase 2 dose of ALT-100 for treatment of bone-predominant metastatic androgen pathway modulation resistant prostate cancer will also be determined in the phase 1 portion of this study.

Being tested
ALT-100
Keywords
Bone-predominant androgen pathway modulator-resistant (APMR) prostate cancer, monoclonal antibody
Medical subject headings
AMR Syndrome, Prostatic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ALT-100Biological

    Participants will receive either 1.0 mg/kg or 4.0 mg/kg of ALT-100 intravenously once every 28 days for up to 6 treatment cycles while receiving standard of care androgen deprivation therapy. The assigned dose will determined by either a 3 + 3 design (for phase 1) or 1:1 randomization (for phase 2).

Study groups in NCT07917390
Study groupRoleWhat they receive
Phase 1 - Dose level 1 - 1.0 mg/kg ALT-100ExperimentalThis is the starting dose for the phase 1 portion of the study.
Receives: Biological: ALT-100
Phase 1 - Dose Level 2 - 4.0 mg/kg of ALT-100ExperimentalThis is the second dose level that will be tested in the phase 1 portion of the study.
Receives: Biological: ALT-100
Phase 2 - Recommended phase 2 dose of ALT-100ExperimentalParticipants randomized to this arm will receive the recommended phase 2 dose determined in the phase 1 portion of the study.
Receives: Biological: ALT-100
Phase 2 - Comparator dose of ALT-100Active comparatorParticipants randomized to this arm will receive a comparator dose of ALT-100 that is not the recommended phase 2 dose determined in phase 1.
Receives: Biological: ALT-100

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of dose limiting toxicities

    Determine the incidence of dose-limiting toxicities during the dose-limiting toxicity evaluation period for participants on the phase 1 portion.

    Measured: first 30 days of treatment with ALT-100

  2. Percentage of participants who achieve a PSA decrease of at least 30%

    Compare the percentage of participants on each arm on the phase 2 portion who achieve a PSA decrease of at least 30%

    Measured: After up to 6 months of treatment with ALT-100

  3. Percentage of participants who achieve a PSA decrease of at least 50%

    Compare the percentage of participants on each arm on the phase 2 portion who achieve a PSA decrease of at least 50%

    Measured: After up to 6 months of treatment with ALT-100

  4. Radiographic progression-free survival

    Compare the radiographic progression-free survival (per Prostate Cancer Working Group 4) of participants on each arm on the phase 2 portion.

    Measured: After up to 6 months of treatment with ALT-100

Secondary outcomes (20)
  1. Maximum plasma concentration of ALT-100

    Determine the maximum plasma concentration of ALT-100 for participants on the Phase 2 portion.

    Measured: At 4 hours after each dose of ALT-100

  2. Time to reach maximum plasma concentration of ALT-100

    Determine the time to reach maximum plasma concentration of ALT-100 for participants on the Phase 2 portion.

    Measured: At 4 hours after each dose of ALT-100

  3. Area under the curve (AUC) up to the last measurable plasma concentration for ALT-100

    Determine the area under the curve (AUC) up to the last measurable plasma concentration for ALT-100 for participants on the Phase 2 portion.

    Measured: At 4 hours after each dose of ALT-100

  4. Area under the curve (AUC) over the dosing interval for ALT-100

    Determine the area under the curve (AUC) over the dosing interval for ALT-100 for participants on the Phase 2 portion.

    Measured: Over the 4 weeks between doses of ALT-100

  5. Half-life for ALT-100

    Determine the half-life for ALT-100 for participants on the Phase 2 portion.

    Measured: At 4 hours after each dose of ALT-100

  6. Trough plasma concentration for ALT-100

    Determine the trough plasma concentration for ALT-100 for participants on the Phase 2 portion.

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  7. Average plasma concentration during a dosing interval for ALT-100

    Determine the average plasma concentration during a dosing interval for ALT-100 for participants on the Phase 2 portion.

    Measured: Over the 4 weeks between doses of ALT-100

  8. Plasma concentration of eNAMPT

    Measure the plasma concentration of eNAMPT

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  9. Plasma concentration of IL-6

    Measure the plasma concentration of IL-6

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  10. Plasma concentration of IL-8

    Measure the plasma concentration of IL-8

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  11. Plasma concentration of TNF-a

    Measure the plasma concentration of TNF-a

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  12. Plasma concentration of IL-1b

    Measure the plasma concentration of IL-1b

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  13. Plasma concentration of IL-1RA

    Measure the plasma concentration of IL-1RA

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  14. Plasma concentration of Ang2

    Measure the plasma concentration of Ang2

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  15. Plasma concentration of VEGF

    Measure the plasma concentration of VEGF

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  16. Plasma concentration of BMP-2

    Measure the plasma concentration of BMP-2

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  17. Plasma concentration of PDGF-BB

    Measure the plasma concentration of PDGF-BB

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  18. Plasma concentration of osteopontin

    Measure the plasma concentration of osteopontin

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  19. Plasma concentration of osteocalcin

    Measure the plasma concentration of osteocalcin

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

  20. Plasma concentration of bALP

    Measure the plasma concentration of bALP

    Measured: Prior to dosing of ALT-100 on day 1 of each cycle (each cycle is 28 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Nov 2026
  2. Study startJan 2027 (estimated)
  3. Primary completionAug 2028 (estimated)
  4. Study completionAug 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07917390
Sponsor's protocol ID
UF-GU-015
Status last verified
Oct 2026
First submitted
28 Oct 2026
Last updated
4 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ALT-100 in people with Prostate Cancer Metastatic to Bone, run by University of Florida.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Alexandra Leggett (352-273-9785, agmueller@ufl.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of dose limiting toxicities (time frame: first 30 days of treatment with ALT-100). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2026.

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