Evaluation of [68Ga]DOTA-IR-780-C-4 in PET Imaging Studies for PSMA-Positive Prostate Cancer Patients

Inclusion Criteria:

* Able to understand and voluntarily sign the written Informed Consent Form (ICF); Willing and able to participate in procedures required by the trial, including examinations and follow-ups; Male, aged ≥ 18 years;

Histologically or cytologically confirmed prostate cancer, with failure of standard treatment, refusal of standard treatment, no available standard treatment, or disease progression after refractory previous treatments, or no available treatment options according to current guidelines:

Patients who have not received, refused to receive, or progressed after receiving at least 1 but no more than 2 taxane-based treatments. The taxane treatment regimen must include exposure to taxanes for at least 2 cycles. If the subject has only received one type of taxane and the doctor deems that he is not suitable for a second taxane treatment regimen (e.g., due to assessment of old age or health status indicating non-frailty or intolerance, etc.), he may also be included; Patients who have progressed after receiving at least one novel androgen-targeted drug (such as abiraterone, enzalutamide);

Meet the Prostate Cancer Working Group 3 (PCWG3) criteria for diagnosis of metastatic castration-resistant prostate cancer (mCRPC), including:

1. Serum testosterone reaches castration level (serum testosterone \< 50 ng/dL or 1.7 nmol/L);
2. And at least one of the following:

Serum PSA progression: PSA \> 1 ng/mL, and PSA increases consecutively twice at 1-week intervals, with both values exceeding 50% of the lowest value; or bone scan indicates ≥ 2 new bone lesions; or CT or MRI indicates progression of soft tissue lesions (RECIST 1.1) Confirmed as PSMA-positive by 68Ga-PSMA PET/CT scan; At least one measurable lesion (RECIST 1.1); Eastern Cooperative Oncology Group (ECOG) performance status score ≤ 2; Expected survival \> 6 months;

Sufficient organ function:

1. Bone marrow function: neutrophil count ≥ 1.5 × 109/L; white blood cell count ≥ 2.5 × 109/L; platelet count ≥ 100 × 109/L; hemoglobin ≥ 90 g/L;
2. Liver function: total bilirubin ≤ 1.5 × ULN; albumin ≥ 30 g/L; ALT and AST \< 3 × ULN in subjects without liver metastasis; \< 5 × ULN in those with liver metastasis;
3. Renal function: creatinine clearance ≥ 60 mL/min calculated by the Cockcroft-Gault formula;
4. Coagulation function: INR ≤ 1.5; activated partial thromboplastin time (APTT) ≤ 2 × ULN (for patients not receiving anticoagulant therapy or receiving stable-dose anticoagulants); All clinically significant toxic reactions related to previous anti-tumor treatments (such as chemotherapy, radiotherapy, etc.) have recovered to ≤ Grade 1 (CTCAE V5.0) (except alopecia).

Agree to take radiation protection measures as directed by the doctor during the trial.

Exclusion Criteria:

Unable to tolerate imaging procedures; Having received other investigational drugs or devices within 4 weeks prior to screening; Having received any of the following treatments within 6 months prior to administration: radium-223, strontium-89, samarium-153, rhenium-188, or hemibody radiotherapy; Having previously received PSMA-targeted radioligand therapy; or having received systemic anticancer therapy such as radiotherapy, chemotherapy, immunotherapy, or biotherapy within 4 weeks prior to the first administration; Having experienced grade 4 myelosuppression after previous anticancer treatment, or grade 3 myelosuppression that required more than 6 weeks to recover; Planning to use cytotoxic chemotherapeutic drugs, antitumor immunotherapy, radioligand therapy, or other similar antitumor drugs during the trial; Having used blood products, albumin, etc. within half a month prior to administration to make the subject meet the inclusion criteria;

Having brain metastases, meningiomas, or other central nervous system metastases at screening, except for the following cases:

For asymptomatic brain metastases, where the metastatic lesions are limited to the supratentorial and/or cerebellum (i.e., no metastases in the midbrain, pons, medulla oblongata, or spinal cord), no corticosteroid treatment is needed, and there are no brain metastases with a long diameter \> 1.5 cm, the subject can participate in the study; For symptomatic brain metastases, those who have received treatment and whose lesions are confirmed to be stable for more than 4 weeks by imaging can participate in the study; Having other malignant tumors within 5 years (except for locally treated malignant tumors in situ, such as basal cell or squamous cell skin cancer); Having superscan; Having symptomatic spinal cord compression or expected to develop spinal cord compression; Having previously received external beam radiation therapy (EBRT) targeting extensive bone marrow (\>25%); Having undergone allogeneic organ transplantation and requiring immunosuppressive therapy;

Having severe heart disease at screening, including but not limited to the following:

QTcF \> 470 ms or a history of long QTc; Having myocardial infarction, angina pectoris, coronary artery bypass grafting, etc. within 6 months prior to screening, which the investigator deems unsuitable for inclusion; Having any other diseases, metabolic abnormalities, physical examination abnormalities, or laboratory test abnormalities at screening, which, in the investigator's judgment, reasonably suggest a disease or state unsuitable for the use of the study drug, may affect the interpretation of study results, or put the subject at high risk; Having poorly controlled bladder outlet obstruction or urinary incontinence at screening; Having positive hepatitis C virus antigen (HCVAg) or human immunodeficiency virus antibody (HIV) at screening; For those with positive hepatitis B surface antigen (HBsAg) at screening, hepatitis B virus deoxyribonucleic acid (HBV-DNA) testing is required; if the investigator determines that the patient is in the active viral replication stage, they cannot be included; Having active infection prior to administration; Having poor venous conditions at screening and unable to tolerate blood sample collection; Having known allergies to protein and/or polypeptide drugs, or to structural analogs of this product or other excipients; Having a history of drug or alcohol abuse within one year prior to screening, or a long-term history of drug addiction; Failing to take effective contraceptive measures during sexual activity during the trial and within 6 months after the last administration.