Progression after at least one prior line of therapy for metastatic uveal melanoma. Liverdirected therapy (such as hepatic arterial embolization, isolated hepatic perfusion) will count as one line of therapy. Should any additional treatment(s) receive regulatory approval for
metastatic uveal melanoma during the conduct of this trial, subjects (if eligible for the newly approved treatment) would need to demonstrate disease progression on the additional treatment(s) before being eligible to participate in the current study (MTO 201-001). There is no limit to the number of previous treatments for metastatic disease
Patients must have measurable disease per RECIST 1.1
Adults, age 18 or over, with no upper age limit
ECOG performance status of 0-1
Acceptable organ and marrow function as defined by protocol
Male patients who are sexually active, and female patients of child bearing potential must agree to use 2 forms of FDA approved contraceptive methods during treatment with 225Ac-MTI-201 and up to 3 months following treatment
Ability to understand and the willingness to sign a written informed consent document
Has known symptomatic central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable without evidence of progression by imaging for at least four weeks after definitive intervention and using no more than the equivalent of dexamethasone 2 mg/d for the management of vasogenic edema, if necessary. This exception does not include carcinomatous meningitis, which is excluded regardless of clinical stability
Patients with an active malignancy requiring anticancer treatment at the time of study entry that, in the judgment of the investigator could impact the results of treatment of metastatic uveal melanoma
Pregnant or nursing women. Women of childbearing potential (defined as having had a menstrual cycle within the past 12 months, and not having had a surgical procedure for sterilization) must have a negative pregnancy test (urine or serum) within 7 days of treatment with 225 Ac-MTI-201
Patients with uncontrolled inter-current illness including, but not limited to, ongoing or active bacterial infection, active hepatitis B/C infection requiring antiviral therapy, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Immunocompromised patients may be at increased risk of toxicity. Therefore, HIV-positive patients, patients with acquired or congenital immunodeficiency conditions, those on chronic systemic corticosteroids requiring >10 mg of prednisone or equivalent per day will be excluded
from participation. (Patients with autoimmune disease who do not require corticosteroids or are maintained on ≤10 mg of prednisone or equivalent per day ARE eligible for participation; for patients with CNS metastases on steroids, exclusion criterion #2 above will apply)
Prior external beam radiation therapy to more than 25% of the bone marrow
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