GU Cancers 2019 | Prospects and progress of treatments for mCRPC

Michael Morris

Michael Morris, MD, of the Memorial Sloan Kettering Cancer Center, New York City, NY, gives an update on the major strides that have been made in the treatment of metastatic castration-resistant prostate cancer (mCRPC), as well as highlighting the new horizons in mCRPC research and treatment. This video was recorded at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA.

Transcript (edited for clarity):

Well, I think that in terms of my own research focus, I am very focused on that intersection between nuclear medicine and medical oncology. So, systemic drugs that we can give that can deliver nuclear medicine to the tumor or bone. There are now a host of clinical trials, both in early phase and in registration phase of drug development, looking at tumor-directed radioligand therapy. So, I think that those are quite exciting.

Those compounds have been shown to be very active in informal assessments, primarily in Europe. Now, those trials are going into phase three for registration to demonstrate actual formal clinical benefit in men with CRPC, and so I think that that’s a very innovative way of treating the disease. In the past, we focused on delivering radiation to the bone, now we can focus on delivering radiation to the tumor. So, the most advanced of those compounds is radiolabeled with Lutetium 177, but there’s also an alpha emitter radiolabeled with Actinium 225, which is in earlier phases, which is quite exciting, as well.

In the non-radioligand domain, there are a host of studies looking at specifically patients with DNA repair defects, using PARP inhibitors that I think has the potential to really be transformative in prostate cancer, so that we can really leverage the knowledge that we have not just of where the patient is in the clinical course of the disease, like castration-resistant disease, or castration sensitive disease, or metastatic disease, or non-metastatic disease, but really biologically what’s driving their tumor, and then specifically targeting that segment of the patient population.

And then, of course, there’s a whole world of amino therapy that we haven’t really appreciated in terms of obvious levels of activity until more recently, and identifying those patients for whom amino therapy might actually be a viable treatment in light of the fact that it’s not self-evident who those patients are right now, and there may be a toxicity issue that makes patient’s selection all that much more difficult. So, I think that those are pretty exciting studies, as well.

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