Future of advanced prostate cancer treatments. What to expect?

[JNunes]

Someone here is becoming aware of what is expected in terms of future treatments for metastatic prostate cancer?

Are there any news for the coming years?

[GP24]

I think the Lu177 and Ac225 treatments will become very important in the future.

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[p3d1]

Jim Allison is starting a trial In Texas with a combination of 3 immunotherapy drugs. The drug he developed with BMS and a PD-1 ( or PD-L1) combined with a VISTA inhibitor. This should start giving results within a year and if he is right he should be able to get long term remissions.

A trial in China is testing a immunotherapy drug on people with a POLE and/ Or POLD1 genetic mutation. These types of cancers including prostate are hyper-mutated and should be visible to the drug. This will report in December 2020.

[JNunes in reply to p3d1]

Thank you.

[Gunnershome]

Thank you!! 👍

[Patrick-Turner]

For me, the availability of Lu177 in Sydney, only 300km away from where I live has allowed me to live longer where the only other alternatives were various combinations of chemo, and the trouble with chemo is that it interferes with the Pca growth when Pca cells divide. But Pca growth in my case has be quite slow, so cells don't divide to form new Pca cells very often so when I did have 5 shots of Docetaxel, Pca kept growing and Psa increased from 12 to 50 over 3 months, so I had to quit chemo and go to Lu177, which got rid of many mets it seems, but not all, but now docs are hopeful that having more Lu177 beginning next Friday will kill many of the small new bone mets and some older ones which were not killed by first 4 shots of Lu177. All my soft tissue mets seem to be gone, according to lar PsMa scan about a month ago.

There's a lot of talk about immune therapy that might be an alternative to Provenge, but nothing seems to mature into being reliable therapy for a large % of patients.

So it just does not get approved. And we would know know now if some breakthrough IT was being adopted at hospitals but there just is not enough success yet.

In some cases, IT works like a miracle, but in many more cases it does not, and can cause severe side effects.

Making chemo targeted in the same way Lu177 is targeted would be a real wonder, so that a man could have very small dose of chemo which gathered at tumors and thus he would avoid the nasty side effects of chemo. So he could have many more doses of chemo for a longer time, and expose the Pca cells to repeated attack. No such thing is possible yet.

Patrick Turner.

[henukit]

Definitely immunotherapy will be the leading direction in the coming years. Combination of checkpoint inhibitors with other drugs and modalities is very potent approach. Making immunologically cold prostate cancer by modifying tumor micro-environment is the next step to improve response rates and outcomes.

[marnieg46]

You might be interested JNunes in the latest video from UroToday which discusses the treatments GP24 has mentioned.

urotoday.com/video-lectures...

[JNunes in reply to marnieg46]

Thank you, marnieg46.

[Bob10]

No Mention of prostate cancer

[Bob10 in reply to Bob10]

No Mention of prostate cancer JNunes

[JNunes in reply to Bob10]

Right :/

[immunity1]

To add to the above.

PSA will still be used as q screen for 'at risk' persons.

I think PET PSMA scans will become SOC alongside MRI and image-directed peroneal biopsy in order to sequence primary treatment (surgery or radiation).

Following biochemical recurrence (PSA increase), a follow up with PET FDG and PSMA scans, genetic analysis (genomic and/or somatic) to determine secondary treatments,; be they Lu177, chemo, ADT or AR antags, immunotherapy (PARP inhibitors. PD1 inhibs etc).

Rob