What is likely to be the next 'big' thing?

[NickJoy]

I just wondered if anyone knows if there is any new treatment on the horizon in the near future?

I think many of us are familiar with Lu 177 and AC 225, also, that BAT, CAR-T and BITE are showing some promise but it seems that they are still quite a way off being available generally.

Is there anything else imminent other that current drug combos?

Many thanks.

[GP24]

I think most innovations will result from nuclear medicine:

a) Tandem Therapy of Lu 177 and Ac 225 combined

pubmed.ncbi.nlm.nih.gov/317...

b) Combination of Lu177 and Xofigo

frontiersin.org/articles/10...

c) Combination of Lutetium 177 and Enzalutamide

pubmed.ncbi.nlm.nih.gov/340...

d) A more sensitive tracer for Gallium PSMA PET/CT called 89Zr-PSMA-617 PET/CT

uniklinikum-saarland.de/fil...

e) Terbium instead of Lu 177 and Ac 225

prnewswire.com/news-release...

f) Novartis will get Pluvicto approved earlier in the course of the disease.

ascopubs.org/doi/abs/10.120...

Here are new promising systemic therapies:

g) Dr. Fizazi delivers again. Here is the new drug ODM-208:

healthunlocked.com/advanced....

h) Back to the roots. I think the results of this trial will be practice-changing: STAMPEDE Arm L - ADT with transdermal oestradiol patch

thelancet.com/journals/lanc...

[NickJoy in reply to GP24]

Thank you

[NickJoy in reply to GP24]

This is a great list. I really hope something comes of them all. Thank you for taking the time to list them all.

[MateoBeach]

GP24 has a good list. I would add expanded use of BAT and variations as has been carefully summarized in Smurtaw’s recent posts. Many current variations now in trials. And increasingly deployed outside of trials as it is actually easy to do and to monitor. Combining BAT with PARP inhibitors such as Olaparib. Etc.

And monoclonal antibody delivery of Lu and Ac isotopes such as with J591 and others being developed, as probably better than Pluvicto and similar “small molecule radioligands” (PSMA-614 and I&T).

[NickJoy in reply to MateoBeach]

I wish there were more MO's who would consider this in the UK but once it becomes more 'out there' in the US it get to us I hope. Thank you.

[Heykm01]

I like this video from Tanya Dorff at COH:

urotoday.com/video-lectures...

Lutetium targeting PSMA only works for some, and based on what I've read, usually not for very long. It's good to know that there are multiple other antigen targets that are in the works. And yes, hopefully radiopharmaceuticals have a bright future ahead of giving us years not months of OS benefit.

[NickJoy]

I very much hope so. Thank you.