177LU-DTPA-SC16 attaching DLL3 for neuroendocrine cancer

25% of pCA develop into neuroendocrine variant. Research show good preclinical results. Has anyone information of a clinical trial at MSKCC using SC16 as a monoclonal antibody?

pubmed.ncbi.nlm.nih.gov/357...

[Tall_Allen]

This article shows all of the clinical trials I'm aware of:

prostatecancer.news/2016/12...

[Hidden in reply to Tall_Allen]

Thank you very much, I have negative scans for PSMA and FDG, but NSE is 17 indicating T-NEPC.

[Tall_Allen in reply to Hidden]

t-NEPC seems to be a different sort of beast from de novo NEPC. Rahul Agarwal at UCSF is running this clinical trial specifically for t-NEPC:

clinicaltrials.gov/ct2/show...

aacrjournals.org/clincancer...

Other potential therapies that haven't yet made it out of the lab include PARP inhibitors (which I see you've had), somatostatins/Lutathera, and HDAC inhibitors. I haven't seen anything about BAT therapy, but I wonder if it might be useful, at least in some cases.

Was the NSE on a blood test? It's great that you don't have metastases that show up on PET scans.

[Hidden]

I had a DOTADOC for SSTR2 which was negative, MO ordered it because of NSE level of 17 in the monthly blood test, has had that precise level for more than a year. AR is upregulated in some cases of NEPC, that’s why trying BAT. Just got an answer from UKS in Homburg, they can offer a DLL3 scan, maybe also lu177-DPTA-SC16 in the near future, the preclinical results are amazing, CR in 8/8 mice with the intermediate dose.

[GeorgeGlass in reply to Hidden]

is this a new version of lu-177? You said pre-clinical, so I presume it’sa new version targeted at NE mutations?

[Hidden in reply to GeorgeGlass]

That is correct, the target is NE showing DLL3 antigen on the cell membrane.

[GeorgeGlass in reply to Hidden]

and you’re doing this treatment in Hamburg? Where else is it available? Are their restrictions for who can get it? How about clinical trials?

[Hidden in reply to GeorgeGlass]

Homburg close to Frankfurt, not Hamburg. No clinical trial, only amazing preclinical results. Hopefully the treatment will be available in the near future.

[GeorgeGlass in reply to Hidden]

ok, I’ve been to Frankfurt and that area before. Good luck with it and please let Is know how you do with it.

[SimplyT]

How long will it take to make this treatment available? I’m currently participating in the Duke Champ trial for Nepc and Avpc.

[GeorgeGlass in reply to SimplyT]

what is that trial you are doing? Who’s eligible to do it?

[SimplyT in reply to GeorgeGlass]

Duke Champ Trial, 2 chemos, cabazataxil and carboplatin with 2 immunos, ipi and nivi which is opdivo and Yervoy. For Nepc and aggressive variant pca.

[SimplyT in reply to SimplyT]

I’m taking my second round of these cocktails right now

[GeorgeGlass in reply to SimplyT]

I hope it works well for you T.

[SimplyT in reply to GeorgeGlass]

Thank you- me too

[Hidden]

I d’ont know, but as I interpret the answer from UKS it could me a matter of few months- hopefully. They have the scan availability. it’s a matter of attaching lu177 in the right dose.

[SimplyT]

Thank you for the info!

[Atdabeach]

I was surprised to read your first sentence stating that 25% of prostate cancer cases develop into neuroendocrine prostate cancer. I have seen numbers in the 20% range of castrate-resistant PCa going to neuroendocrine, but that would imply a much lower number for prostate cancer cases overall. Is that what you meant to say?

[Hidden]

De Novo neuroendocrine of all prostate cancers is just under 2%, I am referring to T-NEPC where approx 25% of CRPC transform into neuroendocrine type after a median of 39 months from initial diagnosis. The researchers believe that the number could increase due to more extensive use of Enza and/or Abira, thus new treatments like lu177-DPTA-SC16 are urgently needed.

New promising drugs must go thru the clinical trials cycle - 7,8,9 years - and if FDA approves, you get some months extra at an extremely high cost.

In Germany the system is different. They allow use of experimental drugs - so to speak right out of the lab. They have used lu177/ac225 since 2014, 8 years ahead of the US, and the cost was much lower.

It seems that they can offer lu177-DTPA-SC16 in the near future. If Novartis should pick this up the price will soar thru the roof and the clinical trials have to be performed.

This is why it very interesting for us pCA patients to watch the dev of drugs in Germany.

[TeleGuy]

Searching clinicaltrials.gov for SC16 and DLL3 shows several trials for the SC16 monoclonal antibody against small-cell lung cancer, which also exhibits DLL3. I don't see any at MSKCC but I do see a couple of trials such as NCT03334487 that was withdrawn "for strategic reasons" whatever that means...