Taken with the linked co-author interview, expert commentary, and full report access, this an excellent review of the current status of research efficacy for checkpoint inhibitors in PCa. In also provides the status of current trials using CPIs in PCa.
Direct links to the Co-author interview, expert commentary, and full report PDF are below:
Karen Autio, MD, MSc, on Potential Role of CPIs in Prostate Cancer: Single-agent checkpoint inhibition benefits only a small percentage of prostate cancer patients
The problems with CPI's is that they are specific usually for a certain target and some cancers get little reaction to them. Keytruda works well for melanoma (Ask Jimmy Carter !) but not as well for PCa except in combination with other drugs or vaccines. ADXS-PSA was given with Keytruda --see below:
The concern that I have is that CPI's given after chemo seem to be less effective or for shorter periods of time. The study above listed a shorter median survival for those who had prior docetaxel. Another example is the Checkmate 650 trial where 25% of patients that received prior hormonal therapies had a response to the CPI combo of Opdivo and Yervoy-- A PD-1 pathway inhibitor and a CTLA4 inhibitor-- versus 10% who had prior chemo-see below:..
I am sure researchers are asking the question: "What does chemo do that seems to decrease the effectiveness of CPI's???". Should chemo stop being 1st line in PCa and should ADT plus 2nd generation hormonal agents be the new standard??
Kitov, an Israeli company, has a drug NT-219 which increases the effectiveness of CPI's and in initial studies doubled the response to Keytruda . Some info:
The other issue with CPI's is toxicity... I believe they will be important agents in the cancer fight club... The hunt continues as The Science is Coming !!!!
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New Era of Lutetium-PSMA Post Approval: Perspectives, Challenges & Future
