Dr. Denmeade concluded his presentation with the following key takeaways:
The presence of AR alterations in ctDNA may identify patients who may or may not benefit from BAT
In this study patients with no AR alterations treated with BAT exhibit significantly shorter PFS and OS compared to those treated with Enzalutamide
Additional clinical trials with BAT are open and actively accruing:
STEP-UP (sequencing BAT and Enzalutamide)
APEX (sequencing BAT + Difluoromethylornithine (DFMO) with Enzalutamide)
BATRAD (BAT + 223 Radium)
AcroBAT (oral testosterone)
However, patients with AR alterations treated with BAT trend toward prolonged PFS and OS vs. Enzalutamide, although not significant: PFS (p=0.22), OS (p=0.058)
Precision Medicine / Targeted Therapy knowledge continues to grow, and is the future of Medicine. The identification of genetic markers for treatment is in its infancy.
I believe that genetic testing will be moved up sooner and sooner to ID potential treatments for patients as that knowledge base of Targeted Therapy expands.
In the near future, patients will get genetic testing, and an AI will evaluate the data to provide the best individualized treatment plan using genetic deviations information and SOC...
The Science is Coming !! Count on it !!
Don Pescado
I have been on a minitrial for 1 a year now. The MO is analyzing the AR, initially I had 15% AR-V7, indicating CRPC after Enza. Three cycles of BAT eliminated AR-V7. Now I have performed three BAT cycles again, starting with Daro tomorrow. Last year PSA was 7, dropped to 0.14 in six weeks. This time I added Olaparib in 50% dose, PSA is now 3.1. The big question, will I have the same drop again? The cells should be sensitive according to the theory……
If timing and markers are important for this treatment to be effective, what markers are we looking for. (What AR mutations etc I've been using Foundation One so what should I be looking for in the report? Or should I be asking for a different report from another provider
Ciga - Here is a excellent 6 min interview with Denmeade at ASCO that describes the information presented there. Highly recommended for those on or considering doing BAT.
* * *
Samuel Denmeade, MD, of Johns Hopkins University School of Medicine, highlights his research on blood-based markers of differential efficacy of bipolar androgen therapy and enzalutamide in the randomized TRANSFORMER trial.
This research was presented as a late-breaking abstract at the 2024 American Society of Clinical Oncology Annual Meeting.
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Identifying Blood-Based Markers for Optimized Bipolar Androgen Therapy in mCRPC
By Samuel Denmeade, MD - Last Updated: June 6, 2024
My pleasure to be able to do it. I always find that a good interview can help distill complex issues into terms us patients can more easily understand.
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