Extraordinary therapeutic effect of PSMA radioligand therapy in treatment-refractory progressive mPCa with the transketolase inhibitor B-OT

[cujoe]

Super interesting N=1 case study from the PSMA experts in Germany. Like me, you've probably never heard of transketolase or why you would even want to inhibit it. Turns out transketolase is a thiamine-dependent enzyme that serves as the rate-limiting enzyme in the non-oxidative branch of the Pentose Phosphate Pathway. - if that helps you at all.

This particular case is one of a patient with metastatic disease who rapidly progressed in spite of aggressive treatment. He was PSMA-avid on scans, so serially treated with various PSMA radioligands. Late series inclusion of the thiamine antagonist benfo-oxythiamine (B-OT) improved his response and extended his life by an additional 12 months. The docs believe this n=1 adds support to their theory that adding B-OT to PSMA therapy can overcome radiation resistance in PCa.

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The NIH National Library of Medicine's National Center for Biotechnology Information currently lists 179 related citations on PubMed for the transketolase gene, TKT . The most abundant location of the TKT gene is in bone - and by a very large margin, with ranges for fat less than 1/2 and prostate not even 1/4 the amount in bone. Here is a link to the NIH site:

ncbi.nlm.nih.gov/gene/7086

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Full Case Report is here:

Extraordinary therapeutic effect of PSMA radioligand therapy in treatment-refractory progressive metastatic prostate cancer with the transketolase inhibitor benfo-oxythiamine as a radiosensitizer—A case report, CASE REPORT article

Front. Med., 08 October 2024, Sec. Nuclear Medicine, Volume 11 - 2024.

frontiersin.org/journals/me...

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As our loyal friend npfisherman is fond of saying . . . "The Science is Coming".

Y'all Stay S&W, Ciao - Capt'n cujoe

[NPfisherman]

Dog of Terror,

Thanks for posting this information. As we know, this is how knowledge of our disease starts...with n=1 cases...

Folks, if you have aggressive disease, then this is another option to consider. For many on these forums, possible treatment options can be found here at FPC, despite being relegated to an unmoderated/ heavily moderated status.

I hope , Top Dog, that things are going well doing your n=1, and that things are going well with recovery in NC...

All the best, amigo....

DD