Earlier this month, Dr. Himisha Beltran presented exciting new research results for those with metastatic prostate cancer at the European Society of Medical Oncology (ESMO)’s annual meeting in Copenhagen, Denmark. Cancer experts and patients from around the world came to the 2016 ESMO Congress to discuss the latest research and cutting-edge treatment options for people with cancer.
Dr. Beltran’s research presentation highlighted promising results from a clinical trial for men with aggressive prostate cancer. Aggressive prostate cancer sub-types represent approximately 25% of all prostate cancer cases, and neuroendocrine prostate cancer (NEPC) is considered to be the sub-type that is most resistant to currently-available treatments.
Dr. Beltran and the Weill Cornell Medicine (WCM) Genitourinary (GU) Oncology team led this multicenter, phase 2 clinical trial, which was based upon prior WCM work which identified aurora kinase A as a key target in NEPC. The trial enrolled sixty patients from across the United States. It was the first clinical trial to study a new, targeted treatment for men with NEPC. The drug used in this study, Alisertib, is an oral medication that is an Aurora Kinase A Inhibitor.
This clinical trial confirmed our hypothesis that different men’s tumors genetically expressed different levels of the targets for the drug, and as a result their response rates to this treatment varied. Those with the most optimal responses had cancers that genetically appeared to be most like NEPC in both biopsies and whole exome genomic sequencing of the tumor. As part of our Institute for Precision Medicine, we use the Exact-1 whole exome sequencing test to categorize more than 21,000 genes within the tumor. This is the most comprehensive way to determine where mutations and mechanisms for treatment resistance may exist in patients with advanced stage cancer and allows us to narrowly target different patient’s treatment regimens on the molecular level. In addition, some of the tumor biopsies were analyzed for gene expression (RNA) and organoids, which are tumor models that we are able to grow from the biopsy tissue, were developed.
In this clinical trial, we were able to learn a lot on the molecular level from the patients who had the most exceptional responses to Alisertib. Based on these results and establishing biomarkers to predict Alisertib response rates, future clinical trials could be much more targeted to include only the men whose tumors indicate that they are likely to respond to this therapy.
Additionally, there is great potential to learn much more about the tumor evolution and the biology of resistance. This clinical trial underscores the need to more narrowly focus on the sub-set of prostate cancer patients with NEPC, as there are few standard treatment options and limited clinical trials available for these men.
Thank you to all the men who enrolled in this clinical trial and helped further the field of research in the search for new cures for prostate cancer.
We’re always working to increase access to new promising treatments for NEPC and other aggressive forms of prostate cancer through clinical trials. To learn more about our open studies and to make an appointment with the Weill Cornell Genitourinary (GU) Oncology Program, call 646-962-2072.