Weill Cornell researchers recently published findings from a Phase II study of the lutetium-177-labeled monoclonal antibody J591 (called Lu-J591).
J591 is a man-made monoclonal antibody that is able to recognize a protein antigen (PSMA) expressed on virtually all prostate cancer cells, and more so in men with treatment-resistant metastatic disease. When a tiny tag of radioactive material is attached to the J591 antibody, that specifically targets prostate cancer cells, and delivered systemically this is known as “radioimmunotherapy.” Dr. Scott Tagawa and colleagues at Weill Cornell have been conducting clinical trials of the precision radioimmunotherapeutic J591 to determine its ability to eradicate prostate cancer cells.
In the recently published study, 47 prostate cancer patients with PSA progression after hormonal therapies with or without chemotherapy were treated with Lu-J591. 10.6 percent experienced more than 50% PSA decline, and 36.2% experienced more than 30% decline. Among those treated at the maximum tolerated dose, 46.9% had more than 30% PSA decline. Furthermore, 75% of patients with radiographically measurable disease had some measure of disease control; 67% of those assessed for circulating tumor cells had more than 50% decline in tumor cell counts 4 to 6 weeks after treatment.
The researchers concluded that a single dose of Lu-J591 was well tolerated and they found a measurable response rate. The authors conclude that Lu-J591 is a promising new therapeutic strategy to explore.
Click here to read the published abstract. Click here to read an article about the study and the findings.
The Weill Cornell Urological Oncology Program has recently opened a new clinical trial for for men who have metastatic castration-resistant prostate cancer (mCRPC) and who have not previously been treated with chemotherapy for their cancer. The study is evaluating the benefit of an early switch from docetaxel plus prednisone to cabazitaxel plus prednisone if the PSA level is not reduced by at least 30% after 4 cycles of treatment. The opposite sequence will also be evaluated. The sponsor of the trial is Sanofi, and the principal investigator at Weill Cornell is Dr. Scott Tagawa.
For more information about the study, please call Renee Khan, RN at (212) 746-1851, e-mail Renee at email@example.com.
Metastatic castration-resistant prostate cancer (mCRPC)
Progressive disease while receiving hormonal therapy or after surgical castration
Have not received prior chemotherapy for prostate cancer
Detailed eligibility reviewed when you contact the study team\
The purpose of this study is to evaluate the benefit of an early switch from docetaxel plus prednisone (Treatment A in this study) to cabazitaxel plus prednisone (Treatment B) if the PSA level is not reduced by at least 30% after 4 cycles of treatment. The opposite sequence will also be evaluated.
Cabazitaxel is FDA-approved for treating mCRPC previously treated with the chemotherapy drug docetaxel. However, cabazitaxel is not approved for treating mCRPC that has not been previously treated with chemotherapy, and therefore its use in this study is considered experimental.
Study participants will be randomly assigned to one of two treatment arms:
Treatment A: participants will receive docetaxel via infusion once every 3 weeks plus oral prednisone taken daily. Participants whose PSA level is not reduced by at least 30% after 4 treatment cycles will switch chemotherapy to receive cabazitaxel via infusion once every 3 weeks plus oral prednisone taken daily. Participants who do achieve a 30% or greater PSA reduction will continue taking docetaxel and prednisone.
Treatment B: participants will receive cabazitaxel via infusion once every 3 weeks plus oral prednisone taken daily. Participants whose PSA level is not reduced by at least 30% after 4 treatment cycles will switch chemotherapy to receive docetaxel infusion every 3 weeks plus daily oral prednisone. Those who do achieve a 30% or greater PSA reduction will continue taking cabazitaxel and prednisone.
Participants may continue to receive study treatment as long as they are responding to therapy and not experiencing intolerable side effects. As a key part of the research, investigational biomarkers (blood tests) will be explored to help researchers determine who will (or will not) benefit from each type of chemotherapy. After completing the treatment period, participants will be seen for follow-up every 3 months for the first year and then every 6 months for about 3.5 years.
Click here to view all current prostate cancer clinical trials in the Department of Medicine.
Weill Cornell’s Dr. Scott Tagawa presented four research posters at this year’s American Association for Cancer Research (AACR) annual meeting. Each of the presentations is summarized below. Click on the title to view the published abstracts.
J591 is a man-made monoclonal antibody that is able to recognize a protein antigen (PSMA) expressed on virtually all prostate cancer cells, and more so in men with treatment-resistant metastatic disease. When a tiny tag of radioactive material is attached to the J591 antibody, that specifically targets prostate cancer cells, and delivered systemically this is known as radioimmunotherapy. Dr. Tagawa has been conducting clinical trials of the precision radioimmunotherapeutic J591 to determine its ability to eradicate prostate cancer cells that have metastasized. In this poster presentation, Tagawa and colleagues performed a combined analysis of four clinical studies of this radioimmunotherapeutic that examined 130 patients with metastatic treatment-resistant prostate cancer. They found that the levels of PSMA expression—as determined by a non-invasive scan–can be used to indicate response to their radioimmunotherapy.
Taxanes are a type of chemotherapy drug that are used to treat advanced prostate cancer; however, inevitably prostate cancer patients develop resistance to these chemotherapy drugs. In this poster, Tagawa et al demonstrate that a genetic abnormality (ERG positivity) found in half of all men with prostate cancer plays an active role in inducing resistance to taxane-based chemotherapeutics. Additionally they’ve determined that men with ERG positive tumors have upregulation of another protein (clusterin) that can cause resistance to taxane chemotherapeutics. This work dovetails nicely with Dr. Zoubeidi’s work (see above) and shows the potential to use a drug now in clinical trials (OGX-011) to enhance response to chemotherapy in men whose prostate cancer is positive for the ERG genetic aberration.
This poster describes a prospective, randomized multi-site clinical trial that will enroll 100 men with treatment resistant prostate cancer and use advanced technology to capture and analyze cancer cells that are freely circulating in their bloodstreams. This trial will allow the researchers to look for early signs of treatment response or failure in individual cancer cells and examine the genetic and other molecular factors that indicate or lead to either a response or lack of response to chemotherapy. This is one of the few studies to utilize blood-based biomarkers in a prospective fashion. It is also a demonstration of cooperation between academic partners and the pharmaceutical industry—one that was facilitated by the Prostate Cancer Foundation.
This poster describes a molecular dance that prostate tumor cells exploit as they metastasize to bone. Understanding and characterizing the mechanisms that tumor cells use exit the bloodstream and to home to bone and set up shop should allow researchers to develop ways to interrupt the process and prevent circulating prostate cancer tumor cells from setting up cancerous shop in men’s bones.