New Evidence for Combined “Chemohormonal” Approach to Treating Metastatic Prostate Cancer

Hormone-dependent cancers rely on normal signalling pathways of the body in order to fuel their malignant potential. Fortunately, targeted therapies designed to deprive cancers of these growth signals have proven to be effective tools for treating patients with these types of cancers. New evidence published on August 5th by the New England Journal of Medicine now shows that combining androgen-deprivation therapy (ADT) and the chemotherapy drug docetaxel increases survival in patients with hormone-sensitive prostate cancer. The study found that patients receiving ADT and docetaxel together improved their survival by 13.6 months compared to patients receiving ADT alone.
Read more at the NEJM.

Institute for Precision Medicine Offers New Strategies for Approaching Cancer Treatment

Dr. Himisha Beltran and her team of researchers at the Institute for Precision Medicine at Weill Cornell and NewYork-Presbyterian Hospital have published findings in the May 28 edition of JAMA Oncology that offer new insight into treatment options for resistant cancers. Genetic sequencing has allowed oncologists to further classify and predict the behavior of many cancers, allowing patients to receive treatments that are more tailored to their cancer’s unique mutations. Traditionally this has meant hunting for specific mutations in a patient’s cancer, but new advances in exome sequencing could streamline this process and offer physicians new precision in choosing the right treatments for their patients.

“Most institutions are using focused or panel sequencing to look at a few hot spot mutation areas in cancer,” said senior author Dr. Mark Rubin, the institute’s director, and the Homer T. Hirst III Professor of Oncology in Pathology and a professor of pathology and laboratory medicine at Weill Cornell. “But we believe that Whole Exome Sequencing, which tests more than 21,000 genes in the cancer’s exome, the DNA that is transcribed into RNA, is ideal for patients with advanced cancer where we dont know where the mutations of resistance are.”

Read more at the Cornell Chronicle.

Dr. Tagawa Presents Updated Results of ATL101 at AACR

At the annual American Association for Cancer Research in Washington, DC last week, Dr. Scott Tagawa presented updated combined analysis of 4 Phase I and Phase II studies involving 114 patients treated with ATL101. The analysis demonstrated that PSMA imaging might be used to predict the response to ATL101 radioimmunotherapy.ATL101 is a new targeted radiotherapy experimental drug for treating prostate cancer. ATL101 combines the humanized J591 monoclonal antibody targeting prostate-specific membrane antigen (PSMA) plus the Lutetium-177 radioisotope, creating the first tumor-specific delivery system able to target radiation to radio-sensitive prostate cancer cells wherever they are in the body.

From the sponsor’s press release:

14 patients were evaluable for semi-quantitative analysis of planar gamma images acquired after injection of ATL101 (35 patients from phase I at dose of 10-75 mCi/m²; 47 patients from Phase II at dose of 65-70 mCi/m² and 39 patients from phase I with a fractionated schedule at dose of 40-90 mCi/m²). 22 patients were also evaluable after injection of Indium-111 labeled J591 and treatment by Yttrium-90 labeled J591 at dose of 5-20mCi/m². Patients were sorted into 3 groups: low PSMA expression group included one third of patients, with no uptake (18%) or with weakly positive images (16%); high PSMA expression group included one half of patients, with tumor image as intense (26%) or more intense (24%) than liver. The 16 % remaining patients had intermediate uptake.

Significant correlation was found between higher PSMA expression (high vs. low) and higher response rates (RR) to treatment defined as >30% decline in PSA (RR=32% vs. 12.5%, p=0.01). RR was itself significantly correlated to longer survival. An association between PSMA expression by imaging and reduction in circulating tumor cell counts was also found (p=0.07). Further studies will examine quantitative molecular imaging with anti-PSMA PET/CT as recently published in animal models (Morris et al, 2013 ASCO Genitourinary Cancers Symposium).

Click here to read the complete press release.