During the past 19 years we have participated in more than 300 urologic clinical trials mainly focusing upon urologic cancer treatments and diagnostics. We have participated in numerous phase III registrational trials, which have led to FDA, approved diagnostics and therapeutics, which have contributed to the advancement of urologic care globally. Our therapeutic trials attaining registrational approval have included taxane based chemotherapies, including both docetaxel and cabazitaxel, novel oral hormonal agents, including abiraterone and enzalutamide, immunotherapies, including sipuleucel-T, pembrolizumab and atezolizumab, as well as antiresorptives, including zoledronic acid and denosumab, as well as androgen deprivation therapies, including the GnRH antagonist degarelix and numerous longer acting depot formulations of LHRH agonists.
We are honored to have infused the first US patient with Radium 223, post FDA approval, having participated earlier with the Radium 223 Expanded Access Program. Approval of Radium 223 has heralded the rapidly developing field of targeted alpha therapy (TAT). TAT will provide another CRPC therapeutic modality with a unique mechanism of action that can now offer additional options to patient with bone metastases in conjunction with CRPC biology. Future and ongoing studies are planned to explore the benefits of combining and layering other approved CRPC therapies with radium-223, given its ease of administration, its unique and targeted effect on bone metastases alongside its very well established patient safety profile.. The approval of radium-223 promotes the facilitation of the multidisciplinary care management of CRPC patients. Medical oncology, radiation oncology, nuclear medicine, and urology specialists who focus upon advanced prostate cancer patients care can optimize and coordinate the administration of TAT while collaborating on the optimal treatment for the CRPC patient with bone metastases. I am truly encouraged how the development of radium 223 and other CRPC therapeutic advancements are not only expanding our therapeutic CRPC armamentarium but also providing for much needed trials in both castration naïve and castration resistant prostate cancer patients in order that we continue our goals of precision medicine while also attaining the goals of prolonging survival, preserving quality of life, and preventing complications from selected therapies..
This Center of Excellence will focus on present systemic therapies for advanced prostate cancer, specifically updating on preclinical and clinical trials exploring endpoints that affect bone metastases. We will provide contemporaneous content on the optimization for the successful incorporation of radium-223 and other bone targeted agents into the CRPC treatment paradigm, which will include new information on other novel targeted alpha therapy strategies, inclusive of conjugates exploring TAT therapies. Additionally, we will maintain a focus of reporting on the most recent presentations for both combination and layering strategies for maximizing the care of your CRPC patient with bone metastases.. As the editor for Center of Excellence on Castration Resistant Prostate Cancer (CRPC) with Bone Metastases I’m honored to work with the dedicated team at UroToday.
Written by: Neal Shore, MD