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Highlights from the 2022 American Society of Clinical Oncology Annual Meeting
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| T-Cell Engagers for Prostate Cancer: Efficacy and Toxicity Management
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| Michael Thomas Schweizer, MD
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| At the 2022 American Society of Clinical Oncology annual meeting, Michael Schweizer began the case-based discussion of T-cell redirection against prostate cancers. Despite progress on multiple lines of therapy for metastatic castration resistant prostate cancer, this patient has good performance status and organ function, and would be a reasonable candidate for clinical trials. Dr. Schweizer discussed that he may consider this patient for a trial testing the efficacy of bi-specific T-cell engagers (BiTEs).
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| CAR T for Prostate Cancer: Current Strategies to Improve Efficacy |
| Tanya Dorff, MD |
| In her portion of this case-based panel, Tanya Dorff described chimeric antigen receptor T-cell (CAR-T) therapy and its potential use in prostate cancer. She indicated that CAR-Ts are especially exciting given their potential to induce long-term disease responses, such as have been seen in leukemias and lymphomas. |
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| Future Targets for Cellular Therapy in Prostate Cancer |
| Vivek Narayan, MD, MS |
| In his portion of this case-based discussion, Vivek Narayan discussed some of the barriers to the efficacy of CAR-T therapies. These include limited T-cell expansion or persistence once infused, dysfunction of infused T-cells, tumor immune escape by down-regulation of the targeted tumor antigen, and inflammatory toxicities such as CRS or neurotoxicity. |
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| Introduction as well as Panel Question and Answer
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| David James VanderWeele, MD, Ph.D.
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| As an introduction to this case based session, David VanderWeele laid the groundwork for a discussion primarily around T-cell redirection in advanced prostate cancer to prevent cancer progression and death. This is an interesting and important topic as immunotherapy has not been as effective in prostate cancer as opposed to other solid tumor malignancies.
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| AR and PARP: Partners in Crime - Discussion |
| Heather H. Cheng, MD, Ph.D. |
| Heather Cheng discussed three important abstracts incorporating inhibition of AR + PARP in advanced prostate cancer. These included, “BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with mCRPC with DNA repair defects” presented by Dr. Maha Hussain, “Tolerability of abiraterone combined with olaparib in patients with mCRPC: Further results from the phase III PROpel trial” presented by Dr. Antoine Thiery-Vuillemin, and “Gene-by-gene analysis in the MAGNITUDE study of niraparib with abiraterone acetate and prednisone in patients with mCRPC and HRR gene alterations” presented by Shahneen Sandhu. |
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| Eight-Year Survival Rates by Baseline Prognostic Groups in Patients with mHSPC: An Analysis from the ECOG-ACRIN 3805 (CHAARTED) Trial |
| Abhishek Tripathi, MD |
| Abhishek Tripathi discussed the 8-year survival rates by baseline prognostic groups in patients with mHSPC from the CHAARTED trial. Treatment intensification with docetaxel improves overall survival (OS) in mHSPC when added to testosterone suppression. To date there is no prospective survival data beyond 5 years for patients treated with ADT with or without docetaxel when analyzed by well-defined baseline prognostic risk groups and treatment arms. |
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| A Randomized Phase Ib/II Study of Intermittent Androgen Deprivation Therapy Plus Nivolumab With or Without Interleukin-8 Blockade in Men With Hormone-Sensitive Prostate Cancer (MAGIC-8) |
| Matthew Dallos, MD |
| Thus far the revolution of immune checkpoint inhibitors (ICI) has largely passed by prostate cancer. Despite the past success of autologous cellular therapy (Sipuleucel-T), immunotherapy has had limited efficacy in prostate cancer. Advancing the use of immune-based therapies for prostate cancer is an actively pursued goal and a space in which successful use of ICI would be a breakthrough. |
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| Randomized Phase II Trial of Neoadjuvant ADT plus Abiraterone and Apalutamide for Patients with High-Risk Localized Prostate Cancer: Pathologic Response and PSMA Imaging Correlates |
| Diogo A. Bastos, MD |
| Diogo Bastos discussed pathologic response and PSMA imaging correlates from a randomized phase II trial of neoadjuvant ADT plus abiraterone and apalutamide for patients with high-risk localized prostate cancer. Neoadjuvant therapy remains investigational but there may be a role for the next-generation androgen signaling inhibitors. Dr. Bastos and colleagues sought to evaluate pathologic and imaging responses after the intense neoadjuvant approach. |
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| Predictive Value of Extra-Prostatic Disease Detection by Pre-Operative PSMA-PET for Biochemical Recurrence-Free Survival in Patients Treated with Radical Prostatectomy: Follow-up Analysis of a Multicenter Prospective Phase 3 Imaging Trial |
| Loic Djaileb |
| Loic Djaileb discussed the predictive value of extra-prostatic disease detection by pre-operative PSMA-PET for biochemical recurrence-free survival in patients treated with radical prostatectomy. The goal of this study was to assess this predictive value among patients with intermediate-risk to high-risk prostate cancer included in the prospective trial used for the FDA approval of 68Ga-PSMA-11. |
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| Genomic Alterations and Evolution in Patients With Prostate Cancer With Histologic Evidence of Neuroendocrine Differentiation |
| Ethan Barnett |
| The authors sought to better characterize the sequence of genomic events that lead to tNEPC development. To this goal, they collected in-house targeted sequencing data from 1447 patients with prostate cancer. These data were matched to histological data, including pathologically confirmed NEPC with notation of the first sample with “unequivocal” evidence of NEPC. This study used descriptions in pathology reports of “neuroendocrine carcinoma,” “neuroendocrine features,” or “neuroendocrine differentiation.” |
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| Defining More Precisely the Effects of Docetaxel plus ADT for Men with mHSPC: Meta-Analysis of Individual Participant Data from Randomized Trials |
| Claire L. Vale, Ph.D. |
| Claire Vale discussed a meta-analysis of individual participant data (IPD) from randomized trials to more precisely define the effects of docetaxel plus ADT for men with mHSPC. Adding docetaxel to ADT improves survival in mHSPC, but uncertainty remains about who benefits most. To investigate this thoroughly and reliably, the STOPCAP M1 collaboration conducted a meta-analysis of IPD from relevant trials. |
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