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Highlights from the 2022 European Society of Medical Oncology Annual Meeting |
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PSMA Biology, Diagnostics, and Treatment
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| Observations on the Biology of PSMA Implications for Targeting |
| Neil Bander, MD |
| Neil Bander gave a presentation focusing on PSMA biology. He focused his presentation on unpublished data and that which he felt had the greatest therapeutic implications. He noted that both small molecular ligands and J591 antibody radionuclides have favorable activity. However, co-administration appears to have additional benefit. In pre-clinical data, this shows promising synergistic activity. However, a trial exploring this is underway to better assess its clinical implications.
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| PSMA for Diagnosis and Staging |
| Daniela Oprea-Lager, MD, Ph.D. |
| During a breakout session focused on prostate-specific membrane antigen (PSMA) biology, diagnostics and treatment was held in conjunction with the European Society for Medical Oncology (ESMO) Annual Congress. Daniela Oprea-Lager presented second in this session focusing on PSMA for diagnosis and staging of prostate cancer, a “pandora’s box” as she describes it. |
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| Lu-PSMA for Prostate Cancer Treatment
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| Shahneen K. Sandhu, MBBS, FRACP
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| The 2022 ESMO annual meeting included a session focusing on PSMA biology, diagnostics and treatment and a presentation by Dr. Shahneen Sandhu discussing 177-Lutetium (Lu)-PSMA for prostate cancer treatment. The use of Lu-PSMA in mCRPC is for men post-androgen receptor pathway inhibitor and post-taxane chemotherapy. We should use PSMA PET to select patients. Recent works has suggested increased response rate with increased PSMA intensity.
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| PSMA Targeted T Cell Engagers
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| Karim Fizazi, MD, Ph.D.
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| Karim Fizazi discussed PSMA Targeted T cell engagers. Dr. Fizazi started by noting that existing immunotherapies have minimally impacted outcomes of men with mCRPC, even though CTLA-4 inhibition was associated with excess in long-term survivors in a phase 3 trial.
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| Treatment Efficacy and Safety of 177Lu-PSMA Radioligand Therapy in Octogenarians with Metastatic Castration-Resistant Prostate Cancer
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| Robert L. Tauber, MD
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| Robert Tauber discussed treatment efficacy and safety of 177Lu-PSMA radioligand therapy in octogenarians with mCRPC. Based on several studies, including the phase 3 VISION trial [1], 177Lu-PSMA radioligand therapy is an option for treatment of mCRPC. Additionally, it is increasingly used in old or comorbid patients. The purpose of this analysis presented at ESMO 2022 was to evaluate the safety and efficacy in patients ≥80 years of age.
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| A Phase 1b Study of a Single Priming Dose of 177Lu-PSMA-617 Coupled with Pembrolizumab in Metastatic Castration Resistant Prostate Cancer
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| Rahul Aggarwal, MD
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| In the Prostate Cancer poster session of the European Society for Medical Oncology (ESMO) Annual Congress, Dr. Aggarwal provided preliminary results from a phase Ib study of a single dose of 177Lu-PSMA-617 followed by pembrolizumab in patients with metastatic castration-resistant prostate cancer (mCRPC).
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| Lutetium-177-PSMA Therapy in Patients with Prior Radium-223: Safety and Effectiveness Outcomes in the RALU Study
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| Kambiz Rahbar, MD
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| Kambiz Rahbar discussed safety and effectiveness outcomes of 177Lu-PSMA therapy in patients with prior treatment with radium-223. In patients for whom radium-223 had been used as part of routine disease management, subsequent 177Lu-PSMA therapy was clinically feasible and well tolerated, with acceptable myelosuppression rates. Survival outcomes in patients who received the radium-223/177Lu-PSMA sequence were similar to those reported in previous real-world studies and the phase 3 VISION trial.
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| Efficacy and Safety of 177Lu-PNT2002 Prostate-Specific Membrane Antigen (PSMA) Therapy in Metastatic Castration Resistant Prostate Cancer (mCRPC): Initial Results from SPLASH
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| Aaron Hansen BSc, MBBS, FRACP
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| Aaron Hansen presented the first, preliminary results of the SPLASH trial assessing the radioligand 177Lu-PNT2002 (also known as 177Lu-PSMA I&T) in PSMA-positive patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC) who progressed after treatment with androgen receptor axis-targeted therapy (ARAT). This first analysis presents the lead-in component of the phase 3 SPLASH trial.
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