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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| The Future of Radiopharmaceuticals in the Treatment of Prostate Cancer
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Alicia Morgans, MD, Ph.D. and Philip Kantoff, MD
Phil Kantoff joins Alicia Morgans to discuss the future of radioligand therapy in the treatment of advanced prostate cancer. Philip Kantoff provides an overview of exciting results seen in studies on actinium-225, a powerful alpha-emitter tested in patients with advanced prostate cancer that also may be promising for patients with earlier-stage disease. |
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| Determining Dose-Limiting Toxicity and Maximum Tolerated Dose of 225Ac-J591 in Metastatic Castration-Resistant Prostate Cancer
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| Scott Tagawa, MD, MS, FACP |
| Scott Tagawa joins Alicia Morgans in a discussion on a Phase I study evaluating the tolerability of 225Ac-J591 in metastatic castration-resistant prostate cancer. Dr. Tagawa discusses data on the overall combined results, longer follow-up, as well as increased numbers of PSA responses, CTC count changes, and adverse events.
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| The Next Wave of Novel Radiopharmaceuticals
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| Shahneen Sandhu, MD, PhD, MBBS, FRACP
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| Alicia Morgans is joined by Shahneen Sandhu to discuss targeting prostate-specific membrane antigen (PSMA), specifically lutetium, and the next wave of novel radiopharmaceuticals. Dr. Sandhu's presentation focused on where we go with PSMA treatments in the future.
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| Phase I Study of JNJ-69086420, An Actinium-225-Labeled Antibody Targeting Human Kallikrein-2, for Advanced Prostate Cancer
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| Michael Morris, MD
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| Michael Morris discusses the rationale, design, and protocol of a phase I trial of 69086420, an actinium-225-labeled antibody targeting human kallikrein-2, for advanced prostate cancer. This is the first-in-human study to assess the safety, pharmacokinetics, pharmacodynamic, and clinical activity of Ac-225 radiolabeled JNJ-420, to determine its recommended phase 2 dose in adults with advanced PC.
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| Long-Term Adverse Events in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving PSMA-Based Targeted Radionuclide Therapy
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| Michael Sun, MD
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| Michael Sun presents data assessing long-term effects of PSMA-TRT on marrow, renal, and liver function. The authors concluded that in this largest analysis to date of long-term AEs in patients who have received PSMA-TRT, the long-term effects on renal, liver, and marrow function are infrequent. Further, the majority of patients are able to receive further lines of therapy.
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| Mechanisms of Resistance to Radiopharmaceuticals
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| Johannes Czernin, MD
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| Johannes Czernin discusses the mechanisms of resistance to radiopharmaceuticals. Dr. Czernin starts his presentation by emphasizing that we can have remarkable treatment responses to 177Lu-PSMA-617, and highlighted pre- and post-177Lu-PSMA-617 treatment.
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| PSMA Imaging and Outcome Following Dose-Intense PSMA-Targeted Radionuclide Therapy in Men with PSMA-Unselected, Pre-Treated, Metastatic Castration-Resistant Prostate Cancer
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| Scott Tagawa, MD, MS, FACP
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| Scott Tagawa presents the combined results of two parallel prospective dose-escalation/expansion trials of high-potency, dose-intense PSMA-TRT (defined by a single cycle of dose-intense beta-emitting 177Lu-PSMA-617 or alpha-emitting 225Ac-J591). The authors sought to assess, primarily, if pre-selection by PSMA imaging is necessary when employing a dose-intense or high-potency TRT approach.
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| Phase I/II Trial of Pembrolizumab and AR Signaling Inhibitor +/- 225Ac-J591 for Chemo-Naive Metastatic Castration-Resistant Prostate Cancer
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| Scott Tagawa, MD, MS, FACP
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| In this study, chemotherapy-naïve patients who have progressive metastatic castration-resistant prostate cancer (PCWG3 criteria) after receiving at least one androgen pathway inhibitor will be first enrolled in a phase I dose-finding study looking for the optimal dose of 225Ac-J591 in combination with pembrolizumab and an androgen pathway inhibitor. In the subsequent phase II portion, patients will be randomized to androgen pathway inhibition plus pembrolizumab (for up to 2 years) with or without 225Ac-J591.
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| Alpha-Emitting PSMA Molecular Radiotherapy for mCRPC
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| Hossein Jadvar, MD, Ph.D.
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| Hossein Jadvar discusses alpha-emitting PSMA molecular radiotherapy in mCRPC. There is a need for improving the production, availability, accessibility, and cost, as well as improvement in chelation techniques. There is also a need for improvement in the methods for pharmacokinetic and (micro)dosimetric modeling for robust comparison of alpha and beta therapies.
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