Novel Prostate Cancer Treatment Options Inspire ‘Optimism,’ Expert Says

With a wide range of treatment options such as novel androgen receptor (AR) degraders and antibody-drug conjugates on the horizon in prostate cancer care, Neeraj Agarwal, MD, says that there may come a day when practices can ensure patients that they will not die due to their disease.

Additionally, following the FDA approval of ¹⁷⁷Lu-PSMA-617 (Pluvicto) in prostate-specific antigen membrane (PSMA)–positive metastatic castration resistant prostate cancer in March 2022, Agarwal stated that the potential next steps for radionuclide therapy may include the development of rosopatamab (J591). It is believed that this antibody may be able to deliver a larger payload of beta particles into prostate cancer cells, which may minimize the number of doses needed to treat patients.

Agarwal is a professor of medicine, presidential endowed chair of cancer research, and director of both the Genitourinary Oncology (GU) Program and the Center of Investigational Therapeutics at the Huntsman Cancer Institute (HCI) of the University of Utah.

Transcript:

I don’t think we are far away from a day when we will be able to assure our patients that they will not die of their prostate cancer; they will die with their prostate cancer. Some of the therapies I would like to highlight, which I think are close to being approved, include AR-targeted therapies. I remain optimistic about [proteolysis-targeting chimera] PROTAC technology, the AR degraders, and the antibody-drug conjugates that are using novel ways to deliver chemotherapy in prostate cancer. I also remain optimistic about immunotherapy beyond immune checkpoint inhibitors such as CAR T cells and bispecific T cells that are being developed by different companies. B7-H3 targeting is another novel tool that I hope will see some more momentum on in the phase 3 trials.

We also know that the ¹⁷⁷Lu-PSMA-617 approval was just the start of delivering radionuclide therapy in precise fashion in prostate cancer cells. We are going to see an antibody rosopatamab which utilizes an antibody to deliver the beta particles into the prostate cancer cells. Antibodies can carry a bigger payload of radiation particles, so hopefully we’ll use fewer doses to achieve the same results.

Reference

Novartis Pluvicto approved by FDA as first targeted radioligand therapy for treatment of progressive, PSMA positive metastatic castration-resistant prostate cancer. News release. Novartis. March 23, 2022. Accessed October 11, 2023. https://bit.ly/36lu4Ct