William K. Oh, MD, is the director of Precision Medicine at the Yale Cancer Center and Smilow Cancer Hospital, and service line medical director at the  Smilow Cancer Hospital, Greenwich Hospital.

William K. Oh, MD, highlights the evolution of targeted therapy for prostate cancer treatment, including antibody-drug conjugates and bispecific antibodies. 

Dr Oh on the Development of Targeted Therapies in Prostate Cancer

“Prostate cancer is very much in evolution. We have new PET imaging—PSMA PET—that’s completely transformed how I think of prostate cancer from early diagnosis all the way to advanced disease. Tied to that are new ways of developing therapy.”

William K. Oh, MD, director, Precision Medicine, Yale Cancer Center and Smilow Cancer Hospital; service line medical director, Smilow Cancer Hospital, Greenwich Hospital, highlights the evolution of the prostate cancer treatment paradigm regarding targeted therapies.

In recent years, the field of prostate cancer has significantly changed, particularly regarding imaging with the emergence of prostate-specific membrane antigen (PSMA) PET scans, Oh begins. The integration of this approach has improved prostate cancer treatment from early diagnosis to the management of advanced disease, he says. Along with this, he notes that there are also new ways to deliver therapy to patients with prostate cancer, such as with the PSMA targeted therapy, lutetium Lu 177 vipovotide tetraxetan (Pluvicto). Previously, prostate cancer treatments included androgen-targeted therapies and chemotherapies, but treatment with lutetium Lu 177 vipovotide tetraxetan offers a new approach, Oh shares.

FDA approved lutetium Lu 177 vipovotide tetraxetan

 for the treatment of patients with PSMA–positive metastatic castration-resistant prostate cancer who received prior anticancer therapies, including androgen receptor pathway inhibition and taxane-based chemotherapy. Simultaneously, the FDA approved gallium Ga 68 gozetotide (Locametz), a radioactive diagnostic agent for PET of PSMA–positive lesions, which included for the population of patients in which the therapy was indicated.

Lutetium Lu 177 vipovotide tetraxetan delivers the radioactive payload, Lu 177, to PSMA–carrying targets, primarily in prostate cancer cells, Oh explains. Following the approval of this agent, he emphasizes that the field is continuing to grow as more targeted treatments become available. Notably, he adds that these targeted agents will help deliver treatment beyond radiopharmaceuticals; chemotherapy payloads could be administered via antibody-drug conjugates, or an immunotherapy method could be used with bispecific antibodies. These new treatment strategies could help deliver prostate cancer treatments more precisely to the tumor cells, Oh concludes.

Videos

William Oh, MD, chief, Division of Hematology and Medical Oncology, professor of medicine and urology, Mount Sinai School of Medicine, discusses the management of patients with hormone-sensitive prostate cancer.

One of the biggest developments for the treatment of patients with advanced prostate cancer has been the management of metastatic hormone-sensitive prostate cancer, says Oh. The CHAARTED trial compared androgen deprivation therapy (ADT) versus ADT plus 6 cycles of docetaxel. This study favored the early use of chemotherapy, while the STAMPEDE trial further confirmed those findings.

The LATITUDE trial investigated ADT plus or minus abiraterone (Zytiga) and showed a comparable benefit of up to 2 to 3 years of abiraterone plus prednisone in the treatment of hormone-sensitive prostate cancer.

Dr. Oh on the Management of Hormone-Sensitive Prostate Cancer

William Oh, MD, professor, Mount Sinai Hospital, discusses the results from a trial that compared second-line chemotherapy to alternative androgen receptor-targeted agents (ARTA) in patients with metastatic castration-resistant prostate cancer (mCRPC).

In this study, 345 patients who showed a lack of response to first-line ARTA were enrolled using Altos electronic medical records. Patients received either second-line docetaxel or cabazitaxel, or alternative ARTA.

Oh concludes that treatment with second-line chemotherapy proved more suitable for this patient subset than ARTA.

View more from the 2017 Genitourinary Cancers Symposium

William K. Oh, MD

Articles

Dr Oh on the Development of Targeted Therapies in Prostate Cancer

Dr. Oh on the Management of Hormone-Sensitive Prostate Cancer

Dr. Oh on Results of Chemotherapy Versus ARTA in Prostate Cancer