Dr Garje on Emerging Biomarkers in mCRPC

Rohan Garje, MD, chief, Genitourinary Medical Oncology, Baptist Health Miami Cancer Institute,discusses emerging biomarkers and the approaches that are being developed to target them in patients with metastatic castration-resistant prostate cancer (mCRPC), as well as where the treatment field for this patient population is headed.

Novel biomarkers, such as STK1 and DLL3, have been identified as unique to prostate cancer, providing new targets for therapeutic intervention, Garje begins. Theragnostics, a combination of therapy and diagnostics, is one promising approach being developed to target these biomarkers, according to Garje. This method identifies the presence of cancerous cells and delivers targeted treatment to those cells, enhancing the specificity and efficacy of the treatment, he explains.

Additionally, the use of bispecific T-cell engagers and monoclonal antibodies offers another avenue for targeting these biomarkers, Garje continues. Recent studies have shown promising results in using bispecific T-cell engagers in later-line treatments for prostate cancer, indicating their potential to significantly impact patient outcomes, he explains. However, Garje notes some challenges to address, particularly concerning the toxicity profiles of these drugs. Cytokine release syndrome is a notable adverse effect and can be particularly harmful to elderly patients who often cannot tolerate intensetreatments, Garje reports.

Looking to the future, the field of cancer treatment is heading toward several exciting developments, Garje emphasizes. In radiotheragnostics, new agents, such as Actinium-225, Thorium-229, and Copper-64/65 are being explored, offering potentially more effective options for targeting cancer cells with radiation, he states. Another promising area is the development of CAR T-cell therapies, Garje explains. Although still in the early phases of research, there is significant enthusiasm around the potential of CAR T-cell therapies to revolutionize cancer treatment by harnessing the body’s own immune system to fight cancer, Garje says.

Bispecific T-cell engagers continue to be rapidly tested, and new treatment modalities, such as androgen receptor degraders, are being investigated, he expands. These degraders could provide benefits to patients who have developed resistance to androgen receptor pathway inhibitors, potentially improving outcomes by degrading the androgen receptors themselves. The next 5 to 10 years are expected to bring rapid advancements in these areas, Garje concludes.