So, a new immune research treatment that I've heard about is Amgen's and it's called BiTE,
and can you explain what that is and how we will see this affect prostate cancer patients?
Some of the amazing discoveries that have come along, things like—as we know—the PSMA
handle on the surface of cancer cells is being used to
detect prostate cancer cells and now to treat prostate cancer cells, and
if it was possible to somehow draw T-cells, those are like the army cells of our immune system
close to the cancer cells to attack them, then people believe that would be advantageous. So,
Amgen has developed an antibody that will clip onto the surface of cancer cells
and then wave a flag for the T-cells to come and attack. Now we're looking at phase I trials
right now where they're just trying to find the right dosage, but there are indeed PSA declines
that are occurring. In some cases, there are pretty notable immune reactions. This whole
issue of people becoming familiar with Covid overreaction of the immune system it helps
illustrate what can happen in some of these powerful immune therapies that we do because
if you have an overreaction then that can make people sick and so these treatments are being
given in the hospital right now so patients could be under observation when these things
are administered. So, the bi-specific monoclonal antibody that is injected and then draws in the
patient's own immune system is a whole other area of immune research that looks very promising.
So I know that data is super early, but do we have any sense of a response rate?
It seems in the preliminary—these are phase one trials—that maybe, and of course these are people
that have very advanced cancers typically people that don't have any other options
certainly not ideal patients for an immune therapy in theory,
but maybe as many as a third of the patients have been getting PSA declines.
What sort of outcome do you hope that we see with these patients? Are they hoping for
actual remissions? Is it just temporary, or is it in combination with other therapies?
Well, one of the difficult things about treating people with very advanced cancers
is that there is a lot of heterogeneity in the cancer cell so you're not
really treating one cancer anymore. In the earlier stages people had a monoclonal or a, you know,
genetically uniform cancer but then it mutates over time and so when you find something that's
working, it may only be working at one of the types of cancer in that individual's body,
and so you can see regression of all the cancer that has a certain genetic susceptibility to the
treatment but then the other aspects of the cancer aren't affected. So these remissions that we see
can sometimes be, you know, brief—three months, six months, a year—and
then the other cancers that aren't susceptible to the other component of the cancer that aren't
susceptible then start to grow and that becomes the dominant type of cancer. So, it gives people
some benefit in advanced disease but probably the future application of these things will be
to take these therapies and move them earlier in the disease course when the disease isn't
as mutated and variable and then really durable remissions are much more attainable.
So since it's in a phase I trial, when will we see this go into larger,
more phase II and phase III trials. Like, what do you think the timeline will be?
Well it's always hard to say; there's a lot of government supervision and bureaucracy that is
associated with this, but I think that you know, Amgen is a very proficient and
very wealthy company so they can push it along as quickly as they want to but typically you're
looking at three or four years before something like this could be on the market commercially.
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