One of the treatments that we're hearing a lot about and we're very excited about is
lutetium-177. So, can you explain how that works and the response rates that we're hoping to see?
So this is an injected radioactive substance that swims around in the body, finds the cancer,
and kills it. It's obviously a very attractive format because the healthy cells in the body have
limited exposure to the radiation and the cancer takes the brunt of the radiation. So it's
well-tolerated and the phase III trials that have been done are now completed and we are waiting
to see if the placebo group and the treatment group, you know, separate in terms of survival,
and if that is confirmed—perhaps that information will be out over the next year or so—then the FDA
usually takes three to six months to review it and approve it. So, this type of treatment is likely
to be on the market probably in the next 18 to 24 months. It's an injection given every six weeks it
is well-tolerated. It can cause a dry mouth because sometimes the salivary glands
have some of the same attraction to the treatment as the cancer does and it can cause some low blood
counts because radiation can do that. It's not a prominent problem but I believe that
it'll be another arrow in our quiver in the next couple years for people with advanced disease.
There's some question as to whether this can be brought earlier in to treat earlier disease in
the future. It'll probably depend on how much the if there's lingering effects from the radiation
exposure. You know, squirting radiation into your body, you say, "well what would the results be
ten years later," and we certainly don't know the answer to that yet.
So, one of the things that I've heard patients kind of talk about is bipolar androgen therapy
and I've heard Dr. Moyad mention it at our conferences. Can you explain what this is
and how will we see this play out as a prostate cancer treatment?
So, our theme today has been talking about research and how does research impact people
with prostate cancer. I think the people are interested for two reasons: one is, they wonder
if someday I'll be in a position where I run out of options and what new things are coming,
and then others are starting to run out of options and they need something—a salvation—and
this idea of giving people testosterone is an idea that's been around for a while,
and people obviously thought it sounds so counterintuitive, "give
testosterone to someone with hormone-resistant prostate cancer, won't that just be fuel on the
fire?" and the surprising thing is if you take people with prostate cancer who have very advanced
prostate cancers, that have been on Lupron and Xtandi, Zytiga, and had chemotherapy, maybe some
immune treatments in the past, and their PSA is still rising and the disease is metastatic,
a percentage of them appear to get a drop in PSA and sometimes shrinkage of the tumor
by being exposed to testosterone. There have been some laboratory studies that suggested
this might be the case but it seems seemed like such an outlandish idea that people have
really been very nervous about testing it, but at a few universities under very carefully controlled
circumstances it appears that that certain individuals will respond and we're talking about
people with advanced resistant cancers that really don't have any other options. I don't think giving
testosterone as a therapeutic maneuver is going to benefit people with hormone-sensitive disease.
We do know that people with early-stage disease that are on intermittent therapy—take Lupron,
stop Lupron, take Lupron, stop Lupron—can do that. It doesn't cause a regression of
the cancer to re-expose with testosterone in someone with hormone-sensitive disease,
but in hormone-resistant disease, the treatment is a single injection of relatively high-dose
testosterone given every 60 days. The testosterone stays in the individual's bloodstream for a week
or two and of course prior testosterone levels were very low because they're on
Lupron or whatever and so they get a big burst of testosterone and then the testosterone dissipates;
they stay on their Lupron, and then that's repeated every 60 days. And perhaps 25 of men,
20%-25% of men will have a decline in PSA who really otherwise didn't have much of any options.
So, it's unexpected. The patients do feel good when they have testosterone.
They're enjoying their testosterone and sometimes it's beneficial. The patients have to be carefully
monitored, if there were acceleration of disease obviously it needs to be stopped, and if people
are already having some pain from the cancer in the bones, for example, I don't think it's a very
good idea to be giving any testosterone to those individuals, but bipolar antigen therapy or BAT
is gaining more interest and is probably going to be utilized to some degree in very select cases.
Hi everyone, this is my new puppy. We haven't named him yet, but I'm sure you'll hear his name
soon. We're super excited about him and he's gonna be around for our outros. If he lets me do them.
So, anyway, if you can visit our website PCRI.ORG that'd be great. We have a ton of information
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saying "yes." And we come out with new prostate cancer videos every week. Have a great time.