mCRPC in focus
Transcript: What are the unmet medical needs for management of mCRPC?
Professor Karim Fizazi
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
Well, I guess for men with mCRPC, the big move is that the key drugs we've been using in the last decade or so have been moved earlier. This is true for androgen receptor pathway inhibitor, abiraterone, enzalutamide, darolutamide, apalutamide. So they will, or they are disappearing from the mCRPC setting. And this also applies, at least for some patients, with a second big family, which is that of taxane with the taxol being used also in the mCSPC space.
So this means that typically the patients I will now see with mCRPC will have already exhausted those two options, or at least one of the two. Indicating that we need more weapons. So what are the key weapons we can consider right now?
I guess cabazitaxel is an important one, and we have clear demonstration from the current phase four trial that overall survival remains improved with cabazitaxel when used after AR pathway inhibitors and the taxol. So very important to consider for your next patients. We also have a demonstration with PSMA lutetium, this is important and we are waiting for trials testing PSMA lutetium earlier in men with mCRPC. PSMA4 and SPLASH should probably major sure this year or early next year. So hopefully PSMA lutetium will become more and more of a label in the early mCRPC setting. PARP inhibitors, at least for BRCA patients are very important also to consider in these men. And then the unmet need is obvious because these men are still in a non-curative situation when they develop mCRPC, so we really need to have as soon as possible new and effective treatments coming to the market for them. Um, I think important candidates includes third generation AR targeting with ODM-208 or AR degraders. Hopefully we'll see phase three trials starting soon. Immunotherapy for some of these patients with PD-1 inhibitors for MSI high patients.
But hopefully B7-H3 targeting will also come, and some other targets are also considered. So, and, and it obviously there is very active research with you know, for example Kallikrein-2 targeting or some other targets. So, the unmet need again is obvious, but I'm quite confident that at least some of these treatments will find their way to the market and eventually will help all patients.
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