Robert Dreicer, MD
As oncologists await the next major treatment advances in metastatic castration-resistant prostate cancer (mCRPC), the key in the interim is to optimize the available therapies, says Robert Dreicer, MD.
at the 2016 Chemotherapy Foundation Symposium (CFS), Dreicer, associate director, Clinical Research, deputy director, University of Virginia Cancer Center, discussed ongoing developments in mCRPC, including the latest approaches with radium-223.
OncLive: Please provide an overview of your presentation at the CFS.
: We reviewed the current state of what we know about next-generation antiandrogen therapies. These therapies have been around for a couple of years now, and one of the striking findings that all clinicians deal with is the cross-resistance to both enzalutamide and abiraterone. This is a major clinical dilemma, and we’re sort of in between recognizing multiple different resistance pathways, but not necessarily being able to predict, with any of the assays available—including AR-V7, probably the most well-defined resistance pathway.
So, we’re really left with making clinical judgments about when a patient might go from one drug to another, and that might depend on prior response, clinical setting, or whether the patient is symptomatic. It’s this kind of clinical management paradigm that we’re in, until we can develop predictive biomarkers to really give us data-driven ways to make decisions.
Are there any agents or trials in development seeking to answer these questions?
We were disappointed earlier this year when the trial of galeterone—which was an agent that was hoped to be able to overcome AR-V7 resistance—was stopped prematurely. There are other next-generation compounds in development, and the AR-V7 assay is moving its way to commercialization. I think this is an area that has active research ongoing.
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