Dr. Sartor on Promising Treatment Approaches in Prostate Cancer

A. Oliver Sartor, MD, professor of medicine, medical director, Tulane Cancer Center, C. E. and Bernadine Laborde Professor of Cancer Research, Departments of Medicine and Urology, Tulane University, discusses research on immunotherapy, radiopharmaceuticals, and combinations in prostate cancer.

Prostate cancer is not curable for most patients once it becomes metastatic. Some subsets of patients respond to immunotherapy; pembrolizumab (Keytruda) was approved for patients with microsatellite instability—high or mismatch repair deficiency without regard to underlying tumor source. Responses have been positive in this patient population, according to Sartor.

Research is also investigating the use of the radiopharmaceutical lutetium-177 PSMA-617 (LuPSMA) with positive responses, says Sartor. In the future, prostate cancer will be divided into smaller subsets with some receiving molecularly targeted therapy. However, Sartor prefers the radiopharmaceuticals because, according to him, they will ablate the cancer regardless of the underlying genotype.

The exploration of combination therapies in prostate cancer are examining LuPSMA with a PARP inhibitor or immunotherapy. Alpha and beta particles can also be combined, as well as alpha or beta particles with radiation sensitizers, modulating the way the drugs are excreted, concludes Sartor.