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Prostate Cancer Lab #8: Decisions in Advanced Prostate Cancer

Meeting Summary

Advanced prostate cancer patient and bioinformatician Rick Stanton introduced the treatment options he and his medical team are considering, using the standard (NCCN) treatment guidelines as a way to tell the story of how he got here. This built on Rick’s previous session (see the notes from meeting #6 here), in which he walked through his and Brian McCloskey’s medical history. We have discussed potential enhancements to the guidelines, such as:

  • Bring testing forward in the guidelines to help people at each decision point.
  • Embed more real world evidence in the decisions.
  • Add more structure and explicit guidance for decisions in the late stages.
  • Make the guidelines more dynamic and predictive.
  • Put a treatment strategy with guiding principles on top of it.
 
To guide his treatment decision, Rick shared his test results (DNA sequencing, immunohistochemistry, and RNA sequencing). The DNA sequencing identified two CDK12 mutations. The RNA sequencing identified three biomarkers which were overexpressed: AR, PSMA, and B7-H3.

Based on the test results and his medical history, Rick and his medical team have identified this list of treatment options:

  • Pluvicto (radioligand attacking PSMA, currently unavailable due to production issues)
  • Olaparib (targeting CDK12) + CTLA4 inhibitor + PDL1 blockade
  • PSMA CAR-T from Poseida (targeting PSMA)
  • PSMA bispecific from Calibr (targeting PSMA)
  • ASRV-766 AR degrader (targeting AR)
  • Daiichi antibody drug conjugate to B7-H3 (targeting B7-H3)
  • Cabazitaxel (chemotherapy)

 

Requests

Do you have any feedback on Rick’s testing and treatment options?

Meeting Recording

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