Daniel P. Petrylak, MD

Daniel P. Petrylak, MD

Yale University Cancer Center

New Haven, Connecticut

Daniel P. Petrylak, MD, leads the genitourinary cancers medical oncology team at Smilow Cancer Hospital as director of the genitourinary cancer research group, professor, and co-director of the Cancer Signaling Network program. Dr. Petrylak joined Yale from Herbert Irving Cancer Center at Columbia University Medical Center with New York-Presbyterian Hospital, where he served as Professor of Medicine (Medical Oncology) and Urology and began his appointment in September of 2012. Dr. Petrylak is a member of the American Association for Cancer Research (AACR), American Society for Clinical Oncology (ASCO), American College of Physicians (ACP), American Association for the Advancement of Science (AAAS), American Urological Association (AUA), and the Southwest Oncology Group (SWOG). After serving for more than 20 years as the advanced bladder chair for SWOG, Dr. Petrylak is now the Vice Chair of the Genitourinary Committee. He additionally has led multiple national and international studies in prostate and bladder cancer. Dr. Petrylak’s research interests span both prostate and bladder cancer. He led an investigator-initiated trial of docetaxel and estramustine in castration resistant prostate cancer. The results of this study supported a phase 3 trial of this combination in SWOG led by Dr. Petrylak, which in turn, supported the FDA approval of docetaxel for castration resistant prostate cancer. This was one of the first two trials to demonstrate a survival benefit in this state of disease. Dr. Petrylak has also been instrumental in the development of immunotherapy and targeted therapies for refractory bladder cancer. His work with Enfortumab Vedotin has supported the accelerated and full FDA approval of this drug. Dr. Petrylak received his undergraduate degree from Columbia College and his medical degree from Case Western University School of Medicine. He completed his internship and residency at Albert Einstein College of Medicine and his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. He has authored more than 200 peer-reviewed articles and book chapters on prostate and bladder cancer research outcomes.

Disclosures:

Dr. Petrylak has the following disclosures:

Consultant fees: *Ada Cap (Advanced Accelerator Applications), *Amgen, Astellas, AstraZeneca,
Bayer, *Bicycle Therapeutics, *Boehringer Ingelheim, Bristol Myers Squibb, *Clovis
Oncology, *Eli Lilly, Exelixis, Gilead Sciences, *Incyte, Infinity Pharmaceuticals,
Ipsen, *Janssen, Merck & Company Inc, *Mirati, Monopteros, Pfizer,
*Pharmacyclics, Regeneron, *Roche, Sanofi Aventis Pharmaceuticals, Seattle
Genetics, *Urogen

Grant Support: Ada Cap (Advanced Accelerator Applications), *Agensys Inc, Arvinas, Astellas,
AstraZeneca, *Bayer, BioXcel Therapeutics, Bristol Myers Squibb, Clovis Oncology,
Daiichi Sankyo Company Limited, *Eisai, *Eli Lilly, Endocyte, Ferring, Genentech,
Gilead Sciences, *Innocrin, *MedImmune, *Medivation, Merck, *Mirati, *Novartis,
Pfizer, *Progenics, *Replimune, *Roche, *Sanofi Aventis, Seattle Genetics

Ownership interest/investment: *Bellicum (Sold 7/2020), *Tyme (sold 10/2019)

*denotes relationships recently terminated

Talks by Daniel P. Petrylak, MD

Sacituzumab Govitecan Given Accelerated FDA Approval for Advanced Urothelial Cancer

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center, discusses the FDA’s recent approval of sacituzumab govitecan for metastatic urothelial carcinoma. He notes how previously, treatment options were limited for patients who failed initial chemotherapy. Dr. Petrylak then describes how the new antibody drug conjugate sacituzumab govitecan acts as a “smart bomb” in the way it can recognize cancer markers and deliver chemotherapy directly to affected cells. He then describes the trial that led to the approval of sacituzumab govitecan, including differences between it and enfortumab vedotin, how treatment has been combined with both drugs, and how it is expanding the spectrum of treatments for advanced urothelial carcinoma. Dr. Petrylak also discusses side effects of the drug and potential next steps for its use in treatment.

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Management of BCG-Unresponsive Cystectomy-Ineligible Bladder Cancer Patients: Pembrolizumab

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center in New Haven, Connecticut, discusses alternatives to bacillus Calmette-Guerin (BCG) immunotherapy for non-muscle invasive bladder cancer (NMIBC), focusing on pembrolizumab. Dr. Petrylak gives an overview of NMIBC and of NMIBC management with BCG immunotherapy. He explains that BCG immunotherapy is standard of care for this difficult-to-treat disease state and has proven capable of reducing recurrence, progression, and death rates, but that there is a subset of patients who experience BCG failure. Dr. Petrylak describes the different kinds of BCG failure, including BCG-relapsing, BCG-intolerant, BCG-refractory, and BCG-resistant disease, and then discusses the limited treatments currently available for these patients. He observes that intravesical chemotherapies have not proven highly efficacious for NMIBC, but that immune checkpoint inhibitors like pembrolizumab show significant promise. Dr. Petrylak reviews the KEYNOTE-057 trial, which found that immune checkpoint therapy with pembrolizumab can lead to complete responses in 40% of patients, and the SWOG S1605 trial, which did not reach its endpoint but found a complete response to immune checkpoint therapy with atezolizumab at 6 months in 27% of patients. He concludes by discussing other ongoing and future trials to further evaluate checkpoint inhibitors for NMIBC.

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Immunotherapy Trials

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center, discusses the various trials currently evaluating immunotherapies for castration-resistant prostate cancer (CRPC) and metastatic castration-resistant prostate cancer (mCRPC). To this point, Dr. Petrylak explains, there have not been many obvious survival benefits from immunotherapy in prostate cancer, except in patients with specific tumor mutations; therefore, sipuleucel-T and pembrolizumab are currently the only FDA-approved immunotherapeutic agents for CRPC. Fortunately, numerous trials are underway that study more effective ways to use immunotherapies for prostate cancer, including trials to improve sipuleucel-T, trials researching vaccine-based immunotherapy regimens, and numerous combination therapy trials. Dr. Petrylak also discusses alternative approaches to immune treatment, including CAR-T cell and BiTE studies in CRPC.

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Theranostics & Radiopharmaceutical Trials

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center, reviews several studies in which radium-223 is used both alone and in combination with other treatments for prostate cancer. Since radium-223 is an alpha particle, it requires fewer hits to damage DNA, offering an advantage over beta particles. Dr. Petrylak further explains the benefits of theranostics which deliver isotopes directly to the tumor site. He concludes that radium-223 is effective in treating metastatic castration-resistant prostate cancer (mCRPC), but cautions that until potential toxicity levels are better understood, combining radium-223 with either abiraterone or prednisone is not advised.

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Chemotherapy Trials

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center in New Haven, Connecticut, discusses data from recent chemotherapy trials for castrate-resistant prostate cancer (CRPC). Dr. Petrylak specifically examines trials evaluating drug combinations as treatment for CRPC patients. Additionally, he reviews the effectiveness of PARP inhibitors in patients with DNA repair mutations. Finally, he notes the apparent superiority of cabazitaxel to NG AA treatment after progression on docetaxel.

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