Daniel P. Petrylak, MD, presented “Updates on PSMA Imaging and PSMA CAR T Therapy” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Petrylak, Daniel P. “Updates on PSMA Imaging and PSMA CAR T Therapy.” July 2021. Accessed Jul 2024. https://grandroundsinurology.com/updates-on-psma-imaging-and-psma-car-t-therapy/
Updates on PSMA Imaging and PSMA CAR T Therapy – Summary
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 CAR T therapy for prostate cancer and the ways in which its efficacy is impacted by tumor type and stem memory T cells (TSCM). He begins by reviewing the VISION Trial of LuPSMA which found a 40% reduction in the risk of death and 4-month improvement in median overall survival (OS) versus standard of care (SOC) alone. He also looks at the FDA approval of PYLARIFY in May 2021, the first commercially available PSMA PET imaging agent for prostate cancer. Dr. Petrylak then poses the question of how to combine immunotherapy with PSMA. He suggests that the answer may exist in CAR T therapy despite its historically poor results in solid tumors, and discusses the different types of CAR T cells along a spectrum of less differentiated, self-renewing, and long-lived cells to more differentiated, less stem-like cells. Dr. Petrylak states that TSCM, which exist on the less differentiated side of the spectrum, are key to CAR T therapy’s success in solid tumors based on evidence from a study using a TSCM-based approach that found 100% tumor elimination in animals at standard and low doses after 2 weeks. He reviews early information on a Phase I trial of TSCM based CAR T therapy on mCRPC patients which appears to have positive early results. Dr. Petrylak concludes that PSMA is proving to be an excellent target for imaging and therapy in mCRPC and CAR T therapy may be able to enhance treatment as well.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Petrylak delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.
ABOUT THE AUTHOR
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.
