Gurkamal Chatta, MD
Patients with metastatic, castration-resistant prostate cancer (mCRPC) have a median overall survival of only about two to three years, but genomic sequencing is making inroads against that grim prognosis. Today it’s possible to match patients’ specific tumor mutations with targeted treatments, and a phase 2 clinical trial underway at Roswell Park Comprehensive Cancer Center aims to expand on that strategy.
Gurkamal Chatta, MD, Professor of Oncology, Clinical Chief of Genitourinary Medicine and Chief and Director of Genitourinary Research at Roswell Park Comprehensive Cancer Center, serves as site director for the study, “Targeted Treatment for Metastatic Prostate Cancer, The PREDICT Trial” (NCT06632977). “This study underscores the importance of rationally sequencing the rapidly increasing treatment options in metastatic CRPC to maximize benefits for our patients,” he says.
Participants’ tumor tissue samples, acquired from biopsies or prior surgery, are tested for DNA and RNA mutations. Based on the test results and the advice of Roswell Park’s Molecular Tumor Board, patients are assigned to one of three treatment arms to determine the objective response rate for each group:
- Patients in Arm A receive a once-a-day oral dose of valemetostat tosylate every day of each 28-day cycle. The drug blocks the EZH1 and EZH2 proteins — which are overexpressed in metastatic prostate cancer — to slow or stop metastasis.
- Patients in Arm B receive carboplatin IV, a platinum-based chemotherapy that directly kills, slows or stops the growth of tumor cells, plus cabazitaxel IV, a microtubule inhibitor that slows or stops the growth of tumor cells, on the first day of every 21-day cycle.
- Patients in Arm C receive one of the following treatment regimens as directed by the treating physician:
- Cabazitaxel IV, once on the first day of each 21-day cycle.
- Second treatment with an androgen receptor pathway inhibitor (ARPI) — either abiraterone or enzalutamide.
- Lutetium Lu 177 vipivotide tetraxetan IV, a radiopharmaceutical that directly damages and kills tumor cells, on the first day of each 42-day cycle.
Roswell Park is the only cancer center in upstate New York offering the clinical trial, called PREcision Diagnostics in Prostate Cancer Treatment (PREDICT). Sponsored by the Alliance for Clinical Trials in Oncology, it aims to enroll 474 patients nationwide.
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