Personalized Medicine (2) [611350]

Personalized Medicine
for PCa patients
A Dream or Reality??
Cristian -Doru POP
Urologist in training
PhD researcher at “Iuliu Ha țieganu ” University of Medicine

2

PCa
adenocarcinoma
RP = gold standard
RPRP
LRP
RARP

PCa
Clinically non -significant?
WW
Active surveillance

PCa
RP complications:
Continence
Sexual dysfunction
HIFU/Cryo 
Hormones 
Radiotherapy 
Chemotherapy 

PCa
32-53% lossof sexual function
8% incontinence
10% early complications
POTENCY, CONTINENCE AND COMPLICATION RATES IN 1,870 CONSECUTIVE RADICAL RETROPUBIC
PROSTATECTOMIES. Catalona , J William, et al. 2, s.l.: The Journal of Urology, 1999, Vol. 162, pp. 433 -8=150 cases

PCa
What if wecould specifically target and
destroy cancer cells?

PCa
Advantages :
Preserve anatomy
Preserve function
Cure disease

A brief history
1950 –DNA double helix
1960 –nucleotides
1970 –first DNA sequencing
1980 –PCR developed
1990 –Human Genome Project
2000 –targeted therapies
….
2100 –cancer surgery obsolete

Personalized medicine

Personalized medecine

PCa
Diagnosis 
Treatement 
BUT
WHEN
SHOULD
WE
TREAT?
12

13

14

Targeted therapy

Targeted therapy

Targeted therapy

BIND-014 for PCa

BIND-014 for PCa

BIND-014 for PCa
<500 Da
ligand= Urea-based PSMA inhibitors
Specificity ~ antibodies
Docetaxel loaded
Scalable
Phase I January 2011Phase II

BIND-014 for PCa
10x more effective delivery
Higher plasma % vs. free drug
1000x increase of plasma docetaxel
Welltolerated

BIND-014 for PCa
targets PSMA
receptor -mediated endocytosis
accumulation effect on non -PSMA cells

BIND-014 for PCa
More effective vs. Taxotere ®

Personalized medicine
Histology
Specific cure
Cured

25

Impediments

References
1.European Association of Urology. Guidelines 2016 edition. Munich : s.n., 2016.
2.POTENCY, CONTINENCE AND COMPLICATION RATES IN 1,870 CONSECUTIVE RADICAL
RETROPUBIC PROSTATECTOMIES. Catalona , J William, et al. 2, s.l.: The Journal of Urology,
1999, Vol. 162, pp. 433 -8.
3.Focal High -intensity Focused Ultrasound Targeted Hemiablation for Unilateral Prostate Cancer: A
Prospective Evaluation of Oncologic and Functional Outcomes. Cordeiro Feijoo , R Ernesto, et al.
2, 2016, European Urology, Vol. 69, pp. 214 -20.
4.Paul Ehrlich's magic bullet concept: 100 years of progress. Strebhardt , K and Ullrich, A. 6, 2008,
Nat Rev Cancer, Vol. 8, pp. 473 -80.
5.Targeted therapy using nanotechnology: focus on cancer. Sanna , Vanna, Pala, Nicolino and
Sechi , Mario. 2014, IntJ Nanomedicine, Vol. 9, pp. 467 -83.
6.68Ga -PSMA ligand PET/CT in patients with prostate cancer: How we review and report.
Rauscher, Isabel, et al. 14, 2016, Cancer Imaging, Vol. 16.
7.Conflict of interest in academic oncology: moving beyond the blame game and forging a path
forward. Prasad, V and Rajkumar , S V. 2006, Blood Cancer Journal, Vol. 6, p. 489.
8.Marshall, L John. Is 'Conflict of Interest' Hampering Cancer Research? Medscape Oncology.
[Online] 3 9, 2015. [Cited: 2 26, 2017.] http://www.medscape.com/viewarticle/840872 .
9.Docetaxel chemotherapy in metastatic castration -resistant prostate cancer ( mCRPC ): Cost of care
for Medicare and commercially insured men. Armstrong, Andrew J., et al. 2suppl, 2016, Journal of
Clinical Oncology , Vol. 34, p. 262.