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Role of Predictive Biomarkers as a Measure of Individualized Medicine Maha Hussain, M.D., FACP Professor of Medicine & Urology Associate Director for Clinical Research University of Michigan Comprehensive Cancer Center
Nine  FDA Approvals for Metastatic  Castration Resistant Prostate Cancer  in 15 Years  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Minimize the Number of Negative  Trials ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Plethora of Targets and Agents in Prostate Cancer  What to Pick and How Best to Test?  Pathway Target Agents Angiogenesis PDGF receptor Olaratumab Unknown Tasquinimod VEGF Aflibercept VEGF receptor Ramucirumab Androgen Androgen receptor ARN-509, MDV3100 CYP17 Abiraterone, Orteronel Apoptosis BCL-2 AT-101 Clusterin Custirsen Cell division Microtubules Eribulin, nab-Docetaxel DNA repair PARP Veliparib Endothelin Endothelin receptor Atrasentan, Zibotentan Histone acetylation HDAC Vorinostat Immune modulation CTLA-4 Ipilimumab Multiple Lenalidomide Insulin-like growth factor IGF-1R Cixutumumab Other mTOR Everolimus, Temsirolimus Multiple, including Src Dasatinib Multiple,  MET/VEGFR2 XL184
Prognosis and Prediction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Modified from Clin cancer  research  16 (6) 1745-55, 2010 & C. Tangen.
Challenges for Drug Development in the “Era of Targeted Therapies & Personalized Medicine” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AR signaling and DNA Damage/Repair  ,[object Object],[object Object],[object Object],Haffner MC,  et al: Nat Genet 42:668-75, 2010,  Lin C, et al:  Cell 139:1069-83, 2009 Haffner M, et al:  Clin Cancer Res, 2011
Individualized Medicine in prostate Cancer Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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NY Prostate Cancer Conference - M.H. Hussain - Highlights of Day 2 breakout sessions (Oncology room)

  • 1. Role of Predictive Biomarkers as a Measure of Individualized Medicine Maha Hussain, M.D., FACP Professor of Medicine & Urology Associate Director for Clinical Research University of Michigan Comprehensive Cancer Center
  • 2.
  • 3.
  • 4. Plethora of Targets and Agents in Prostate Cancer What to Pick and How Best to Test? Pathway Target Agents Angiogenesis PDGF receptor Olaratumab Unknown Tasquinimod VEGF Aflibercept VEGF receptor Ramucirumab Androgen Androgen receptor ARN-509, MDV3100 CYP17 Abiraterone, Orteronel Apoptosis BCL-2 AT-101 Clusterin Custirsen Cell division Microtubules Eribulin, nab-Docetaxel DNA repair PARP Veliparib Endothelin Endothelin receptor Atrasentan, Zibotentan Histone acetylation HDAC Vorinostat Immune modulation CTLA-4 Ipilimumab Multiple Lenalidomide Insulin-like growth factor IGF-1R Cixutumumab Other mTOR Everolimus, Temsirolimus Multiple, including Src Dasatinib Multiple, MET/VEGFR2 XL184
  • 5.
  • 6.
  • 7.
  • 8.

Notas do Editor

  1. Novel agents pose new challenges. Rather than conventional histological criteria for diagnosis, we may need to re-define how we classify cancers based on the mechanism of pathogenesis and therapy. This may allow greater efficiency in the clinical trial process by selecting populations with a greater liklihood of responding to treatments. Novel surrogates will need validation and acceptance by the scientific community. Starting doses of agents may need to be aimed at inhibiting or interacting with a target rather than the MTD. Dose ranging studies, accepted as a norm in most other therapeutic areas, may be accepted by oncologists to avoid toxicities and optimize the therapy’s interaction with targets.