Investigating Immunotherapy Approaches in Genitourinary Oncology
“Immunotherapy represents a new frontier in genitourinary cancers,” says Charles G. Drake, MD, PhD, Director of Genitourinary Oncology and Co-Director of Cancer Immunotherapy, New York-Presbyterian/Columbia University Irving Medical Center.
“We are looking at how these therapies can be used synergistically with traditional therapies in prostate cancer, kidney cancer and bladder cancer.”
Dr. Drake and his clinical team, including three medical oncology fellows who have been awarded Young Investigator Awards from the American Society of Clinical Oncology, have initiated a series of clinical trials aimed at treating prostate cancer in early settings. This includes a cutting-edge trial in which androgen deprivation therapy (ADT) is combined with a novel drug aimed at preventing suppressive myeloid cells from entering the prostate tumor microenvironment at the time of therapy.
“To me, this is the most exciting immunotherapy trial in all of GU cancer,” says Dr. Drake. The trial, MAGIC-8, is now open and accruing patients at three sites. In a second clinical trial, patients who present with metastatic disease are being treated with the combination of chemotherapy, ADT, and immunotherapy.
Mark N. Stein, MD, an Associate Professor of Medical Oncology at Columbia, is focused on precision-targeted immunotherapy for late stage disease. Dr. Stein is leading a trial of a novel prostate cancer drug aimed at “dragging” immune cells to cancer using a “bi-specific” antibody – one arm latches onto prostate cancer cells, and a second arm serves to trap nearby immune cells and activate them. “This is an exciting approach that is already showing promising signs of activity,” says Dr. Stein.
The GU group at Columbia is working with Columbia's imaging specialists on several advanced imaging trials that are seeking to locate small prostate tumors using an imaging tracer that shows PSMA after initial surgery or radiation therapy.
In kidney cancer, Dr. Drake’s lab has also made significant strides with the discovery that the Interleukin-1 (IL-1) cytokine seems to lie upstream of many of the mechanisms that inhibit a significant anti-tumor immune response. Based on these data, they have initiated a trial combining an Il-1 blocking drug with immunotherapy in high-risk kidney cancer patients eligible for surgery. “By treating patients before surgery, we will be able to determine if giving combination immunotherapy results in an inflamed tumor that’s less likely to recur,” notes Dr. Drake.