Read about cancer treatment options listed by gene mutation, type of cancer and type of treatment.
Cancer Treatment > By Cancer Type > Prostate > Biomarkers, targeted and immunotherapies
Biomarkers, targeted and immunotherapies for cancer
This section covers the following topics:
- Genetic testing for inherited mutations for treatment selection
- Tumor testing for treatment selection
Genetic tests for inherited mutations for treatment selection
Any person diagnosed with mCRPC meets national guidelines for genetic testing for an inherited mutation. Genetic testing may be used to guide treatment selection.
- Men with mCRPC who test positive for an inherited mutation in , , , , or other gene linked to a certain type of damage repair may benefit from a type of known as a .
- Men who test positive for an inherited mutation linked to , may benefit from the pembrolizumab (Keytruda).
tests
tests look at samples of blood, tumor or other tissue for changes or abnormalities caused by cancer. These tests can give doctors clues about the cancer, including:
- how fast the cancer is growing
- which treatments are most likely to work
- whether or not the cancer is responding to treatment or growing
- whether or not the cancer has come back after remission
Biomarkers for treatment selection
tests may be used to select treatments, and help patients avoid side effects from treatments that will not work for them. tests used to select a specific treatment are sometimes called "companion diagnostic tests." These tests may be done on tumor tissue or (in many cases) on blood. See our Testing section for more information.
Experts recommend testing for cancer based on risk groups.
- Men with low and favorable-intermediate-risk cancer and a life expectancy of > 10 years should consider multi-gene tumor testing. Multi-gene tumor testing can help predict how aggressive the cancer is and guide treatment.
- multi-gene tumor tests include Decipher, Oncotype DX , Prolaris and ProMark.
- Men with regional or metastic cancer should consider tumor testing for:
- An abnormality known as ().
- If tumor mutations in , , , or are found, patients should be considered for referral for genetic counseling and testing for an inherited mutation.
- An abnormality known as “" (MSI-H or ) also known as "" ( or ).
- cancers are common in people with a gene mutations. People with advanced/metastatic cancer may respond well to an agent.
- An abnormality known as ().
- Additional tests that may be used for metastic (mCRPC) include AR-V7 testing. AR-V7 stands for Androgen Receptor Variant 7. AR-V7 is a blood test that looks for a form of the androgen receptor that makes androgen therapy less effective. AR-V7 testing can help identify patients who would not benefit from androgen receptor therapies.
Immunotherapies
Immunotherapies are cancer treatments that help the body’s immune system detect and attack cancer cells.
- Immune checkpoint inhibitors are a type of most often used to treat advanced/metastatic cancer that have MSI-H or dMMR; usually after other treatments have been tried.
- Keytruda (pembrolizumab) may be used to treat patients with castration resistant cancer that is MSI-H or and have had one line of therapy affecting the whole body.
- Cancer treatment vaccines are a type of that uses a patient’s own cancer cells to boost their immune system.
- Provenge (sipuleucel-T) may be used to treat patients with prostate cancer whose disease has progressed aftger hormonal treatment who have either no or very minimal symptoms related to the cancer.
Targeted therapies
The , Lynparza (olaparib) has received FDA-approval to treat men with , castration-resistent cancer, who have a mutation in , , or other gene linked to a certain type of damage repair. Lynparza may be used to treat men whose cancer has progressed on enzalutamide (Xtandi) or abiraterone (Zytiga).
The , Lynparza (olaparib) has received FDA-approval to treat men with , castration-resistent cancer, who have a mutation in , , or other gene linked to a certain type of damage repair. Lynparza may be used to treat men whose cancer has progressed on enzalutamide (Xtandi) or abiraterone (Zytiga).
Table of targeted and immunotherapies for cancer
Name of drug | Cancer | Indication | Type of agent | |
---|---|---|---|---|
Lynparza (olaparib) |
castration-resistant cancer (mCRPC) | Men with mCRPC whose cancer has progressed following treatment with Xtandi (enzalutamide) or Zytiga (abiraterone) | Inherited mutation in or or tumor mutation one of the following genes: , , , , , CDK12, , FANCL, , RAD51B, , , RAD54 |
|
() |
castration-resistant cancer (mCRPC) | Men with mCRPC who have been treated with androgen receptor-directed therapy and a taxane-based chemotherapy | Inherited or acquired (tumor) mutation in or | |
Provenge (sipuleucel-T) | castration resistant cancer (mCRPC) | For the treatment of asymptomatic or minimally symptomatic castrate resistant cancer | No needed | Cancer vaccine |
Keytruda (pembrolizumab) | or unresectable | For treatment of that have progressed after treatment and for which there are no other treatment options | MSI-H ( High) or () | Immune checkpoint inhibitor |
Keytruda (pembrolizumab) | or unresectable |
For the treatment of that have progressed following prior treatment and for which there are no satisfactory alternative treatment options |
High (TMB-H) | Immune checkpoint inhibitor |
Vitrakvi (larotrectinib) | solid tumors | For treatment in solid tumors where surgical resection is likely to result in severe , and for which there are no satisfactory alternative treatments or the cancer progressed following treatment | NTRK fusion | Kinase inhibitor |
The following organizations offer peer support services for people with, or at high risk for cancer:
- FORCE peer support
- Visit our message boards.
- Once you register, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Sign up for our Peer Navigation Program.
- Users are matched with a volunteer who shares your mutation and situation.
- Join our private Facebook group.
- Find a virtual or in-person support meeting.
- Join a Zoom community group meeting.
- LGBTQIA
- Men
- American Sign Language
- People of Color
- Visit our message boards.
- ZERO - The End of Cancer is a nonprofit organization that provides information and support resources for men with cancer.
updated: 01/30/2022
The following are studies looking at PARP inhibitors and similar agents for treating people with advanced cancer.
- NCT04821622: TALAPRO-3: A Clinical Trial in Men with Castration-Sensitive Cancer (mCSPC) and Damage Repair (DDR) Gene Alterations. TALAPRO-3 is a trial for men who have been diagnosed with castration-sensitive cancer (mCSPC) which means that the tumor has spread to other parts of the body but is still sensitive to hormone therapies.
- NCT05005728: XmAb®20717 Alone or in Combination With Chemotherapy or in Patients With Castration-Resistant Cancer. This study will look at the safety and clinical activity of the drug XmAb20717 alone or in combination with standard of care anticancer therapies in patients with castration-resistant cancer who have been treated with at least 2 prior lines of treatment.
- NCT03012321: Abiraterone/Prednisone, Olaparib, or Abiraterone/Prednisone + Olaparib in Patients With Castration-Resistant Cancer With Repair Defects. This is a phase II study in men with castration resistant cancer (mCRPC) open to men with a or other mutation.
- NCT04455750: A Clinical Study Evaluating The Benefit of Adding to Enzalutamide for Men With Prostate Cancer That Has Become Resistant To Testosterone-Deprivation Therapy. This trial is evaluating the benefit of and enzalutamide combination therapy versus enzalutamide alone for the treatment of men with prostate cancer that has become resistant to testosterone-deprivation therapy.
A number of other clinical trials for people with cancer can be found here.
updated: 04/16/2022