“Feedback on My 17 Treatment Options ”

g good Antibody Drug Conjugates. The drug combination options were a concern for Rana McKay, due to toxicity and quality of life risks. Brad Power and Saed Sayad recommended lower dosages for each of the drugs in a drug

“Feedback on My 17 Treatment Options?” (Brian McCloskey) [#15] combination. Brian wanted to see evidence for lower dosages. Brad said that is in the domain of experts (not clinical trial evidence), and suggested we tap a dosing expert. Requests ●Do you know anyone who is an expert on dosing, especially as a way to reduce toxicity concerns in drug combinations?

●Would you like to join a group to talk about how we could create or find protocols (observational trials) that willing physicians could put their patients in to benefit them in real time, as opposed to 20 years from now, after you collect enough data?

The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab/Prostate Cancer Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

“Feedback on My 17 Treatment Options?

” (Brian McCloskey) [#15] Meeting Notes The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab/Prostate Cancer Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. Brian McCloskey: I'm going to be speaking to you about the process that I've gone through to identify treatment options. Many of you have been part of that journey in helping me along the way.

I first want to thank all those that have contributed to this. This is an inflection point in terms of how the Prostate Cancer Lab is benefiting me and Rick, and other patients, such as Ken and Mike who are teed up in the process as well.

Over the past several months I have had the great pleasure of working with three companies to help me identify potential targeted therapies for me to consider and to take to my doctor. The process has been really straightforward and very simple. It consists of two components. One is data gathering. As many of you know, I'm being treated primarily at UC San Diego Health.

I'm also at The City of Hope and the Larry Ellison Institute for Transformative Medicine.

ke to my doctor. The process has been really straightforward and very simple. It consists of two components. One is data gathering. As many of you know, I'm being treated primarily at UC San Diego Health. I'm also at The City of Hope and the Larry Ellison Institute for Transformative Medicine. Over the course of the past six years, I have a pretty long rap sheet in terms of my medical records.

My medical records from UC San Diego are long and illustrious. The other data input is my genomic profile. I have five separate genomic reports.

“Feedback on My 17 Treatment Options?” (Brian McCloskey) [#15] some relate to my metastatic tumors, and then liquid biopsies along the way. In total, there were nine different documents that went into the analysis that I've shared with three different companies. The first is CureMatch.

Ally Pearlina has provided concierge, white glove service to me in terms of taking in all of my information and integrating that into their treatment matching process. The second company is Massive Bio. Their process is a little bit different, and similar to xCure’s, where all of those nine different documents were uploaded into their portal.

Then they reached back out to me to make sure that they had everything. They worked directly with UCSD to capture all of my medical record information, imaging, et cetera. That was basically the same for xCures – a combination of online document uploading and white glove service where they worked directly with the healthcare provider, and then made sure that they had all of the information.

Once those three companies have all of the information, they then run it through their matching algorithms. Depending upon their focus, they provide treatment options. For example, CureMatch is very focused on combinatorial approaches that are targeting my specific molecular targets.

Massive Bio does something similar, but they're really not focused so much on drug combinations, although that is part of their solution. They focus on clinical trials. How do you find the right treatments? Based upon the profile of the patient, their history, medical records, molecular profile genomics, et cetera, and then find those trials.

xCures is similar to Massive Bio in that they are using the same information for their matching. They consider clinical trials as well as standard of care and some off-label drugs as well. Across all three vendors, you have a pretty rich group of different options to choose from.

It's interesting that across each of these three vendors, I received 17 different treatment options, and there was no overlap in any of them. That's kind of nice because they were complementary, I have more options. But on the other hand, it raises the question: can we do better in terms of having the right information upfront to have more precise treatment options?

erlap in any of them. That's kind of nice because they were complementary, I have more options. But on the other hand, it raises the question: can we do better in terms of having the right information upfront to have more precise treatment options?

Brian McCloskey’s 17 Treatment Options Therapy OptionTargetsRationale and Expert Input SourceDrug Access 1Antibody Drug ConjugateCD276 (B7- H3)Primary and met tumor RNAseq analysis shows very high expressions of B7-H3 relative to pan cancer and prostate cancer cohorts.

Tempus/ Stanton BiosciencesDaichi 2CabazitaxelUnspecifiedSOCxCures/ Cancer CommonsN/A 3177Lu- PSMA-617, PembrolizumPSMAIf eligible for a clinical trial, consider the combination of 177Lu-PMSA-617 and the immune checkpoint inhibitor xCures/ Cancer Commonshttps:// www.clinica ltrials.

“Feedback on My 17 Treatment Options?” (Brian McCloskey) [#15] abpembrolizumab. Trial located at UCSF. The Phase 3 VISION study reported a 38% reduction in risk of death and 60% reduction in risk of radiographic disease progression or death in men with PMSA-positive mCRPC who received 177 Lu- PMSA-617 plus best standard of care as compared with standard of care alone. (https://www.globenewswire.

com/ news-release/ 2021/06/03/2241602/0/en/ Novartis-177Lu-PSMA-617- significantly-improves-overall-survival- and-radiographic-progression-free- survival-for-men-with-metastatic- castration-resistant-prostate-cancer- in-Phase-III.html).ct2/show/ NCT038055 94 4Cabozantinib , AtezolizumabUnspecifiedIf eligible for a clinical trial, consider the combination of cabozantinib and atezolizumab.

Trial has multiple locations in CA. A Phase 1b trial of cabozantinib and atezolizumab in advanced solid tumor patients reported, in 132 patients with mCRPC, a partial response rate of 15% and a median overall survival time of 18.4 months (https://www.targetedonc.com/view/at ezolizumab-combined-with- cabozantinib-shows-efficacy-in-high- risk-mcrpc)xCures/ Cancer Commonshttps:// clinicaltrials.

gov/ct2/ show/ NCT031709 60 5Degarelix, Enzalutamid e, TrametinibBRAF, AR, MAP2K2 over expressionConsider the combination of AR inhibition with the MEK inhibitor trametinib. Targets the BRAF, AR, and MAP2K2 overexpression. Mimics part of ongoing NCT01990196.

A study in a mCRPC patient reported a decrease in PSA of 85% and 93% at 3- and 5-months following treatment with trametinib, and no radiologic or clinical progression for 18 months (https://www.nature.com/articles/s413 91-019-0134-5)xCures/ Cancer CommonsOff Label 61)Apalutamid e, 2) olaparib, 1)AR,2) FANCA via PARP1, CM_006190 BM CureMatch Report 20220418.

“Feedback on My 17 Treatment Options?” (Brian McCloskey) [#15] 3)trametinibPARP2, 3) BRAF via MAP2K1, MAP2K2 MAP2K2approved 3) Off label 71) Carboplatin 2) regorafinib 3) trametinib1) FANCA via DNA damage 2) BRAF TP53 via FLT1, KDR 3) BRAF via MAP2K1, MAP2K2