Project Details
Description
PROJECT SUMMARY/ABSTRACT
The last decade has seen a significant increase in the number of FDA approved treatments for men
with metastatic castrate resistant prostate cancer (mCRPC). Even greater improvements in survival
were observed for men with metastatic castration sensitive PC (mCSPC) treated with chemotherapy or
androgen receptor signaling inhibitors compared to hormone therapy alone (Despite these advances
in mCSPC, median OS for men with mCRPC remains less than two years and cross-resistance to
therapies within the same class (e.g. Enzalutamide and Abiraterone) occurs in >90% of patients, limiting
effective treatments in mCRPC to agents with OS improvements ranging from only 2-4 months. There
is a critical need to identify new agents that can eliminate resistant disease5. Understanding the
molecular associations driving resistance may identify new therapeutic sensitivities in these aggressive
cancers to improve quality and quantity of life for men with mCRPC. Translational research studies
focused on understanding the underlying mechanisms driving treatment resistance in CRPC have
identified a wide range of genomic, epigenomic and transcriptional alterations. Approximately 15-20%
of patients with mCRPC develop lineage plasticity, with small cell neuroendocrine CRPC (SCNPC)
representing the most aggressive subtype. However, the field lacks consensus definitions for the
diverse lineage plasticity phenotypes observed in mCRPC, and few therapeutic targets have been
developed to date. In this study, we propose Trop-2 (Trophoblastic cell-surface antigen) as a high value
target for therapy of mCRPC with an antibody-drug conjugate Sacituzumab Govitecan (SG). We
hypothesize that ARSI-resistant phenotypes in mCRPC can be identified through integrated solid
tumor and liquid biopsy analysis and targeted therapeutically with SG. To test this hypothesis, we
propose to study Trop-2 regulation in pre-clinical and clinical specimens and test this agent in a
prospective Phase II clinical trial for ARSI-resistant mCRPC. In Aim 1, we will conduct molecular-spatial
analysis of Trop-2 expression in mCRPC PDX tissues as well as solid tumor and liquid biopsies from
patients with CSPC, CRPC and SCNPC In Aim 2, we will evaluate solid tumor and liquid biopsies
collected longitudinally from patients with mCRPC treated with SG in a prospective Phase II trial. Aim
2 will characterize chromatin enhancer profiles in the TACSTD2 gene encoding Trop-2 to identify
factors regulating Trop-2 levels in prostate cancer. We will test if Trop-2 levels determine sensitivity to
SG therapy, and identify SG-based combination regimens that enhance therapeutic efficacy in vitro
and in vivo.
Status | Active |
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Effective start/end date | 7/1/23 → 6/30/24 |
Funding
- National Cancer Institute: $695,050.00
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