Prostate Cancer Lab #56 Bipolar Androgen Therapy (BAT) - (Emmanuel Antonarakis)

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07/13/23

In Prostate Cancer Lab #21, advanced prostate cancer patient Bryce Olson shared the story of his exceptional response to Bipolar Androgen Therapy (BAT), where high doses of testosterone are alternated with androgen deprivation therapy. Then Bob Gatenby, MD, commented on Bryce’s experience and strategy from his perspective as a leader in adaptive therapy -- using evolutionary and game theory to inform cancer treatment strategy. Super patient Russ Hollyer has been self-administering BAT and has written a book about it, available on cancerpatientlab.circle.so.

Emmanuel Antonarakis, MD, is uniquely qualified to update us on bipolar androgen therapy for advanced prostate cancer. He is the Clark Endowed Professor of Medicine and Associate Director of Translational Research, Masonic Cancer Center, at the University of Minnesota Medical School. Dr. Antonarakis is a genitourinary medical oncologist with a particular focus on recurrent and advanced prostate cancer. He conducts clinical and translational studies to bring new therapies to patients with prostate cancer. In particular, he is interested in developing novel androgen-directed therapies, genetically-targeted therapies, and immunotherapies for men with recurrent or advanced prostate cancer, and using germline and tumor genomics to inform precision oncology approaches for these patients.

00:00:00 Meeting Introduction
00:02:54 Prostate Cancer Lab #56 Bipolar Androgen Therapy (BAT): A paradoxical approach
00:03:35 Bipolar Androgen Therapy - BAT
00:06:18 First-in-Human BAT in mCRPC
00:08:29 Clinical Trial with BAT (2013-2023)
00:09:11 When is the Ideal Time to Give BAT?
00:10:35 What Are the Types of Responses to BAT?
00:13:33 Beware of Bone Scan "Flare" with BAT
00:16:42 TRANSFORMER Study
00:18:17 TRANSFORMER: PFS and OS
00:19:23 TRANSFORMER: PSA50 Response Rate
00:20:11 TRANSFORMER: Crossover (PSA50, PFS2)
00:21:19 Quality of Life
00:22:42 BAT: Effect of HRR and/or TP53 Mutations
00:23:40 BAT: Effect of HRR Mutations (e. g. BRCA2)
00:24:02 BAT: Effect of Combined Tumor Suppressor
00:25:05 Trial Design of STEP-UP Study (NCT04363104)
00:25:55 Q&A