Epigenomic Liquid Biopsy for Detecting Tumor PSMA in Prostate Cancer

Jacob E. Berchuck, MD, assistant professor, Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, discusses research behind using a blood-based liquid biopsy over traditional PSMA PET scans presented at the 2024 ESMO Congress, and highlights some of their main advantages.

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0:09 | The objective of our study at ESMO was to evaluate whether a new epigenomic liquid biopsy tool could non invasively detect tumor PSMA expression in men with metastatic castration-resistant prostate cancer. Liquid biopsy tools focused on epigenomic profiling of tumor features in the blood have enabled sort of some new capabilities that previous liquid biopsy tools focused on genomics were not able to do. We specifically sought to evaluate whether the new epigenomic liquid biopsy platform from Precede Biosciences could non invasively detect tumor PSMA expression, and we correlated the tumor PSMA expression on PET scan with what we were able to observe in the blood using this liquid biopsy platform.

0:58 | I'll highlight 2 things. The first, which I think is really important, is access. The FDA label for [¹⁷⁷Lu-PSMA-617 (Pluvicto)] requires a PSMA PET scan to confirm tumor PSMA expression prior to patients receiving or being eligible to receive treatment. We know that PSMA PET scans are not available in some places in the United States and certainly globally, and so I think the opportunity, or the ability to assess tumor PSMA expression, in which patients are eligible for this FDA-approved life prolonging drug in other ways that are more accessible to communities, especially with underserved populations, is incredibly important, which we are hopeful that this liquid biopsy approach we'll be able to achieve.

1:40 | The second is that, as I mentioned, PSMA PET scans, molecular imaging, are limited to a single target, so the implications there are that I am incredibly optimistic with all of the clinical trials going on in this space, that there are going to be FDA-approved drugs, 3, 4, or 5 years from now for men with prostate cancer, but really all solid tumor types targeting an array of different targets. So, how are we going to, in the clinic, identify which patients tumors express, which targets to prioritize specific treatments for individual patients to maximize response rates, [and] improve clinical outcomes while minimizing delivering treatments that are not going to be effective for individuals. So, I think what this epigenomic liquid biopsy platform potentially provides is a way with a single blood draw to profile several therapeutic targets for patients with advanced solid tumors to facilitate precision treatment.