Dr Peter Black

Peter Black: So, I’m Peter Black, urologist in Vancouver, University of British Columbia. I was talking this morning, you know I typically talk about bladder cancer. I’m talking to a prostate cancer audience, so what I tried to do was to take the data and the experience from immunotherapy in bladder cancer and apply it to how we might move forward in prostate cancer, some lessons learned. Especially I think there’s something to be learned about toxicity and managing toxicity with these agents. There’s a lot to be learned about biomarkers and patient selection, and I think we need to take a step back and really rationalize how we plan future trials. We’re not just testing everything willy nilly without any real rationale for next steps.

So, one of the big limitations is that only about 20% of patients largely respond to the single agent checkpoint inhibitors that we’re using which is what we usually talk about in the context of immunotherapy, and I think if you apply that to prostate cancer which is probably less immunogenic that number might even be lower. So you know, we have to bear that in mind as we’re doing trials. We don’t want to put patients at risk for very low success rates and I think the path forward in prostate cancer is going to be that we give something else to prime the immune system and then add in the checkpoint inhibitor to enhance the response.