Advances in Precision Medicine Rapidly Transforming Treatment Options for Bladder Cancer Patients - Daniel Castellano
December 30, 2022
Daniel Castellano emphasizes the importance of multidisciplinary approaches in patient care and research. He advocates for precision medicine in genitourinary tumors, highlighting advancements in prostate and bladder cancer treatments. Dr. Castellano stresses the need to overcome barriers in drug access and regulatory processes to provide better care. He expresses a strong connection with Argentina, offering support for collaborative efforts in the field.
Biographies:
Daniel Castellano, MD, Hospital Universitario 12 de Octubre, Madrid, Spain
Biographies:
Daniel Castellano, MD, Hospital Universitario 12 de Octubre, Madrid, Spain
Read the Full Video Transcript
Daniel Castellano: I’m Daniel Castellano, a medical oncologist. I lead the genitourinary tumor department of the Hospital 12 de Octubre in Madrid, and there, for many years, I have been conducting research on genitourinary tumors. And well, I wanted to thank you, obviously, for the invitation to take part in... this conference, on this platform, which is UroTarget, and, needless to say, I have to congratulate you for... having made it a multidisciplinary conference. I think now is the time we need to change paths to provide good care and research.
All of this naturally on behalf of the patients, right? That is the clear goal, I think, right? Which I feel is... This is a goal I have always had in my clinical practice, and I feel very comfortable because I think it is... the ideal scenario in which we can all develop, obviously on behalf of medicine. Yes, I believe this is a key point.
For years, we have been working hard to achieve precision medicine, personalized medicine in medical oncology, and now, little by little, this has become part of our standard practice on genitourinary tumors. I mean, I talked earlier today about precision medicine in bladder cancer, but we already have a wealth of knowledge from prostate cancer, in which we already have approved drugs, right? With positive results in a subgroup of patients with specific alterations in DNA damage repair genes, in which PARP inhibitors have been shown to have a clear benefit in bladder cancer.
We’re on that. Little by little, we have been incorporating the possibility of testing our patients, of being able to sequence them early, and identify molecular profiles in them. Probably, the closest is still the pathway of gene alterations related to the Fibroblast Growth Factor Receptor (FGFR), and with that, there are drugs which are also coming, and which would seem will show efficacy in phase-3 studies, right?
Which is the ... This is, we could say, the positive part of precision medicine. What’s the tricky, or, for not saying the negative part? I think rather than a negative part, we should say the complicated part.
It is what is experienced in general. I’m not just talking about Argentina, but about various countries in Latin America, and also in Europe. Well, yes, the access to drugs, right? I think it is a barrier we somehow have to overcome, because you can’t understand that you have to see a patient in clinical practice and you have to inform him of a molecular alteration that... promotes a worse prognosis for his tumor, and that you can’t offer them adequate treatment, all while knowing that treatments for that exist.
So, I think we have to do something more. We have to take another step to improve this access from two standpoints, two different angles. One is that, well, tumor-agnostic indications will probably arrive, only related to those alterations, but we also have to make an effort to find and facilitate the drug approval process for these patients who have molecular alterations, and not only with phase-3 study results, which, as you know, is difficult to get results in scenarios of patients with, who make up a tiny proportion, and be able to prove it with objectives such as overall survival. So, we’ll have to do something about it and change it. I’m not just talking about Latin America,
I’m also talking about drug regulatory agencies and agencies that must measure which endpoints we need to pivot to get precision medicine for all of our patients. No, again, I would like to thank you for the invitation.
I am from Spain, and within this scenario, in which we have to live, I think, probably sharing a very similar culture, a very similar language, I have a very strong bond with Argentina because I was born here, and also because I went to school here, and because I know a lot of people here, I’ve always tried to come back and collaborate, and so, you will always have me here for that. And I think it’s important to always have support from outside for things that you believe in, that you are fighting for, and a fight that can sometimes seem a bit lonely, right?
We will be here to help.
Daniel Castellano: I’m Daniel Castellano, a medical oncologist. I lead the genitourinary tumor department of the Hospital 12 de Octubre in Madrid, and there, for many years, I have been conducting research on genitourinary tumors. And well, I wanted to thank you, obviously, for the invitation to take part in... this conference, on this platform, which is UroTarget, and, needless to say, I have to congratulate you for... having made it a multidisciplinary conference. I think now is the time we need to change paths to provide good care and research.
All of this naturally on behalf of the patients, right? That is the clear goal, I think, right? Which I feel is... This is a goal I have always had in my clinical practice, and I feel very comfortable because I think it is... the ideal scenario in which we can all develop, obviously on behalf of medicine. Yes, I believe this is a key point.
For years, we have been working hard to achieve precision medicine, personalized medicine in medical oncology, and now, little by little, this has become part of our standard practice on genitourinary tumors. I mean, I talked earlier today about precision medicine in bladder cancer, but we already have a wealth of knowledge from prostate cancer, in which we already have approved drugs, right? With positive results in a subgroup of patients with specific alterations in DNA damage repair genes, in which PARP inhibitors have been shown to have a clear benefit in bladder cancer.
We’re on that. Little by little, we have been incorporating the possibility of testing our patients, of being able to sequence them early, and identify molecular profiles in them. Probably, the closest is still the pathway of gene alterations related to the Fibroblast Growth Factor Receptor (FGFR), and with that, there are drugs which are also coming, and which would seem will show efficacy in phase-3 studies, right?
Which is the ... This is, we could say, the positive part of precision medicine. What’s the tricky, or, for not saying the negative part? I think rather than a negative part, we should say the complicated part.
It is what is experienced in general. I’m not just talking about Argentina, but about various countries in Latin America, and also in Europe. Well, yes, the access to drugs, right? I think it is a barrier we somehow have to overcome, because you can’t understand that you have to see a patient in clinical practice and you have to inform him of a molecular alteration that... promotes a worse prognosis for his tumor, and that you can’t offer them adequate treatment, all while knowing that treatments for that exist.
So, I think we have to do something more. We have to take another step to improve this access from two standpoints, two different angles. One is that, well, tumor-agnostic indications will probably arrive, only related to those alterations, but we also have to make an effort to find and facilitate the drug approval process for these patients who have molecular alterations, and not only with phase-3 study results, which, as you know, is difficult to get results in scenarios of patients with, who make up a tiny proportion, and be able to prove it with objectives such as overall survival. So, we’ll have to do something about it and change it. I’m not just talking about Latin America,
I’m also talking about drug regulatory agencies and agencies that must measure which endpoints we need to pivot to get precision medicine for all of our patients. No, again, I would like to thank you for the invitation.
I am from Spain, and within this scenario, in which we have to live, I think, probably sharing a very similar culture, a very similar language, I have a very strong bond with Argentina because I was born here, and also because I went to school here, and because I know a lot of people here, I’ve always tried to come back and collaborate, and so, you will always have me here for that. And I think it’s important to always have support from outside for things that you believe in, that you are fighting for, and a fight that can sometimes seem a bit lonely, right?
We will be here to help.