OTL-78 – On Target Laboratories Prostate Cancer Drug Development

Dr. Michael Koch, MD, discusses the development of On Target Laboratories‘ new drug OTL-78 which targets and binds to cancerous cells, causing them to fluoresce to treat prostate cancer.

Dr. Koch joined the faculty and became Chairman of the Department of Urology at Indiana University School of Medicine in 1998. He had previously been a member of the faculty at Vanderbilt University for 12 years. Dr. Koch has served in many roles for urology nationally. Dr. Koch is a previous trustee and past-president of the American Board of Urology, past-Chairman of the Examination Committee for the American Board of Urology, past-President of the Society of Urology Chairpersons, past president of the Society of University Chairpersons, Chair of the Residency Review Committee for urology training programs and a member of the honorary societies of the GU Surgeons and the Clinical Society of GU Surgeons. In 2015, he was honored by the American Urologic Association with a distinguished contribution award. In 2017, he was awarded the Health Care Hero award by the Indianapolis Business Journal for his involvement in the development of High Intensity Ultrasound for the treatment of prostate cancer. During Dr. Koch’s tenure as chairman of the Department of Urology at Indiana University, the Department has grown from 7 to 23 faculty and has risen to one of the highest ranked programs at IU School of Medicine.


Neal Howard: Welcome to the program. I’m your host Neal Howard here on Health Professional Radio, glad that you could join us. We’re going to have a conversation this morning with Dr. Michael Koch, he’s the Chair of Department of Neurology at Indiana University Medical Center and he’s joining us on the program today to talk about the development of On Target Laboratories’ brand new drug for treating prostate cancer. Welcome to Health Professional Radio Dr. Koch.

Dr. Michael Koch: Thank you.

Neal: Well why don’t you give our listeners just a little bit of background about yourself and we’ll jump right into this discussion of this new drug called OTL-78, okay?

Dr Koch: Sure. so I’m the head of the Urology Department at Indiana University School of Medicine. I’ve been here in this capacity for 20 years and the focus of my clinical work is prostate cancer and have been approaching it from a number of different attacks. This drug is quite unique in terms of anything we’ve ever had, the potential to use before because it’s going to allow us to approach the worst prostate cancer patients and potentially offer curative therapy that we’ve not been able to offer before.

Neal: Is that the reason that there is this critical need in healthcare for enhanced prostate cancer treatment methods such as the one we’re discussing this morning?

Dr Koch: Yes. So one of the issues with prostate cancer is we’ve done a sort of about-face, yet 15 years ago we used to try primarily to cure people with low risk prostate cancer, people that did not have a high risk of spread. As it turns out, that disease grow so slowly that it doesn’t need to be cured but we need to be able to cure is the people who have either not quite had the cancer spread or just begun to spread outside the prostate and they have a high risk of death from prostate cancer if they’re not cured. And our current techniques are somewhat inadequate in terms of assessing where the disease is and where it is not which limits our ability to address all the disease that the patient has.

Neal: So if you’re having difficulty determining where the disease is and where the disease isn’t, doesn’t that leave the potential for leaving cancerous cells after treatment for the patient to have to live with and come back for surgery or other treatment later on?

Dr Koch: Exactly, that is exactly the issue. We really want to particularly, if you’re talking about surgery you want to eliminate all the disease first time in and not need any other treatment whether it be chemotherapy radiation or hormonal therapy in the case of prostate cancer.

Neal: So how many people are we talking about that are suffering from the type of cancer that this new drug is effective for or is going to be used for?

Dr Koch: Well the numbers vary somewhat but there’s around 160,000 to 200,000 men that are diagnosed with prostate cancer in the United States. There are about 30,000 men every year that die from prostate cancer so of the 160 or so they’re diagnosed every year, it’s probably at least a third of them that have this higher risk prostate cancer that really really really require a need for aggressive treatment in an attempt to cure it, so it’s a lot of people.

Neal: Exactly how does this new drug OTL-78 work?

Dr Koch: Let me back-up one. So one of the issues with prostate cancer, I’m primarily a prostate cancer surgeon, okay. So when I’m operating on somebody the edge of the prostate is somewhat subtle tactically and cancer doesn’t always look that different than normal tissue particularly bladder tissue, tissue around the rectum, tissue just outside the prostate – it’s not as clear as one might think. The second problem of prostate cancer is when it spreads to lymph nodes around the prostate, it does not do that in a totally predictable pattern. There are some diseases where it spreads much more predictably but when you’re dealing with prostate cancer for example, if you’re talking about spreading to lymph nodes – you want to know exactly which lymph nodes it has spread to so you can get those lymph nodes. And otherwise, you’re just kind of guessing but you don’t know for sure. Similarly, if it’s broken through the outer wall the prostate into the tissue beyond the prostate, you need to be able to try to see that. So what’s unique about this drug is that it binds to any prostate cancer areas. And secondly it fluorescents when stimulated by the right type of light so if you were removing the prostate, you want to assess the tissues around the prostate, you would take the prostate out and you would apply the light to see if anything any fluorescent tissue remains and if it does and you can resect that. Similarly, you can put the stimulating light on the lymph nodes and see if any of them glow fluorescently and then you can remove that set of lymph nodes.

Neal: Is this damaging to any healthy tissue at all in any type of way? I mean how is it Illuminating? Is it not radiation, it’s just simple fluorescence?

Dr Koch:  Yeah, similar to a black light or something like that. I mean it’s it’s fluorescence and it’s similar to fireflies that you see in the summer. They fluoresce and not radioactive, it’s not damaging. It gives us the potential to be much less damaging surgically so we know where to remove the tissue in the prostate.

Neal: Once everything is lit up, all of the tissue can be removed and the survival rate of the patient greatly increased.

Dr Koch: For example, the nerves that give a man his sexual function are immediately outside the prostate so were you able to give this drug and then apply the fluorescence to the prostate and that area lit up and you would know that those nerves can be removed with the prostate to effectively remove all the tumor. On the other hand, if they didn’t then you would know that you could spare all that tissue so it’s a way to inspect tissue to see how much much tissue it really needs to be removed.

Neal: Is prostate cancer the only condition that this drug is going to be effective with or can it be used universally to track these or to light up cancer cells?

Dr Koch: This particular drug is prostate specific. They have other drugs that are unique for other types of cancer but is the goal may be to create something, a one-stop shop for cancer that illuminates all these cells and makes it easier in all different types of cancers not just Prostate?

Dr Koch: Well I think you’d have to ask On Target Laboratories that.

Neal: Where can we go online and get some more information about On Target’s new drug and about your practice as well?

Dr Koch: Indiana University School of Medicine website.

Neal: And I’m assuming that On Target Laboratories would have a website of their own.

Dr Koch: Yes.

Neal: I do believe that website would be ontargetlaboratories.com and you say you’re located on the Indiana University’s School of Medicine website.

Dr Koch: Yes.

Neal: Alright. Well seeing as how surgeons do have a kind of a difficult time as you say differentiating between the healthy tissue and the cancerous tissue, I’m sure that this brand new drug once it is available.

Dr Koch: Yes, it’s very exciting. I think it’s going to give us potential to increase our cure rate in the patients that need the cure the most.

Neal: Well I thank you for dropping in this morning and giving us this information. I’m hoping that we can talk again when the drug becomes available.

Dr Koch: Alright, thank you Mr. Howard.

Neal: Thank you. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at HP RFM and healthprofessionalradio.com.au. You can also subscribe to this podcast on iTunes, listen in and download at SoundCloud and be sure and visit our Affiliate Page at healthprofessionalradio.com.au and hpr.fm

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