Clonal Hematopoiesis as a Determinant for Bone Marrow Toxicities for Targeted Radiation Therapies in Prostate Cancer

Abstract

Targeted radionuclide therapy (TRT) is an emerging therapy in prostate cancer (PC), with PSMA-TRT showing a survival advantage with near-term approval for 177Lu-PSMA-617 expected and trials activated in earlier disease states. While most patients tolerate treatment, myelosuppression to varying degrees is one of the common toxicities and there is a risk of long-term bone marrow toxicity due to radiation. Identification of patients that are predicted to have short- and long-term toxicities from TRT is of major clinical interest. Clonal Hematopoiesis (CH) is aging related and is associated with smoking and previous exposure to radiation/chemotherapy. Our long-term goal is to identify CH signatures that predict short term and long-term bone marrow toxicities from TRT. Our hypothesis is that CH mutations have variable penetration based on specific PC therapies (especially TRT) and impact incidence of cytopenias and future risk of MDS/AML. We will utilize samples collected retrospectively and prospectively to: (1) Determine the prevalence of pre and post treatment cytopenias in patients with and without CH (2) Compare longitudinal behavior of individua lCH mutations, including those known to impact future risk of MDS and (3) Contrast post treatment CH signatures in TRT patients with non-TRT treated patients.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2023
Accession Number
AD1223422

Entities

People

  • Pinkal Desai

Organizations

  • Cornell University

Tags

Fields of Study

  • Medicine

Readers

  • Molecular and genetic basis of cancer.
  • Oncology
  • Toxicology/Environmental Toxicology