Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment
Abstract
Scientific Objective and Rationale: Prostate cancer is a common diagnosis among men with over 230,000 new cases each year. Most of these cancers are slow-growing, and a majority of men are unlikely to die from these cancers. Therefore, most men should be placed on a regimen of closely watching the cancer over time rather than immediate treatment. The immediate treatment is usually surgery or radiation and can lead to permanent leakage of urine and the inability to have sex due to erectile dysfunction. In order to diagnose prostate cancer, an ultrasound placed into the rectum and 12 needle cores are performed. The prostate biopsy does not target concerning areas as they are rarely seen on ultrasound. Therefore, this technique only allows a sampling of the prostate and can provide incorrect information in one of three cases. If the patient elects active surveillance, they will undergo routine biopsies every 1-2 years to see if the cancer is growing or becoming more dangerous. I propose that by using MRI (magnetic resonance imaging) along with a simple blood test before the confirmatory biopsy, the men can avoid prostate biopsies in the future by repeating the MRI. Additionally, the use of the MRI, blood tests, or sample of the tissue already taken at the time of the biopsy can be used in an online calculator to predict more dangerous cancers in specific patients. Principal Investigator Career Goals: My future career goals are to be a clinical research team leader able to take new discoveries to patients. It is my long-term goal to become a leader in the field of urology as a clinical researcher with a focus in prostate cancer. An intermediate goal is to become competitive for research funding. Herein, I focus to improve the lives of patients with prostate cancer by implementation of imaging and biomarkers to help determine future risk of the prostate cancer progression on an individual basis. The project of this Physician Research Training Award is titled "Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment." The award provides a platform for me to actively pursue my interests of imaging in prostate cancer while preparing me to efficiently run large clinical trials. Imaging in prostate cancer is likely to be a focal point in the future; however, urologists need to understand the strengths and limitations of MRI imaging technology. I hope to be a fulcrum between radiologists, urologists, and basic scientists investigating the use of MRI and its clinical utility. Based on my project, I have developed a training plan to address three areas of improvement: (1) translational research (i.e., taking new discoveries to patients), (2) clinical trial development, and (3) MRI as a biomarker for risk assessment in prostate cancer. The training program will incorporate a certificate in translational research, national meetings, involvement in current prostate cancer clinical trials, and formal didactic teaching in MRI. I have also outlined a mentorship plan to provide oversight in accomplishing these goals. The research plan I have proposed has three specific aims that are intricately entwined within the training proposal and mentorship: Aim 1: Prostate MRI to predict progression on active surveillance. Aim 2: Biomarker testing to predict active surveillance outcomes. Aim 3: Incorporation of imaging and biomarker data into the PROMISS calculator. Applicability: The research applies to any patient who elects active surveillance as his prostate cancer treatment strategy. Ideally, MRI can be done after the diagnosis of prostate cancer prior to the confirmatory biopsy to be followed over time. However, the MRI could be done at any time during the course of active surveillance and monitored as additional information to the current regimen. Moreover, the MRI could also be used in other populations in screening who have high risk for prostate cancer or following patie
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510441
Entities
People
- Michael A Liss
Organizations
- United States Army
- University of Texas Health Science Center at San Antonio