Detection of Aggressive Prostate Tumors Using Novel PET and Hyperpolarized 13C Probes Targeting Interstitial Acidity
Abstract
Scientific Objective and Rationale: Prostate cancer is a disease with a notoriously variable course. Some prostate cancers are slow-growing, indolent tumors, which will never progress or threaten the lives of the people who carry them. However, other prostate tumors are very aggressive, lead to widespread disease, and ultimately prove fatal. Treatment of these different types of cancer is also variable. For example, patients with the indolent tumors may undergo active surveillance, in which they do not undergo treatment. Instead, they will have blood tests, and periodic imaging and biopsy to track if their tumor is growing. In contrast, patients with the aggressive tumor types should undergo definitive treatment of their tumor, either with surgery or radiation. Unfortunately, differentiating between these types of disease is a major challenge in oncology, and some patients with low-grade tumors undergo unnecessary surgery or radiation (exposing themselves to potential side effects such as incontinence and impotence), while some patients who are on active surveillance have hidden aggressive tumors, which will ultimately become life-threatening. The goal of this proposal is to develop new imaging methods to enable physicians to know if their patients carry aggressive or indolent tumors. The new imaging methods outlined in this proposal test the presence of acid in the tumors, which is known to be associated with aggressive tumors for other cancers, such as renal cell and breast cancer. When the experiments in this proposal are completed, they set the stage for the use of these techniques in patients. Training Plan: My long-term goal is to be a physician scientist, splitting my time between being a clinical radiologist (subspecialized in nuclear medicine) and in scientific research in prostate cancer. I have benefited, and will continue to benefit, from training from my outstanding prostate cancer research mentors, Drs. John Kurhanewicz and David Wilson. Dr. Kurhanewicz is an experienced prostate cancer researcher who has been a pioneer in applying magnetic resonance imaging (MRI) to patients with prostate cancer. Dr. Wilson is a more junior faculty mentor, who is developing cutting-edge MRI and positron emission tomography (PET) techniques for imaging prostate cancer. These mentors, and other coworkers in their laboratories, have much to teach me about MRI, PET, and prostate cancer research. I have enjoyed working with them closely over the last few years, and look forward to learning more from them in the years to come. Once the work in this application is completed, it will lay the groundwork for my future career in imaging and prostate cancer research. Applicability: The long-term application of these techniques will be to allow physicians to distinguish between the presence of low- and high-grade tumors in patients with prostate cancer. This key distinction will allow patients to select the type of treatment that is most applicable for them, whether it is active surveillance, surgery, radiation, or medical treatments. We expect that these techniques will be helpful in two main groups of patients. The first is those patients who have new diagnosis and who are deciding their initial therapy. The second group is those who already have more aggressive disease, including metastases. In both cases, I anticipate that the imaging methods outlined in this application will help these patients select the right treatment. Once the experiments in this proposal are completed, I predict that we will be able to perform first-in-man imaging within 2 years, as much of the key groundwork will already be completed. A second area in which this research will be helpful is in developing new drugs. The presence of acid in tumors is known to be associated with aggressive tumors in renal cell, breast cancer, and others. However, this has not been tested in patients with prostate cancer before. Since this has been an
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610389
Entities
People
- Robert R Flavell
Organizations
- United States Army
- University of California, San Francisco