Identification of Novel Features to Assess Risk and Improve Therapeutic Decision Making for Prostate Cancer Through a Novel High-Parameter Imaging System
Abstract
Scientific Objective and Rationale: Approximately one in seven men is diagnosed with prostate cancer, accounting for over 160,000 new cases and 26,000 deaths annually in the United States. Veterans who were exposed to Agent Orange during the Vietnam War may be at increased risk for more aggressive forms of prostate cancer. Information gathered from clinical testing and examination of tumor samples form the basis for the decision to either continue careful monitoring of the cancer or pursue medical treatment. Treatment for prostate cancer can include surgery, radiation treatment, chemotherapy, and immunotherapy. Treatment outcomes are highly variable, and we have a limited understanding of why results are different from patient to patient. We need to be able to improve the assessment of a patient’s risk for progression that goes into a decision to either monitor the disease or intervene with treatment. Similarly, we need to understand the risk of recurrence following prostate removal surgery. We already take samples of the tumor to evaluate the risk of cancer progression and following surgery. However, the information obtained from these samples is limited. If we could get more information from these same samples, it might help us better determine which tumors are aggressive and the likelihood of recurrence after surgery and response to different treatments. Both areas will help patients and their doctors make more informed decisions. In this project, we propose to develop and test a novel combined analysis approach that would greatly multiply the information from existing tumor samples and provide the opportunity to both identify new markers to measure risk of progression at diagnosis and risk of recurrence after surgery. We will apply this approach to biopsies from prostate cancer patients to generate highly detailed maps of cancer and immune cells in the tumor using two cutting-edge imaging technologies. Together, these two measures, matched sample by sample, will build what we call a comprehensive “molecular portrait” of the tumor and surrounding environment, with a level of detail never before observed in prostate cancer. By comparing the features of the “molecular portraits” with patient outcomes, we may be able to identify features that correspond to cancer progression and treatment outcome. In other words, we would be able to better recognize the “face” of dangerous prostate cancers. The long-term goal is to verify the broad utility of these distinguishing features so that they can be developed into tests that can be implemented in standard hospital laboratories. In this way, we can help to determine whether to treat the cancer and how best to treat it, especially for use of immunotherapy. Human prostate cancer samples will be obtained from the MGH Genitourinary Oncology Tumor Bank, founded and managed by the Collaborating Investigator. Access to this unique bank of tissues makes this study possible. Ultimate Applicability of Research: The ultimate applicability of this research is to help patients by providing new tools and information to doctors and researchers to better understand how to treat prostate cancer. First, the information gained from the technologies could lead directly to the development of simpler tests for the clinic that offer patients more precise diagnoses and improve the treatment decision process for patients and physicians. Second, the technology could help us understand why some patients have recurrent tumors and others do not, so that extra treatments can be used sooner after surgery, before the tumor comes back. These are particularly important given the life-altering side effects that surgery and therapy can have for patients. Third, results from application of the technology may provide new insights that will improve the understanding of how prostate cancer progresses and thereby aid in the development and evaluation of new therapies. Components of the technol
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010301
Entities
People
- Patrick Reeves
Organizations
- Massachusetts General Hospital
- United States Army