Improving Outcomes in Prostate Cancer Based on Comorbidities: Developing Personalized Medicine
Abstract
If prostate cancer spreads outside of the prostate, there are several different treatments available to treat the disease. For decades, hormonal blockade of testosterone and other androgens has been an effective treatment and, starting in 2010, new drugs were available that can provide additional reduction of androgens to treat prostate cancer that has become resistant to hormone therapy. These second-generation anti-androgens are pills, are highly effective, and have fewer side effects compared to traditional chemotherapy. These newer medicines have never been compared head-to-head and, therefore, most doctors have little preference in therapy. These medicines are taken daily, and patients who are eligible for this treatment have more medical problems such as diabetes, heart disease, and kidney trouble, making it likely that there are more side effects than was observed in clinical trials. Additionally, these medicines each work slightly differently; therefore, there might be differences in outcomes and understand the side effects and duration of treatment of patients with medical disorders could help select the best treatment. The first goal of this project to understand the side effects of these anti-androgens in Veterans across the nation. Many Veterans have chronic medical diseases such as diabetes and high blood pressure and have a variety of racial and ethnic backgrounds, including many African-Americans. Therefore, for prostate cancer, studying Veterans provides the ideal population to understand side effects in a diverse and vulnerable population. Additionally, because many Veterans use the Veterans Health Affairs, which has complete medical records, we will be able to collect the most complete assessment of side effects of these medicines. The second goal of this project is to understand the relationship between medical problems, prostate cancer treatments, and side effects. We want to know what medical disorders increase risk for side effects and decrease the duration of prostate cancer treatment and survival in this deadly form of prostate cancer. Also, we will compare these important outcomes between different treatments to see if there are indications as to which treatment may be better. Lastly, we will use traditional and modern artificial intelligence techniques to compare treatments in patients with medical disorders to create a treatment selection tool that could select the best treatment for a patient based on their medical disorders and other characteristics. We anticipate that this research will have significant benefit to patients with prostate cancer by providing the largest study of patients of prostate cancer resistant to hormone therapy. Furthermore, we may be able to identify which treatments are ideal for patients with different medical disorders, creating personalized medicine for prostate cancer that could reduce side effects, increase survival, and improve quality of life. Additionally, because we are studying Veterans from across the country which includes patients from many different racial and ethnic backgrounds, we hope to be able to reduce disparities in treatment outcomes in prostate cancer through enhanced understanding of side effects and better selection of treatments. The principal investigator on this project, Dr. Martin Schoen, is a medical oncologist at St. Louis VA Medical Center and Saint Louis University. He has training in outcomes research and public health and has conducted many observational studies of cancer patients. His career goal is to identify problems in cancer care through large data research in real-world patients, then propose methods to improve on that care. He has created a team of experts in large data research and artificial intelligence to support and guide this work and will receive additional training in these methods during this study.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210602
Entities
People
- Martin W Schoen
Organizations
- United States Army