Innovative Prostate Cancer Treatment Model Developed from Clinical Data

A research team at the Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, has initiated a groundbreaking project aimed at enhancing treatment strategies for prostate cancer patients by leveraging extensive clinical data. Led by Dr. Alan Pollack, the team is focused on developing a predictive model that utilizes advanced MRI techniques and liquid biopsy markers to inform treatment decisions for patients diagnosed with intermediate to high-risk prostate cancer.

Historically, patients diagnosed with intermediate to high-risk prostate cancer have faced substantial challenges, including a relapse rate of approximately 30% to 40% within five to ten years post-treatment, according to the National Cancer Institute (NCI). Current treatment protocols typically involve androgen deprivation therapy (ADT) in conjunction with radiotherapy. However, ADT is associated with a range of significant side effects, including increased risk of thromboembolic events, metabolic syndrome, and erectile dysfunction, which can adversely affect the patients' quality of life.

Dr. Pollack's team, which also includes co-principal investigators Dr. Benjamin Spieler and Dr. Radka Stoyanova, recently secured a five-year, $2.6 million R01 grant from the NCI to further develop their model. "What we’re trying to do is gather all this multimodal data and find early measures of treatment response that can guide early intensification or de-intensification of treatment," said Dr. Spieler, an assistant professor of radiation oncology at the Miller School.

Key to this innovative approach is the integration of multimodal data, which includes MRI imaging and liquid biopsy samples. Dr. Stoyanova, who leads the imaging and biomarkers research, emphasized the significance of quantitative imaging in identifying tumor characteristics that dictate treatment outcomes. "Using MRI images collected before and after radiation treatment, we can better identify the highest-risk cancers," stated Dr. Stoyanova. This data will not only be sourced from Sylvester’s clinical trials but will also incorporate external datasets from the NCI to validate findings.

The research aims to personalize treatment for prostate cancer patients, potentially reducing the duration of hormone therapy based on individual responses detected through early biomarkers. This tailored approach could significantly mitigate the adverse effects associated with prolonged hormone treatment. Dr. Stoyanova elaborated, "If a patient is responding positively to long-term androgen deprivation therapy, based on the biomarkers we develop, the doctor could decide to decrease the length of treatment, thus saving the patient from unpleasant side effects."

An essential aspect of the initiative is the UAdapt protocol, which will be implemented towards the end of the five-year grant. This protocol will allow researchers to modify treatment intensity for enrolled patients based on their response. The ultimate goal is to create a model that can be utilized not only at Sylvester but also in clinical settings around the world, thereby broadening access to state-of-the-art prostate cancer treatment.

Dr. Pollack noted the foundational role that previous clinical trials, which began over 15 years ago, have played in the development of this new model. These trials incorporated the collection of MRI imaging data and blood biosamples aimed at improving responses to treatment. "We anticipated the importance of correlative studies built into our clinical trials, making our strategy a perfect fit for this NCI-funding mechanism," Dr. Pollack stated.

The implications of this research are profound, as they could transform the landscape of prostate cancer treatment, enhancing the quality of care and potentially improving survival rates for patients globally. The research team is optimistic about the long-term vision of their work, highlighting the commitment to discovering advancements that can benefit communities beyond their immediate clinical environment. "This is why we enter science or become physicians, to have a discovery or study that we can then give back to our community," Dr. Spieler concluded.

As the project progresses, the Sylvester Comprehensive Cancer Center aims to provide physicians with the tools necessary to make informed decisions about prostate cancer therapies, paving the way for a future where treatment is not only more effective but also more humane.