Weill Cornell Medicine is set to explore a potential breakthrough in prostate cancer monitoring, backed by a $4m grant from the National Cancer Institute, part of the US National Institutes of Health.
The funding will support a clinical trial aimed at assessing whether incorporating prostate specific membrane antigen (PSMA)-positron emission tomography (PET) computed tomography (CT) into active surveillance routines can lessen reliance on biopsies for prostate cancer patients.
The grant, allocated over five years with an option for a two-year extension, is focused on determining if PSMA-PET CT can identify cases of prostate cancer necessitating treatment.
This imaging modality employs a radioactive agent to detect proteins prevalent on prostate cells, particularly those affected by cancer. Although typically used to trace cancer spread in high-risk cases and track recurrence, the trial seeks to apply it to routine monitoring of low and moderate-risk patients.
Weill Cornell Medicine assistant professor and the study’s lead investigator Timothy McClure said: “We hope to use PSMA-PET CT as a less invasive and less costly alternative to biopsy in men undergoing active surveillance for low or moderate-risk prostate cancers.”
According to the New York City-based Weill Cornell Medicine, prostate cancer ranks second as a cause of cancer-related deaths among men in the US. However, many older men diagnosed exhibit low-risk forms that pose minimal threat during their lifetime.
Physicians often suggest active surveillance instead of surgical or radiation interventions to avoid adverse side effects.
Current monitoring involves regular blood tests for prostate-specific antigen (PSA) levels, MRIs, and biopsies, yet repeated biopsies might trigger infections or urinary issues, deterring many from consistent monitoring.
Dr. McClure and his team aim to assess whether adding PSMA-PET CT enhances the accuracy of prostate cancer observation while mitigating potential screening complications.
The trial will involve 200 men with low or intermediate-risk prostate cancer, who have chosen active surveillance. Participants will receive standard surveillance protocols alongside PSMA-PET CT.
Enrolment will occur at NewYork-Presbyterian/Weill Cornell Medical Center and four additional sites. Besides the NCI grant, Lantheus is also providing support, supplying the diagnostic agent for PSMA-PET CT.
In collaboration with Dr. Mert Sabuncu from Weill Cornell Medicine’s Department of Radiology Research and Electrical Engineering departments, Dr. McClure is also working on developing a machine learning algorithm to predict when prostate cancer might progress to a stage requiring treatment. Genomic data from PSA tests will aid in identifying genetic markers indicating elevated risk, potentially steering decisions towards earlier therapeutic interventions.
