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2024 David H. Koch Charitable Foundation – PCF Young Investigator Award

Leveraging Multimodal Data to Further Define and Target Oligometastatic Prostate Cancer

Edward Christopher Dee, MD
Memorial Sloan Kettering Cancer Center

Mentors: Puneeth Iyengar, MD, PhD; Dana Rathkopf, MD; Sean McBride, MD, MPH

Description:

  • Traditional management of metastatic prostate cancer consists of maintaining patients on systemic therapies until disease progression. However, metastasis-directed radiation may improve not only palliation but extend survival, particularly among patients with oligometastatic cancer, a disease state generally defined as having ~5 or fewer metastases.
  • Prior clinical trials have found that metastasis-directed radiation could improve outcomes in patients with oligometastatic cancer, however these studies defined oligometastatic cancer by the number of metastases. Less is known about the biology of oligometastatic prostate cancer, how metastasis-directed radiation delays disease progression, and how racial health disparities may be mitigated in this clinical setting.
  • Improving our understanding of oligometastatic prostate cancer biology and associated clinical implications is critical.
  • In this project, Dr. Edward Christopher “Chris” Dee will build a multimodal dataset of patients with oligometastatic prostate cancer, including sociodemographic, clinical, treatment, radiologic, and genomic variables. The relationship between these variables and clinical outcomes such as overall survival and time to disease progression will be investigated, to guide patient selection for metastasis-directed radiation.
  • The impact of metastasis-directed radiation in extending progression-free survival and slowing progression to castration resistant prostate cancer (CRPC) will be investigated.
  • Whether and how race and socioeconomic status are associated with outcomes of metastasis-directed radiation, and how to reduce racial disparities in patients with oligometastatic cancer will be determined.
  • If successful, this project will improve our understanding of the biology of oligometastatic prostate cancer and help to identify the patients most likely to benefit from metastasis-directed radiation. 

What this means to patients: Oligometastatic prostate cancer is a disease state in which patients have a limited burden of metastases and are considered treatable (and potentially curable) by metastasis-directed radiation. Dr. Dee’s project will determine the relationship between various clinical and sociodemographic factors that impact outcomes with metastasis-directed radiation. The work aims to improve our understanding of the biology of oligometastatic prostate cancer, the clinical impact of metastasis-directed radiation, and the selection of patients who may benefit the most from metastasis-directed radiation. This work will inform clinical practice and future trials aimed at improving the care of this large and diverse patient population, in a manner that is also globally generalizable, with the goal of improving outcomes and reducing disparities in prostate cancer.