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2024 Bayer – PCF Young Investigator Award

Identifying Prostate Cancers with Lethal Potential in Active Surveillance Candidates Using a Liquid Biomarker and Digital Pathology

Claire de la Calle, MD
University of Washington

Mentors: Daniel Lin, MD; Tamara Lotan, MD; Michael Haffner, MD, PhD

Description:

  • Active surveillance is the standard of care for low-risk prostate cancer, but is underutilized in the United States, often out of fear of missing the window of opportunity for cure before metastatic spread. Biomarkers that can identify active surveillance patients at risk of developing lethal disease are needed to offer timely and curative treatment to the highest risk patients and to promote adherence to active surveillance in patients with truly low-risk disease. 
  • Because prostate cancer is heterogeneous and accurate sampling (biopsy) of the prostate remains difficult, effective biomarkers for active surveillance need to account for both biopsied and unbiopsied sites of disease.
  • Dr. Claire de la Calle is creating a new comprehensive risk prediction biomarker for patients on active surveillance that combines Artificial Intelligence (AI)-generated pathology risk scores from serial prostate biopsies and changes in the Prostate Health Index (PHI), a blood test that evaluates several PSA isoforms. 
  • This project will identify associations between serial AI-generated pathology risk scores and adverse active surveillance outcomes, and between PHI changes and adverse active surveillance outcomes. The AI-generated pathology risk scores will include AI-identified features including aggressive pathologies and prostate cancer-driving genomic alterations that AI has been trained to recognize based on pathology slides.
  • The AI-generated pathology risk scores will be combined with PHI changes to develop a comprehensive risk prediction biomarker for patients on active surveillance. 
  • If successful, this project will develop a new biomarker that will provide accurate risk prediction for patients on active surveillance and provide insight on disease biology beyond human Gleason grading and other clinical parameters.

What this means to patients: Active surveillance is recommended for patients with low-risk prostate cancer. However, new biomarkers are needed to assure appropriate selection of patients for active surveillance. Dr. de la Calle is creating a new biomarker thatprovides more accurate risk prediction and insights on disease biology, which will enable identification of lethal prostate cancers when they are still curable and increase active surveillance acceptance. This biomarker would also be a broadly adoptable and cost-effective alternative to currently available biomarkers that require expertise and resources that are not widely available.