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2024 Zuckerman Family Foundation – PCF Young Investigator Award

ProsGATE: Geriatric Assessment and Technology Evaluation in Prostate Cancer

Nabiel Mir, MBBS
University of Chicago

Mentors: Russell Szmulewitz, MD; Megan Huisingh-Scheetz, MD, MPH; Alicia Morgans, MD, MPH

Description:

  • Prostate cancer disproportionately affects older men, who often present with baseline frailty, impacting 30-70% of those with metastatic disease. Frailty increases morbidity risks from metastatic prostate cancer therapies. However, traditional geriatric assessments recommended to mitigate these risks are underutilized due to being resource and time intensive. 
  • Dr. Nabiel Mir aims to address this gap by piloting accessible, scalable tools to assess treatment-related risks in older patients at greater risk of negative effects from prostate cancer therapies. 
  • The relationship between serious adverse events and baseline Cancer and Aging Risk Group (CARG) score, a tool that predicts risk of experiencing severe or fatal toxicity due to chemotherapy, will be determined in older adults with metastatic hormone sensitive prostate cancer (mHSPC) undergoing treatment with androgen-targeted therapies.
  • Whether a wearable device which tracks biometrics including step count, and lean and fat mass, can predict geriatric deficits’ progression will be determined. 
  • The study will also investigate whether clonal hematopoiesis, an age-related abnormal expansion of immune stem cells that often tracks with adverse health outcomes, increases during mHSPC treatment among those who experience cardiovascular serious adverse events. 
  • If successful, this project will validate innovative resource-efficient tools to identify older mHSPC patients at heightened risk of negative effects from androgen-targeted therapies, enhancing treatment decision-making and health outcomes.

What this means to patients:
Androgen-targeted therapies are associated with various negative side effects, and risks for these are increased in older, frail patients. Dr. Mir’s project will evaluate several tools including the Cancer and Aging Risk Group (CARG) score, wearable-derived metrics of physical activity and body composition, and clonal hematopoiesis markers,as potential biomarkers for predicting adverse mHSPC therapy outcomes. This research will enable individualizing therapeutic modality and intensity for vulnerable older adults facing mHSPC.