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2022 National Cancer Institute – PCF Young Investigator Award

Identifying Tumor Microenvironmental Factors Associated with Oncologic Response to Irreversible Electroporation Focal Therapy for Prostate Cancer

Michael Rothberg, MD
National Cancer Institute (NCI)

Mentors: Peter Pinto, MD, Adam Sowalsky, PhD

Description:

  • Contemporary options for management of primary prostate cancer involve either active surveillance, surgical removal, or radiation therapy delivered to the entire prostate gland.
  • Focal therapy is an evolving treatment approach for select patients whereby specific portions of the prostate proven to contain cancer on biopsy are selectively treated sparing the involved prostate. Focal therapy typically has less side effects than current treatments directed towards the entire gland. However, focal therapies have been associated with rates of in-field recurrence between 16 to 50%, thus improved ways to select patients for this treatment are needed.
  • Dr. Michael Rothberg is investigating the effects of the irreversible electroporation (IRE) focal therapy approach in prostate cancer to understand whether and how tumor microenvironmental (TME) factors may mediate resistance to IRE. IRE ablates tumor cells using a non-thermal mechanism that allows for better preservation of the surrounding tissues.
  • In this project, Dr. Rothberg will use samples from patients undergoing IRE to characterize molecular changes during treatment and identify factors that influence the response to IRE. This data will be used to develop biomarkers to predict outcomes from IRE and to identify which patients have a higher likelihood of good outcomes with IRE.
  • If successful, this project will result in the development of biomarkers that can aid in selecting patients for whom IRE may be appropriate as well as improve understanding of mechanisms of resistance to IRE focal therapy.

What this means to patients: Focal therapies have the potential to improve patient outcomes by reducing side effects from treating primary prostate cancer, however it is unclear which patients for whom this treatment approach is appropriate. Dr. Rothberg and team will define the biology of tumor responses and treatment failure to IRE focal therapy and develop biomarkers to identify patients who are likely to benefit from this approach.