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2023 Debbie & Mark Attanasio – PCF Young Investigator Award

Eliminating Disparities in Molecular Testing with Comprehensive Liquid Biopsy Analysis

Amy Taylor, MD
University of Wisconsin

Mentors: Joshua Lang, Kosj Yamoah, Elisabeth Heath

Description:

  • Black patients experience a dramatic disparity in prostate cancer incidence and mortality compared to White patients, yet Black patients have been the least represented in studies on molecular mechanisms that drive prostate cancer progression and treatment resistance.
  • Disparities in equitable molecular testing have a cascading impact and create a knowledge gap that reinforces inaccurate assumptions regarding genomic testing and diminishes the odds of identifying crucial biomarkers needed to identify new therapeutic targets and features of aggressive disease in underrepresented populations.
  • Amy Taylor and team are conducting a clinical trial to perform comprehensive genomic and molecular analyses of metastatic prostate cancer from Black patients to identify pathways driving tumor progression and treatment resistance and identify new therapeutic targets. These studies will use circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) from liquid biopsy (blood) samples collected over time.
  • Baseline genomic alterations that predict aggressive disease will be identified.
  • Comprehensive molecular profiling performed after progression on first line therapy will be used to establish a biomarker predictive of treatment resistance. Clinical features of resistant disease will also be identified.
  • Molecular testing results will be compared between liquid biopsy and tumor tissues samples, to evaluate for data concordance.
  • This trial will include patients from the VA, and the team will evaluate whether tissue testing frequency in this VA patient population differs from the VA National Precision Oncology Program.
  • If successful, this project will provide rationale for longitudinal liquid biopsy analysis in the management of prostate cancer and will establish an approach that serves to eliminate disparities in access to molecular testing for Black patients Additionally, this project will identify blood-based biomarkers that are predictive of treatment resistance and will be the first large multi-institution study to evaluate molecular drivers of treatment resistance in this patient population.

What this means to patients: Black patients experience disparately higher rates of prostate cancer incidence and mortality, yet are underrepresented in molecular testing and molecular profiling studies. Dr. Taylor and team are leading a clinical trial to enroll black patients with metastatic prostate cancer and perform molecular analyses of liquid biopsy samples, to identify molecular drivers and biomarkers of disease progression, outcomes, and treatment resistance. This will increase knowledge of genomics in prostate cancer, and provide a durable means by which to eliminate access barriers to molecular testing and reduce health disparities in underserved patient populations.