An Introduction to the UroToday “Prostate Cancer Translational Research” Center of Excellence

Andrea Miyahira | March 07, 2023

Over the past several decades, significant strides have been made in the development of new treatments for prostate cancer.  Twenty years ago, the only option for patients with metastatic castration-resistant prostate cancer (mCRPC) was to continue androgen deprivation therapy (ADT), despite diminishing efficacy; today, there are over a dozen treatment options and combinations for patients with advanced prostate cancer. These new treatments and the advent of PSA screening have reduced prostate cancer mortality rates by over 50% since 1993; however, an estimated 34,700 patients in the U.S. and 375,000 globally are still dying from prostate cancer each year. 1, 2 Our work is not yet done.

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Andrea K. Miyahira, Ph.D

Dr. Andrea Miyahira, Ph.D is the Senior Director of Global Research & Scientific Communications at the Prostate Cancer Foundation (PCF), where she directs PCF’s global scientific knowledge exchange program and production of scientific publications and communications, and collaborates in the oversight of PCF’s prostate cancer research awards portfolio. Dr. Miyahira has a Ph.D. in cancer-immunology, and in depth-knowledge of basic, translational, and clinical oncology research.

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Clinical Conversations by Experts
Physician-Scientist Commentaries
Peer-reviewed Abstract Supplemental Commentaries
Written by Neal Shore et al.
Results from a recent prostate cancer germline genetic testing (GGT) study provide strong evidence to support GGT for all patients with prostate cancer. The PROstate Cancer registry in Large patient population AIMed to assess efficacy in germline testing (PROCLAIM) trial investigated the impact of universal GGT in a prospective, unselected US population of patients from primarily community urology practices, where the majority of prostate cancer patient care occurs.
Written by Gavin Frame, MSc & Stanley K Liu, PhD, MD
The past few decades have been witness to significant strides in diagnostic, therapeutic, and preventative approaches that have resulted in an overall 29% reduction in cancer deaths since their height in the 1990s.1 Despite this promising trend, the 5-year survival rate of patients with metastases deriving from solid tumours remains between 5-30%,2 a bleak prognosis that reflects a critical lack of effective anti-metastatic therapies in the clinical armamentarium.
Written by Tarek Ajami, MD & Bruno Nahar, MD
Focal therapy is increasingly being used as a treatment for localized prostate cancer (PC). The widespread adoption of focal therapy faces challenges owing to the lack of standardization for patient selection criteria, treatment approaches, and follow-up protocols. We aimed to evaluate oncological outcomes, recurrence patterns, and survival after high-intensity focused ultrasound (HIFU), to discuss the lessons learned from our experience, and to propose strategies to enhance patient selection for HIFU treatment.
Written by Maria Luisa Garo, Petra Petranović Ovčariček, and Luca Giovanella
The systematic review of the current literature on efficacy and safety of [225Ac]Ac-PSMA in patients with hormone-refractory mCRPC presented an interesting clinical and methodological challenge due to the novelty of the topic, the limited number of primary studies and the quality of the currently available evidence. A total of 11 studies were selected to investigate the role of this novel radioligand in improving PSA response in mCRPC with and without prior or concurrent administration of [177Lu]Lu-PSMA [Figure 1].
Written by Jeffrey Zhong, & Pedro Barata, MD
Radionuclide therapy has shown promise in the treatment of metastatic castration resistant prostate cancer (mCRPC). Radium-223, an alpha-emitting radioisotope, was the first radiopharmaceutical to show improvements in overall survival (OS) of patients with mCRPC with bone predominant disease.
Targeted radionuclide therapy is an emerging strategy for treating genitourinary malignancies. PSMA-targeted radiolabeled molecules have shown promising results for both imaging and radiopharmaceutical therapy in prostate cancer. However, a significant fraction of patients are negative for PSMA or develop PSMA negativity during treatment, leading to a lack of response to PSMA-directed radioligand theranostic molecules. Therefore, an unmet need exists to find a biomarker that can be used as an alternative to PSMA in prostate cancer, with several promising targets now under investigation.
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by  Brandon Mahal, MD
The 2024 ASTRO Annual Meeting was host to a presidential symposium of innovations in genitourinary cancers, specifically addressing radiotherapy innovations for prostate cancer that can be implemented in contemporary practice. Dr. Brandon Mahal discussed optimizing prostate radiation dosage and precision using an MRI-defined microboost.