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.


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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Written by Stephen J. Freedland, MD
In castration-resistant prostate cancer (CRPC), tumor progression occurs despite low, castrate levels of serum testosterone.1 Non-metastatic CRPC (nmCRPC) is characterized by the absence of detectable metastases and prostate-specific antigen (PSA) levels that continue to rise even though patients continue to receive androgen-deprivation therapy.2 Patients with nmCRPC are at risk of progression to metastatic disease and nmCRPC patients with shorter PSA doubling time (PSADT) have increased risk of metastasis and poorer clinical outcomes.3–5
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.
Immense resources have been dedicated to identifying innate biological differences between Black and White men that could explain the disparities in prostate cancer with the results being equivocal at best. Prostate cancer, the most commonly diagnosed solid organ cancer in men, represents perhaps the greatest disparity in outcomes in oncology.1 Few studies, if any, have attempted to evaluate the association between prostate cancer outcomes and social determinants of health (SDOH).
The costs incurred for healthcare have historically been opaque, such that patients are often unaware of their treatment costs until their bills come due. To ameliorate this, the Centers for Medicare and Medicaid Services issued a mandate that starting on January 1, 2021, all hospitals in the United States must make the pricing of provided services publicly available on their hospital websites in machine-readable files. We used a dataset that aggregates these publicly-displayed prices to investigate the landscape of pricing for prostate cancer care.
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