Since its beginning in 1997, the PCRP has been committed to supporting the next generation of prostate cancer investigators, offering funding mechanisms designed to encourage physicians and scientists to pursue careers in prostate cancer research. On August 4-5, the Prostate Cancer Research Program (PCRP) hosted IMPaCT 2016, a meeting intended to provide these researchers with an opportunity to discuss their research with their peers, leading prostate cancer experts, and survivors, and to foster new collaborations that will facilitate research aimed at addressing critical issues in prostate cancer.    

IMPaCT 2016 showcased the incredible research being done by 58 PCRP-funded early-career investigators with current PCRP Physician Research Training, Idea Development, or Health Disparity Research Awards.  They presented their work through platform presentations and a poster session (see program book for abstracts).  The meeting also featured keynote presentations from leading prostate cancer experts on topics ranging from tumor biology, treatment resistance, and genomics, to health disparities in prostate cancer and critical issues important to prostate cancer survivors.  Through keynote and platform presentations, panel discussions, and a poster session, IMPaCT 2016 provided a forum for early-career investigators, established scientists and clinicians, and prostate cancer survivors to discuss current topics in prostate cancer and envision the future of prostate cancer patient care. The meeting also offered young investigators insights into the unique aspects of the PCRP’s peer and programmatic review grant application process and advice on how to build strong collaborations with patients, scientists, and clinicians in pursuit of the next breakthroughs in global efforts to conquer prostate cancer.

Keynote presentations by Dr. Karen Knudsen and Dr. Christopher Logothetis each highlighted the role of androgen receptor (AR) signaling in prostate cancer.  Noting the crosstalk between AR-signaling and DNA damage repair, Dr. Knudsen described efforts by her team at the Thomas Jefferson University Sidney Kimmel Cancer Center to use PARP inhibitors to suppress resistance to AR-directed therapy in patients with castrate-resistant prostate cancer (CRPC).  They discovered that PARP1 inhibitors are selectively effective against CRPC, and they are now pursuing rational combination therapies in clinical trials.  Dr. Logothetis of the MD Anderson Cancer Center discussed clinical trials that are investigating the emergence of AR-directed treatment resistance in CRPC.  Using novel imaging technologies and biomarkers, he and his team are hoping to both detect when and determine how patients develop resistance to treatment, so that patients can receive timely and rational combination therapeutic interventions to break the cycle of treatment resistance associated with CRPC.

Dr. Peter Choyke’s keynote presentation provided an overview of the variety of ways that novel noninvasive imaging techniques are being applied to prostate cancer care such as detecting localized disease, aiding in active surveillance, monitoring biochemical recurrence, identifying tumor margins during surgery in real-time, and more.  Current research efforts are aimed at improving image processing for computer-aided diagnosis and developing new imaging tests using novel magnetic resonance imaging (MRI) pulse sequences and positron emission tomography (PET) contrast agents.  While the PSA test is a sensitive method to monitor for prostate cancer recurrence, it cannot identify the location of the recurrent tumor(s) whereas with whole-body imaging techniques, such as PET/MRI, recurrence may be detected and monitored more effectively.  He noted that transitioning these new technologies from the lab to the clinic is a major challenge and a major opportunity for young prostate cancer investigators.

Dr. Peter Carroll and Dr. Howard Scher, both recipients of PCRP Transformative Impact Awards, delivered keynote presentations addressing patient survivorship, biomarkers, and therapy.  Dr. Carroll specifically addressed the problems of overdetection and overtreatment in prostate cancer.  He and his team at the University of California, San Francisco are working to identify valuable factors beyond prostate specific antigen (PSA), Gleason score, and age at diagnosis that can help distinguish between patients whose prostate tumors are likely to develop into aggressive lethal disease requiring immediate treatment, and those whose tumors are low risk and thus are good candidates for active surveillance.  He concluded that we need to “match the treatment to the patient and his cancer” and that “all treatment options require greater scrutiny.” Once the decision to treat is made, choosing the right treatment is of utmost importance; this was the subject of Dr. Scher’s presentation.  He focused on the utility of using circulating tumor cells (CTCs) and AR mutations, particularly one called AR-V7, to inform the decision on whether to try antiandrogen therapies like Xtandi® or Zytiga®, or whether cytotoxic therapy, e.g., docetaxel, is apt to be more effective.  He and his team at Memorial Sloan Kettering Cancer Center have shown that the prevalence of AR-V7 increases with increased exposure to antiandrogen therapy and is associated with shorter overall patient survival.  Treatment decisions are among the most critical ones prostate cancer patients will face, and research that offers the best possible information for decision making will have a major positive impact in their lives.

The topic of health disparities in prostate cancer remains a key focus for the PCRP, and keynote presenter Dr. Folakemi Odedina of the University of Florida has been the recipient of several Health Disparity Research Awards.  In her presentation, she noted that the racial disparity gap has narrowed over the past decade, due to efforts such as community-based intervention; however, more work remains to be done.  Dr. Odedina emphasized that black men are not a monolith, highlighting the different genetic and environmental backgrounds as well as differences in prostate cancer incidence among black men of US, Caribbean, or sub-Saharan African descent.  She also noted that inequitable access to early detection and high-quality treatment continues to translate to diminished quality of life for many black men.  Dr. Odedina laid out her vision for multilevel, translational, and global research efforts, focusing on team science and collaborative research.  She highlighted steps that are currently being made in that direction, including a drive to increase the diversity of genome-wide association studies (GWAS), which currently stands at about 97% white and 3% black.

Also attending the IMPaCT meeting was Dr. Jerry S.H. Lee, a leading member of the White House Cancer Moonshot Task Force and Deputy Director of the National Cancer Institute’s (NCI) Center for Strategic Scientific Initiatives (CSSI), who discussed efforts to empower the entire cancer research community to develop a better understanding of cancer biology and leverage that knowledge for patient benefit.  Dr. Lee emphasized the importance of large, multi-disciplinary teams with trans-disciplinary training to transform cancer drug discovery and diagnostics.  Highlighting the genomic advances in the underlying causes of primary untreated tumors (Cancer Genome Atlas - 12,000 patients), he went on to explain the great potential for new insights by combining cancer proteomic and genomic data (Clinical Proteomics Tumor Analysis Consortium) to accelerate progress in cancer prevention, diagnosis, treatment, and care, ultimately to end cancer as we know it.

As the meeting progressed, it became more and more evident how much the field of prostate cancer has progressed in recent years, to the betterment of patients.  It was also clear that this progress was largely driven by collaborative, team science, multidisciplinary, and multi-institutional approaches toward solving the major issues impacting prostate cancer patients. Perhaps the most inspiring moment of the meeting was delivered by Mr. Wesley Sholes, prostate cancer survivor, advocate, and member of the PCRP Programmatic Panel.  Mr. Sholes delivered an emotional speech in remembrance of the men who had not survived their encounter with prostate cancer and with hope for men today and in the future who are relying on the fruits of PCRP-supported research to increase survival and enhance the well-being of men with prostate cancer.  Rather than lead the meeting in a traditional moment of silence, Mr. Sholes encouraged all in attendance to join him instead in repeating the refrain, “Never, never, never give up!”

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