Prostate cancer (PCa) is the most commonly occurring non-cutaneous malignant cancer in the United States. African American men (AAM) are known to have the highest rates of PCa, present with advanced disease, and have the greatest mortality rates as compared their Caucasian counterparts. Despite the importance of PCa in AAM, we are still unable to make optimal PCa treatment decisions in this group of men. As a result, many clinicians are uncertain about the value of the currently available tools that guide treatment decisions for AAM with PCa. As an African American physician scientist actively involved in the management of PCa patients, I have witnessed the disproportionate severity of disease burden among AAM with PCa. I truly appreciate the importance of additional research in this field with the goal of improving outcomes in AA population. My goal is to help reduce, and ultimately eliminate, the racial disparity in outcomes in PCa.

The purpose of this project is to provide insights about of the underlying causes of racial disparities in PCa outcomes and ultimately improve the current treatment recommendations in AAM with PCa. This project directly addresses the need to effectively identify aggressive disease in specific individuals or groups based on their unique characteristics. The research portion of this project will have two basic goals. The first goal will be to develop a new predictive tool, also known as a nomogram, that will improve the ability to predict aggressive disease and make improved treatment decisions among AAM. This nomogram will include biomarkers predictive of aggressive PCa in addition to the predictors currently used in existing nomograms. The new nomogram's predictive accuracy will be evaluated using a large PCa database. The second goal will be to take steps towards the implementation of this new nomogram into decision making among physicians in the clinical setting.

The training component of this project will utilize the available resources at the Thomas Jefferson University Hospital (TJUH), the University of Pennsylvania Health System (UPHS), and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Leading scientists and physicians at these institutions will serve as project mentors to assist with training and project execution. Training will include educational programs through TJUH's Kimmel Cancer Center lecture series, their weekly Genitourinary Pathology Conference, monthly Prostate Cancer Working Group, and monthly Prostate Cancer Seminar Series. Additionally, the program will enable me to obtain an in-depth understanding of nomogram development, biomarkers, and cancer epidemiology through courses offered at the UPHS. These educational resources and training combined with close guidance from my mentors will help me develop a novel nomogram that improves in the ability to identify AAM men with aggressive PCa. Additionally, the results of this research project will be immediately translatable to impact the decision-making process among physicians when recommending treatment options to "at-risk" individuals or group -- a step towards personalized medicine.