John Kurhanewicz, PhD, University of California, San Francisco
My current grants are really focused on the development and translation of new imaging
biomarkers to help people with prostate cancer, in particular, decide what to do next.
The Prostate Cancer Research Program has funded the area of hyperpolarized magnetic resonance
imaging, and that technique may really change the way we image prostate cancer—because
it gives us the ability to overcome some of the really intrinsic limitations of MRI, which
is sensitivity and specificity.
We can take a probe, an endogenous thing like Pyruvate, which is a downstream metabolic
product of glucose, and enhance this signal from it so that we can follow it all around
the body—so we can just monitor where it goes.
But more important, where it’s metabolized, and where it goes—branches off to.
And from that metabolism, we can figure out the answers to some really important questions—and
the top one is, “Is it an aggressive cancer?”
Do we need to treat it, or is it a disease that we can watch and wait?
You know it’s a very difficult disease because prostate cancer, there’s huge proportions
of patients who have indolent disease, that should probably not be treated immediately
maybe?
And people go, “Oh, why would you want to do that?”
And the answer is, is that all the treatments we have, have side effects right now, and
we’re figuring out better ways of doing this.
And so this watchful waiting period not only helps the person through maybe a period of
their life that they don’t want some of these side effects, but also opens the door
that we might be able to treat it better tomorrow.
So, all the imaging I’m talking about is magnetic resonance imaging, which is available
on every clinical scanner across the country.
What our involvement is, is improving the techniques that specifically can identify
prostate cancer, as well as to more specifically assess its aggressiveness.
Because we know we’re identifying a lot of indolent disease right now, so the $1,000
question to the patient and their doctors is whether it’s aggressive or not.
And that’s what imaging is all about—it’s detecting clinically significant disease.
And can we do it non-invasively, and can we help the patients decide whether they need
to have the whole prostate taken out, and all the consequences of that?
The DoD really played a big role in funding the preclinical studies to show that there
is value to the research.
Then we propose a very unique human tissue model that was based on correcting some of
the limitations of previous mouse models and cell models that have been used in prostate
cancer.
And that’s very hard to get funded by the NIH, and the DoD went out with a synergistic
award and funded us on this.
And we developed the platform where we could look at living, human prostate tissue, taken
out of men at the time of surgery—radical prostatectomy—that we could inject these
probes into and look at the efficacy of how well they reported the parameters we were
interested in, such as aggressiveness, response to therapy, and things of that sort.
And that was huge because that, I think, was one of the really big parameters that pushed
us over the edge to get this FDA IND approval for our first clinical trials.
Any time we see things that are taken from the bench top into the clinic and actually
help patients is so gratifying.
And particularly for me, I’ve seen several imaging techniques in the setting of prostate
cancer taken into the clinic and directly help patients.
Now with this new technique, I think we could change things and make them—I mean very
much faster and much more specific.
So you know, it’s kind of fun being involved a second time around in a technique going
into patients.
And you know the DoD funding was so critical to get the initial data to make this happen.