Dr. Luca Valle, assistant professor of radiation oncology at the David Geffen School of Medicine at UCLA, was awarded a $2.1 million grant from the U.S. Department of Veterans Affairs (VA) to develop new methods to better understand the clinical scope and biological factors that lead to prostate cancer coming back after radiation therapy.
Prostate cancer is one of the most common cancers among veterans, with nearly half of those diagnosed receiving radiation therapy to treat the disease. Radiation therapy is as effective as surgery for curing prostate cancer, but some individuals may experience a recurrence of the disease, known as radiorecurrent prostate cancer, which can pose a serious health risk depending on where the cancer returns
“Significant data exists for how to identify, risk-stratify, and manage prostate cancer that comes back after radical prostatectomy, but there is considerably less data to guide us on how best to address prostate cancer that comes back after radiotherapy,” said Valle, who is an investigator at the UCLA Health Jonsson Comprehensive Cancer Center and staff physician at the Greater Los Angeles VA Healthcare System. “Given improvements in our diagnostic imaging capabilities, localized intraprostatic radiorecurrent prostate cancer is a clinical entity that is being encountered more and more frequently. This project aims to address existing gaps in knowledge by leveraging precision oncology applications to better predict radiorecurrent outcomes.”
Radiorecurrent prostate cancer requires precise diagnosis and a host of other clinical information to determine the best course of treatment. Currently, advanced molecular imaging techniques, such as Prostate Specific Membrane Antigen (PSMA) PET scans, are among the many tools used to pinpoint the anatomic location of the recurrence, but access to these scans within the veteran population is not uniform.
To overcome this challenge, Valle and his team are developing a clinical prediction model, called a nomogram, that can predict the likely outcomes of PSMA PET scans based on other clinical data. This tool can help physicians quickly identify the extent of cancer recurrence after radiotherapy and create personalized treatment plans, even when advanced imaging is unavailable in a timely manner. This work aims to improve health equity for populations of men with radiorecurrent prostate cancer in low healthcare resource settings who may not have immediate access to these scans.
In addition, the researchers will investigate the genetic and biologic factors associated with local cancer recurrence, particularly when the cancer reappears in the prostate itself. By analyzing tumor samples from veterans through the extensive VA-MAPP biospecimen repository, Valle hopes to identify molecular signatures that predict which patients are most at risk for local recurrence. This could lead to more personalized and effective upfront treatments for those individuals.
UCLA mentors and collaborators on the grant include Dr. Nicholas Nickols, associate professor in residence and vice chair of VA services for the department of radiation oncology; Dr. Matthew Rettig, professor of urology and medical director of the prostate cancer program; Dr. Amar Kishan, executive vice chair of radiation oncology; Dr. Paul Boutros, professor of urology and human genetics; Dr. Isla Garraway, professor and director of research in urology; and Dr. David Elashoff, professor of medicine, biostatistics and computational medicine. All are members of the UCLA Health Jonsson Comprehensive Cancer Center.