Modeling Precision Interventions for Prostate Cancer Control

前列腺癌控制的精准干预建模

基本信息

批准号：
10260543
负责人：
RUTH D ETZIONI
金额：
$ 69.83万
依托单位：
FRED HUTCHINSON CANCER RESEARCH CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-10 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10260543
关键词：
Address Adherence Area Bahamas Behavior Biological Markers Biopsy British Columbia Calibration Cancer Control Cancer Etiology Cancer Intervention Cancer Intervention and Surveillance Modeling Network Cessation of life Clinical Clinical Sciences Clinical Trials Country Data Data Set Data Sources Decision Making Development Diagnosis Diagnostic Disease Disease model Early Diagnosis Event Fred Hutchinson Cancer Research Center Funding Opportunities Hormonal Image Imaging Device Imaging technology Incidence Individual International Intervention Lead Leadership Learning London Long-Term Effects Magnetic Resonance Imaging Malignant Neoplasms Malignant neoplasm of prostate Methodology Michigan Modeling Modernization Natural History Neoplasm Metastasis Outcome PSA screening Patient Care Patients Police Policies Population Population Sciences Positioning Attribute Precision therapeutics Process Prostate Prostate Cancer therapy Radical Prostatectomy Recording of previous events Recurrence Research Personnel Resources Risk Risk Estimate Route Salvage Therapy Saudi Arabia Screening for Prostate Cancer Solid Solid Neoplasm Source Statistical Methods Stratification Techniques Technology Testing Therapeutic Time United Kingdom United States Universities Urologic Oncology Validation Work advanced disease base black men cancer diagnosis college cost curative treatments disease natural history disorder risk early screening evidence base genetic testing health disparity high risk men high risk population improved individual patient individualized prevention innovation interdisciplinary approach men models and simulation mortality novel novel marker overtreatment personalized care personalized intervention personalized medicine personalized screening process optimization prostate biopsy prostate cancer model racial disparity randomized trial risk stratification screening screening policy treatment strategy trend working group

项目摘要

PROJECT SUMMARY/ABSTRACT Prostate cancer is the most common solid tumor in men and the second most common cause of cancer death in the United States. The Cancer Intervention and Surveillance Modeling Network (CISNET) Prostate Working Group (PWG) was formed in the year 2000 to address a wide range of questions about effective prostate cancer control. The PWG studied the rapid increase in prostate cancer diagnoses after PSA screening started in the late 1980s to estimate lead time and overdiagnosis associated with the test. The PWG studied the decline in prostate cancer mortality that began in the early 1990s to quantify the plausible contributions of PSA screening and changes in primary treatments. The PWG also studied how to interpret trends in racial disparities in incidence and survival, how to manage men with low-risk disease on active surveillance, and how to reconcile apparently discordant randomized trials of PSA screening and radical prostatectomy. In recent years, technologies surrounding prostate cancer screening and treatment have evolved rapidly, and opportunities to improve patient care using personalized data abound. Genetic testing can identify men at increased risk for developing aggressive disease, new biomarkers and imaging tools can help men avoid unnecessary biopsies, and new hormonal treatments can lengthen survival for men with advanced disease. The objective of this application is to extend PWG models to evaluate optimal ways to utilize personalized data to improve patient care while limiting harms and costs. We will determine whether we can improve early detection using novel stratification approaches and whether we can safely limit overtreatment and other harms by tailored choices of primary and secondary therapies. These approaches will be applied in the United States and in international cancer control settings with different resources and priorities. Our specific aims are as follows. Aim 1: Precision early detection, including risk-stratified screening and biopsy using genetic tests, novel biomarkers, and imaging technology. Aim 2: Precision active surveillance, including adaptive biopsy intervals and imaging technology. Aim 3: Precision treatment, including type and timing of initial and salvage therapies. Aim 4: Targeting screening, biopsy, and treatment policies to reduce racial disparities. Aim 5: Prioritizing screening and treatment interventions in international settings. These aims are highly responsive to the funding opportunity announcement, addressing 7 of the 9 targeted priority areas to varying degrees. Our cumulative expertise in prostate modeling, our existing models, and our close ties with clinical experts who provide access to large, high-quality datasets for model validation and calibration put us in a strong position to answer critical and impactful questions about how best to control this most common cancer in men.

项目概要/摘要前列腺癌是男性最常见的实体瘤，也是癌症死亡的第二大常见原因在美国。癌症干预和监测建模网络 (CISNET) 前列腺工作小组 (PWG) 成立于 2000 年，旨在解决有关有效前列腺的广泛问题癌症控制。 PWG 研究了 PSA 筛查开始后前列腺癌诊断的迅速增加 20 世纪 80 年代末期，用于估计与测试相关的准备时间和过度诊断。 PWG 研究了从 20 世纪 90 年代初开始，前列腺癌死亡率下降，以量化 PSA 的合理贡献筛查和主要治疗的改变。 PWG 还研究了如何解释种族趋势发病率和生存率的差异，如何在主动监测中管理患有低风险疾病的男性，以及如何调和 PSA 筛查和根治性前列腺切除术的明显不一致的随机试验。近年来，前列腺癌筛查和治疗技术迅速发展，使用个性化数据改善患者护理的机会比比皆是。基因检测可以识别男性患侵袭性疾病的风险增加，新的生物标志物和成像工具可以帮助男性避免不必要的活检和新的激素治疗可以延长患有晚期疾病的男性的生存期。此应用程序的目标是扩展 PWG 模型以评估利用个性化数据的最佳方法改善患者护理，同时限制伤害和成本。我们会尽早确定是否可以改进使用新颖的分层方法进行检测以及我们是否可以安全地限制过度治疗和其他伤害通过主要和次要疗法的定制选择。这些方法将在美国应用以及在具有不同资源和优先事项的国际癌症控制环境中。我们的具体目标如下。目标 1：精准早期检测，包括风险分层筛查和活检使用基因测试、新型生物标志物和成像技术。目标 2：精准主动监视，包括自适应活检间隔和成像技术。目标 3：精准治疗，包括治疗类型和时机初始治疗和挽救治疗。目标 4：有针对性的筛查、活检和治疗政策，以减少种族歧视差异。目标 5：在国际环境中优先考虑筛查和治疗干预措施。这些目标是对融资机会公告的高度响应，解决了 9 个目标优先领域中的 7 个领域不同程度的。我们在前列腺建模方面积累的专业知识、我们现有的模型以及我们与临床专家为模型验证和校准提供大量高质量数据集，使我们能够参与其中能够回答有关如何最好地控制这种最常见癌症的关键和有影响力的问题在男性中。