Optimal Strategy for Conservative Management of Prostate Cancer

描述（由申请人提供）：斯泰西勒布博士是一名泌尿科医生，在前列腺癌的临床护理和研究方面具有丰富的经验。这个K 07奖项将允许申请人获得额外的技能，以促进作为独立调查员的职业生涯。这将是 与多学科导师团队合作完成。背景资料：每6名美国男性中就有1人在其一生中被诊断出患有前列腺癌，但只有1/36的人死于前列腺癌。治疗通常是治愈性的，但可能会导致副作用。另一种选择是保守治疗，可以延迟或避免治疗的副作用。保守治疗的主要风险是疾病可能在不治疗的情况下进展。在保守治疗期间，有许多后续测试的选择来监测疾病进展，从血液检查和体格检查到成像和活检。然而，关于后续测试的类型、频率和顺序没有达成共识。更频繁和侵入性的检测可能会更早地发现疾病进展，但可能会增加成本和并发症。在最近的共识会议上，NIH宣布确定保守治疗的最佳方案是前列腺癌研究的一个主要优先事项。项目名称：该提案的目的是使用数学模型比较保守管理的替代策略的有效性，危害和成本。该模型还将研究患者特征、肿瘤特征和偏好对策略选择的影响。这些信息将通过网站的初步设计分发给前列腺癌患者和医生。研究计划与申请人提出的培训课程相吻合，以确保成功提交R 01提案。掌握这些新技能将有助于申请人转变为独立的癌症研究者，能够比较新的前列腺癌管理方案的有效性和成本，并为前列腺癌患者设计决策支持工具。

DESCRIPTION (provided by applicant): Dr. Stacy Loeb is an urologist with significant experience in clinical care and research on prostate cancer. This K07 award will allow the applicant to gain additional skills to foster a career as an independent investigator. This will be accomplished in collaboration with a multidisciplinary mentorship team. Background: One in 6 US men are diagnosed with prostate cancer during their lifetime but only 1 in 36 die from it. Treatment is often curative but may lead to side effects. An alternative option is conservative management, which delays or avoids the side effects of treatment. The major risk of conservative management is that the disease may progress without treatment. During conservative management, there are many options for follow-up testing to monitor for disease progression, ranging from blood tests and physical exams to imaging and biopsies. However, there is no consensus regarding the type, frequency and sequence of follow-up testing. More frequent and invasive tests may identify disease progression earlier, but may increase costs and complications. In a recent Consensus Conference, the NIH declared that identifying the optimal protocol for conservative management is a major priority in prostate cancer research. Project: The goal of this proposal is to compare the effectiveness, harms and costs of alternative strategies for conservative management using a mathematical model. The model will also look at the influence of patient features, tumor features, and preferences on the choice of strategy. This information will be distributed to prostate cancer patients and physicians through the preliminary design of a website. The research plan coincides with the applicant's proposed training curriculum, to ensure a successful bridge to submission of an R01 proposal. Mastery of these new skills will help the applicant transition into an independent cancer investigator with the capacity to compare the effectiveness and costs of new prostate cancer management options, and to design decision support tools for prostate cancer patients.