Modeling Precision Interventions for Prostate Cancer Control

前列腺癌控制的精准干预建模

• 批准号: 10683180
• 负责人: RUTH D ETZIONI
• 金额: $ 123.52万
• 依托单位: FRED HUTCHINSON CANCER CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10683180
• 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; Frustration; 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; Patient Selection; Patients; Police; Policies; Population; Population Sciences; Positioning Attribute; Precision therapeutics; Process; Prostate; Prostate Cancer therapy; Radical Prostatectomy; Recording of previous events; Recurrence; Reduce health disparities; 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; black men; cancer diagnosis; college; cost; curative treatments; disease natural history; disorder risk; early screening; evidence base; genetic testing; 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

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.

项目摘要/摘要 前列腺癌是男性最常见的实体肿瘤，也是导致癌症死亡的第二大原因。 在美国。癌症干预和监测模型网络(CISNET)的前列腺工作 前列腺癌工作组(PWG)成立于2000年，目的是解决有关有效前列腺的一系列问题 癌症控制。PWG研究了前列腺癌筛查开始后前列腺癌诊断的快速增长 在20世纪80年代末，为了估计与测试相关的准备时间和过度诊断。工务小组研究了 前列腺癌死亡率的下降始于20世纪90年代初，以量化PSA的合理贡献 初步治疗中的筛查和变化。PWG还研究了如何解释种族趋势 发病率和存活率的差异，如何在积极监测中管理患有低风险疾病的男性，以及如何 为了协调明显不一致的PSA筛查和根治性前列腺癌根治术随机试验。 近年来，围绕前列腺癌筛查和治疗的技术发展迅速， 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，新的生物标记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晚期疾病患者的生存时间。 该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式 在限制伤害和成本的同时改善患者护理。我们将确定我们是否可以及早改进 使用新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危害 通过对初级和次级治疗的量身定做的选择。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：精确的早期检测，包括风险分层筛查和活组织检查 使用基因测试、新的生物标记物和成像技术。目标2：精确主动监测，包括 自适应活检间隔和成像技术。目标3：精确治疗，包括类型和时机 初始治疗和抢救治疗。目标4：有针对性的筛查、活检和治疗政策，以减少种族歧视 差距。目标5：在国际环境中确定筛查和治疗干预措施的优先顺序。这些目标是 高度响应融资机会公告，解决9个目标优先领域中的7个，以 程度不一。我们在前列腺建模方面的累积专业知识，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了大量高质量的数据集，他们为我们提供了 回答关于如何最好地控制这种最常见的癌症的关键和有影响力的问题的强有力的立场 在男人身上。

项目成果

Editorial Comment.

编辑评论。

• DOI: 10.1097/ju.0000000000001640.01
• 发表时间: 2021
• 期刊: The Journal of urology
• 作者: Bauer,ScottR;Huang,Alison
• 通讯作者: Huang,Alison

Cost-Effectiveness Analysis of Prostate Cancer Screening in the UK: A Decision Model Analysis Based on the CAP Trial.

• DOI: 10.1007/s40273-022-01191-1
• 发表时间: 2022-12
• 期刊: PHARMACOECONOMICS
• 影响因子: 4.4
• 作者: Keeney, Edna;Sanghera, Sabina;Martin, Richard M.;Gulati, Roman;Wiklund, Fredrik;Walsh, Eleanor, I;Donovan, Jenny L.;Hamdy, Freddie;Neal, David E.;Lane, J. Athene;Turner, Emma L.;Thom, Howard;Clements, Mark S.
• 通讯作者: Clements, Mark S.