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2020 David Yurman-PCF VAlor Young Investigator Award

Biomarker-Based Approaches to Predict Fracture Risk among Men with Metastatic Hormone-Sensitive Prostate Cancer

Ravi Parikh, MD

Corporal Michael J. Crescenz VA Medical Center; University of Pennsylvania

Mentors: Alicia Morgans, MD, MPH; Ravishankar Jayadevappa, PhD

Description:

  • Long-term androgen deprivation therapy (ADT), alone or with other agents, is a standard of care, life-extending therapy for metastatic hormone-sensitive prostate cancer (mHSPC). Despite these benefits, ADT accelerates bone loss and is associated with 10-20% risk of significant bone fractures, which result in decreased quality of life, independence, and functional status, and may also increase mortality rates. There is an urgent need to identify men with mHSPC undergoing ADT who are at increased risk of fracture and should be prescribed bone maintenance therapies, as these therapies are not routinely prescribed in this patient population.
  • Dr. Ravi Parikh is developing novel biomarkers to improve fracture risk assessment and facilitate targeted management strategies for men with mHSPC beginning ADT.
  • In this project, Dr. Parikh will validate several potential biomarkers of fracture risk that can be easily integrated into routine labs and staging in mHSPC.
  • The biomarkers to be studied include a technique that assesses bone density and bone strength from routine CT scans, and a blood test to look at a marker of bone damage (Type I collagen C-telopeptide (CTX)).
  • Dr. Parikh will study the performance of these biomarkers for predicting future fracture risk in cohorts of Veterans with mHSPC who are undergoing ADT.
  • If successful, this project will improve care and quality-of-life outcomes for patients with mHSPC, starting with the Veteran population, by developing new biomarker tests to identify patients who are at risk of future fractures and may benefit from early anti-resorptive therapy.

What this means to patients: Dr. Parikh is developing new clinical biomarker tests that can identify which patients undergoing hormonal therapy are at risk for developing bone fractures, and should be prescribed early bone maintenance therapies.  This will significantly improve quality-of-life for patients with advanced prostate cancer, starting with the Veteran population.