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2023 Ben Franklin – PCF Young Investigator Award

Optimizing Outcomes in Survivors of Prostate Cancer with Diabetes

Amanda Leiter, MD
Icahn School of Medicine at Mount Sinai Hospital

Mentors: Juan Wisnivesky, Chung Yin Kong, Matthew Galsky

Description:

  • Approximately 20% of prostate cancer survivors have type 2 diabetes, often with worse control of blood sugars. In prostate cancer survivors, type 2 diabetes is associated with increased mortality.
  • While prostate cancer progression is a concern for prostate cancer survivors, the majority die of comorbid illness, particularly cardiovascular disease.
  • Optimizing type 2 diabetes treatment can have a major beneficial impact in clinical outcomes for prostate cancer survivors, but data regarding the optimal type 2 diabetes treatment strategies is limited. The harm/benefit ratio of different diabetes treatment approaches is likely significantly different for prostate cancer survivors due to differences in competing risks of death from prostate cancer, hyperglycemia from androgen deprivation therapy, increased risk of type 2 diabetes and cardiovascular disease caused by treatments, and differences in baseline quality of life.
  • Dr. Amanda Leiter is investigating optimal type 2 diabetes treatment strategies for advanced prostate cancer survivors with type 2 diabetes.
  • In this project, Dr. Leiter and team will develop a validate a model that simulates the unique natural history and outcomes of type 2 diabetes in advanced prostate cancer survivors.
  • This model will be used to identify the most effective first-line medications and glycemic control goals for advanced prostate cancer survivors with varying clinical characteristics in regard to reducing complications, reducing adverse events, and maximizing quality-adjusted life expectancy.
  • If successful, this project will provide tailored type 2 diabetes care recommendations for prostate cancer survivors and aid with decision-making regarding type 2 diabetes treatment approaches for clinicians, patients, and caregivers, thereby improving quality of life in prostate cancer survivors.

What this means to patients: In prostate cancer survivors, type 2 diabetes is a common comorbidity that is linked to increased mortality and is a risk factor for cardiovascular disease, a major cause of death in prostate cancer survivors. Dr. Leiter and team will develop a simulation model to assess optimal type 2 diabetes treatment approaches in prostate cancer survivors. This study will generate tailored diabetes care recommendations for prostate cancer survivors and aid with decision-making regarding diabetes treatment approaches. This will ultimately improve long-term prostate cancer outcomes by optimizing survival and quality of life in prostate cancer survivors with type 2 diabetes.