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Adam Dicker, MD, PhD; Thomas Jefferson University
So, the first introduction to the DoD Prostate Cancer Research Program was through the funding
of a synergy grant with myself and a number of physicists, where we developed smart needles.
So there are a number of therapies for the treatment of prostate cancer where you’re
inserting needles into the prostate. A common example might be brachytherapy, where needles
are put into the prostate and then radioactive seeds are then inserted through these needles,
or you’re trying to biopsy a particular part of the prostate. So one of the limitations
with current needles is they don’t discriminate between tumor and normal tissue and there’s
no ability to really steer the needle.
So a smart needle can sense the tissue, can sense the difference between normal prostate
and tumor, and most needles are straight, that’s a good thing, but these needles are
actually smart and you can have them bend around and curve, and then become straight.
So they have the ability, with special properties to sense where they are, as well as be able
to direct themselves to particular places where you might want to deliver some sort
of therapy.
We’ve developed the needles. We validated them. We’ve shown that they can discriminate
between normal tissue and prostate using prostatectomy specimens, and we now have a Phase I clinical
trial that’s been approved by the Food and Drug Administration to now enroll patients
and have them treated with this device.
And that’s been a very productive collaboration with Dr. Yan Yu, a physicist at Thomas Jefferson
University, and a number of institutions, and we’re very grateful to the DoD for supporting
that work.
Another grant is a postdoctoral award to Dr. Kosj Yamoah. I’m a mentor to Dr. Yamoah,
as is Dr. Tim Rebbeck at the University of Pennsylvania.
Kosj is from Ghana, and what he’s particularly interested in is, can he use the new molecular
tests that are now being developed to help prostate cancer patients.
The grant is in a collaboration with a company called Genome DX that’s based in Vancouver
and San Diego. And they developed the Decipher signature. This signature was developed from
the Mayo Clinic from about 10,000 prostatectomy specimens.
So this signature identifies which patients are going to develop a metastasis, and they
can predict it with a higher level of certainty than the known clinical parameters that we
currently use when taking care of patients.
Now, in the Mayo Clinic in Rochester, Minnesota, they had a mostly Caucasian population. So
we don’t know if this metastases signature applies to African American patients or African
Kosj Yamoah is a trainee in radiation oncology, and he has a unique access to sample, tumor
samples, prostate biopsies from African American patients in the Philadelphia region, as well as from
African patients in Ghana, Senegal, and other neighboring African countries.
And he’s going to see if he can develop a specific molecular test for these African—either
African American or African-African—patients and see if this can add value because it’s
thought that the African American patients, particularly in the United States, either
present with more-advanced disease or are thought to have a more aggressive type of
prostate cancer. And the molecular test will help personalize therapy so you don’t overtreat
someone if their disease is not as aggressive, and you don’t undertreat someone who may
require a more comprehensive, aggressive approach to their care.
For us and other people in the field, we’re looking to have the greatest therapeutic ratio,
meaning, how can you help the most and hurt the least. No one enjoys having a needle put
into them, but if you can do it in a less invasive way and reduce the risk of
injury, you know that has significant clinical benefit. If you have a molecular test that
can determine whether a patient should be getting a more aggressive therapy or a less
aggressive therapy, it has a huge impact on their quality of life. And I think, in a short
time, meaning, in just a few years, for both the molecular tests, the genomic tests that
we’re involved with, as well as some of this smart-needle technology, we’ll be able
to show direct clinical benefit to patients.
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Smart Needling Technology and Predicting Risk of Metastases

194 Folder Collection
Amy.Lin published on September 29, 2016
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