The NYU Cancer Institute team is actively engaged in research to elucidate the molecular basis of prostate cancer -- the most common cancer among men -- and to devise novel therapies. We incorporate the knowledge gleaned from these studies into clinical trials with the potential to improve upon existing treatments for each stage of the disease.
Prostate Tissue and Serum Banks
The NYUCI is coordinating the U.S. Department of Defense-funded Prostate Cancer Biorepository Network. The bank houses clinically annotated prostate cancer tissue samples and clinical data for prostate cancer cases diagnosed from 1989 onward, including paraffin blocks and frozen tissue from radical prostatectomy specimens and tissue microarrays (TMAs), with a full range of Gleason scores and outcome data. These samples are available to researchers all over the world who are seeking prognostic markers for this disease.
Imaging and Focal Therapy of Prostate Cancer
Investigators are refining new approaches to visualizing the prostate and using this information to apply focal therapy to the prostate. They are conducting studies using vascular-targeted photodynamic therapy for prostate hemi-ablation in men with low-risk disease. They are also exploring multi-parametric MRI for prostate tumor detection and localization.
Our researchers are exploring molecular factors that may explain why prostate cancer is more common in African American men than in other racial groups by studying racial disparities in prostate cancer diagnosis, biology, and outcomes. They are performing comparative genomic studies in primary and metastatic prostate cancers from Caucasian and African American men, and employing proteomic approaches to identify alterations in signaling pathways between these two groups.
Localized Prostate Cancer
Patients with localized prostate cancer with a high risk of recurring are a focus of special interest to our team. Because of the high probability of recurrence and progression after surgery or radiation therapy alone, we are exploring strategies that combine surgery and radiation therapy with hormones and chemotherapy to diminish the chance of recurrence and optimize quality of life.
Recurrent and Advanced Disease
At the NYU Cancer Institute, our medical oncologists specializing in the treatment of prostate cancer are evaluating new ways of treating men with recurrent and castration-resistant prostate cancer.
Hormonal therapies. New approaches aim to restore the sensitivity of advanced prostate cancer to standard therapies. The androgen receptor is the main driver of prostate cancer growth in disease that has become resistant to hormonal therapies and which continue to grow even in the absence of very low testosterone levels. NYUCI investigators are working to identify proteins that interact with the androgen receptor to influence cancer growth, in the hope of finding ways to circumvent this process. They found one protein called ART-27 (androgen receptor-trapped clone 27) which normally inhibits androgen receptor activity, but which is inactive or lost in patients with recurrent prostate cancer.
The researchers are continuing to study ART-27 and other proteins it interacts with to regulate the genes associated with androgen receptor activity. They have found a new complex of some two dozen proteins that repress androgen receptor activity and suppress prostate cancer growth. The goal is to find a means of restoring the normal function of these repressor proteins so they can inhibit prostate cell growth.
Our investigators also found that proteins called kinases attach phosphate groups to proteins that affect androgen receptor activity, which further promotes prostate cancer growth. Existing kinase-inhibiting drugs may have potential use for slowing prostate cancer growth in castration-resistant disease by inhibiting kinase activity.
Using what is known about androgen receptors and their effects on prostate cancer growth, our researchers are designing clinical trials of new drugs with the potential to inhibit androgen receptor activity and restore the sensitivity of prostate cancer cells to hormonal therapies. One example is panobinostat (LBH589), an inhibitor of an enzyme called deacetylase. Panobinostat causes genetic changes in the androgen receptor, and laboratory studies have shown that it makes prostate cancer cells sensitive to the hormonal therapy bicalutamide. Our investigators are leading research evaluating panobinostat plus bicalutamide in men with castration-resistant prostate cancer.
They have also been seeking drugs that target the androgen receptor without reducing testosterone levels. An example is MK-2206, an oral drug that turns off a protein called AKT inside cancer cells. Because AKT allows cells to survive despite anticancer treatment, turning it off could make the cells more sensitive to standard treatments. MK-2206 may be assessed with and without bicalutamide in men with castration-resistant prostate cancer to see if it inhibits cancer growth.
Immunotherapy is another area of major research interest to NYUCI investigators. They were involved in clinical trials assessing a new prostate cancer vaccine designed to stimulate the immune system to recognize, fight, and kill prostate cancer cells, wherever they may be in the body. The first vaccine for the treatment of cancer, called PROVENGE®, was approved in April 2010 by the U.S. Food and Drug Administration. The NYUCI is one of the few centers in New York City offering this vaccine.
Chemotherapy is also a very important weapon against prostate cancer that has become refractory to hormones and has metastasized to the lymph nodes or the bones. Several clinical trials are assessing the efficacy of chemotherapy combined with novel agents or with hormone therapy to improve patient outcome.
Quality of life. Our team of medical oncology experts advises patients on diet and exercise and provides guidelines to maximize and enhance quality of life and performance through the various stages and treatments of prostate cancer.
Our investigators have been conducting outcomes research for a decade to assess the satisfaction of men who have had prostate cancer surgery (radical prostatectomy). NYU is home to the most robust long-term database in the world on quality of life outcomes after radical prostatectomy. Our researchers have found that long-term predictors of satisfaction includeurinary and sexual function as well as freedom from PSA increases.
Prostate Cancer Stem Cells
NYUCI investigators are exploring the ways in which molecules and signaling pathways differ between normal (adult) stem cells and tumor stem cells in the prostate, and how this information could be used to develop new drug targets. They have identified and characterized normal and prostate cancer stem cells, and determined adult and fetal prostate stem cell gene expression signatures.
Our scientists have discovered that prostate cancers contain cancer stem cells with features similar to those of normal prostate stem cells. They are working to see if their findings can be used to predict the aggressiveness of an individual’s prostate cancer. They hope to learn how to stratify human prostate cancers by prognosis and identify therapeutic targets that are unique to cancer stem cells.