Development of treatment intensification strategies for high-risk prostate cancer based on clinicopathological and molecular modeling, with the aim of delivering precision medicine to the individual patient.

Prostate cancer (PCa) is a tremendous health problem that affects
about 1 in 8 men in developed countries. High-risk PCa covers 20%
of new diagnoses and accounts for more than two-thirds of all deaths
from prostate cancer. Better risk stratification within high-risk PCa
can help determine who are suitable candidates for de-escalation
versus intensification of therapy, potentially affecting tens of
thousands of patients worldwide. In our previous work, we have,
among other things, improved risk stratification, confirmed PSMA
PET/MRI as a novel staging method and ideal imaging modality to
predict the outcome of neoadjuvant treatment, identified XPO-1 and
AZIN-1 as potential - and targetable - drivers of lethal disease and
studied the intensification of treatment before surgery with degarelix
+ apalutamide in the ARNEO study. In this Senior Clinical
Investigator Renewal, we aim to build on these achievements. We
will perform in-depth genomic and gene expression analyzes (bulk
and single cell) on the ARNEO samples to understand why some
patients are exceptional responders and others are not. We will also
design a next-generation clinical trial, stratifying patients for
individualized treatment based on molecular tumor characteristics.
These efforts will result in personalized treatments for patients and
better treatment outcomes.