Longitudinal Molecular Characterization of Lethal Prostate Cancer: A Major Step Towards Precision Oncology

A multi-disciplinary team of clinicians and researchers from three institutions in Quebec are uniting to accelerate precision medicine for patients with prostate cancer thanks to new funding from the Marathon of Hope Cancer Centres Network.

Funded through the Network’s pan-Canadian Project Program, the team will deploy a multi-pronged approach to better understand why some prostate cancer patients respond to treatment and others don’t, with the goal of developing tests that predict who is at a greater risk of suffering from disease progression and create interventions to stop this from occurring. 

"This project represents a significant step forward in understanding and combating lethal prostate cancer,” says Dr. Simone Chevalier, a senior scientist at the Research Institute of the McGill University Health Centre, who will co-lead the team. “By harnessing cutting-edge molecular and imaging techniques, we aim to transform how we diagnose and treat this complex disease."

Prostate cancer remains one of the most prevalent and deadly cancers among Canadian men, posing significant challenges in early detection and treatment. It is estimated that in 2023, 25,900 Canadian men were diagnosed with prostate cancer, and 4,900 died from it, making it the third leading cause of death from cancer in men in Canada.

This newly formed team aims to change this by tackling two distinct issues. On the one hand, they will use Network funding to do genomic and transcriptomic sequencing of prostate cancer tumours at the time of diagnosis. Thanks to the PROCURE Foundation in Quebec that helped establish a large longitudinal biobank, such critical studies are now feasible. With funding from other sources, they will perform similar analyses in the blood drawn during the course of disease from cases whose cancer has progressed and led to death. This will help to identify key genetic drivers of disease severity, metastatic progression and death from cancer, amongst individuals, which they hope will help them develop tests that could search for those markers earlier.

In parallel, the team will explore novel imaging approaches called radiomics, which will help determine how different cancer cells within each patient’s tumour deposit, in the prostate or metastasis, differentially respond to therapy. The objective is to determine if there are imaging patterns that could help predict treatment response and select the best therapy for each patient.

By combining these two approaches, they will have a wealth of data that can then be analyzed using artificial intelligence to find new ways to predict treatment response.  

“In this project, we aim to elucidate the impact of prostate cancer heterogeneity on disease progression by linking molecular imaging features (called radiomics), cancer gene alterations (called genomics) and clinical data, using artificial intelligence-assisted analysis,” says Dr. Frédéric Pouliot, a urologist and clinician-scientist at the Centre de Recherche du CHU de Québec - Université Laval and another project co-lead. 

In addition to supporting the aims of the research team, the genomic, radiomic and clinical data collected through this study will be contributed to the MOHCCN Gold Cohort, which seeks to be the largest and most complete cancer case resource in Canada, providing valuable data that other research teams will be able to use to advance precision medicine for cancer in Canada.