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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 youre

  • 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 youre 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.

  • Weve developed the needles. We validated them. Weve 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 were 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

  • patients.

  • 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 Africaneither

  • African American or African-Africanpatients 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, were 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

  • were involved with, as well as some of this smart-needle technology, well be able

  • to show direct clinical benefit to patients.

Adam Dicker, MD, PhD; Thomas Jefferson University

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智能針刺技術與轉移風險預測 (Smart Needling Technology and Predicting Risk of Metastases)

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    Amy.Lin posted on 2021/01/14
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