# Polygenic risk stratification combined with mpMRI to identify clinically relevant prostate cancer

> **NIH NIH U01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $674,729

## Abstract

Prostate cancer has the highest estimate of heritability of any cancer, with 58% of variability in prostate
cancer incidence attributed to inherited genetic factors. Genome wide association studies have validated 269
single nucleotide polymorphisms that are strongly associated with prostate cancer risk. We found that a
multiethnic polygenic risk score (PRS) combining these SNPs demonstrate a 9-fold difference in risk of
disease comparing men with high vs. low PRS in a both Black and White men. This proposal aims to translate
this prostate cancer PRS into clinical practice by addressing four important questions: 1) Can the PRS be
integrated with other tools including MRI and rare genetic variants in DNA damage repair (DDR) pathways as
part of an early detection strategy to identify clinically-relevant, potentially lethal prostate cancer? 2) At what
point in a man's life should an early detection program begin if he is at increased genetic risk? 3) What is the
optimal interval of imaging to detect clinically relevant cancer in men at high genetic risk?
 This collaborative U01 proposal addresses these issues in three specific aims. Aim 1 - we will prospectively
determine the ability of a prostate cancer PRS integrated with MRI to identify higher-grade, potentially lethal
prostate cancer. We will recruit 1500 men (600 Black, 900 White) from the MGB Biobank, the Walter Reed
Biobank, and the primary care network at Howard University and Brigham & Women's Hospital. All men will be
stratified into low, average, and high risk on the basis genotyping. PSA, MRI, and DDR variants will be
obtained followed by biopsy for elevated PSA or abnormal MRI. We expect to find the PRS identifies a
population at risk for prostate cancer while the DDR variants and MRI identifies a subset with clinically relevant
disease. In Aim 2, we will evaluate at what point in a man's life an MRI is clinically useful. Our population will
be imaged across 5 year age groups from 40-69 years. In addition, men at the high genetic risk without cancer
will undergo serial MRI imaging at the NCI at 2 year intervals. In Aim 3 we will determine if deep learning
methods applied to mpMRI and informed by genetic risk can more accurately predict significant cancers.
 This will be the first in field prospective trial to integrate germline genetics with MRI to identify men at risk of
clinically-relevant prostate cancer. The results will have short-term impact by establishing an optimal early
detection algorithm and show the utility of incorporating information on the germline into an early detection
strategy. It will establish the role of MRI in detecting clinically relevant cancers among those with high genetic
risk. The longer-term goal will be to use the knowledge gained to design trials of the at-risk populations with
longer follow-up to prove that genetic testing can improve our ability to prevent prostate cancer mortality
through targeted screening and prophylaxis. Importantly, men at low risk...

## Key facts

- **NIH application ID:** 10827944
- **Project number:** 5U01CA268810-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** ADAM S KIBEL
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $674,729
- **Award type:** 5
- **Project period:** 2023-04-12 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10827944

## Citation

> US National Institutes of Health, RePORTER application 10827944, Polygenic risk stratification combined with mpMRI to identify clinically relevant prostate cancer (5U01CA268810-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10827944. Licensed CC0.

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