# Genetic Predictors of Prostate Cancer Survival

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $104,118

## Abstract

Project Summary / Abstract
Even though most men diagnosed with prostate cancer will not die of the disease, prostate cancer is still the
second leading cause of cancer death among men in the United States. While screening for prostate cancer
reduces death from disease, this comes at the price of both unnecessary biopsies that reveal no evidence of
cancer and treatment of otherwise indolent cancer resulting in unnecessary adverse events. Therefore, there
is an unmet need for improved screening tools for prostate cancer. To address this need, we have previously
developed a four-kallikrein biomarker panel that is now commercially available as a reflex test for use after an
initial PSA screening; found that the four kallikrein model improves the prediction, prior to any diagnosis of
prostate cancer, of which men may die of prostate cancer; and identified SNPs associated with survival time
after diagnosis, independent of known prognostic factors. Combining these SNPs and the four kallikrein panel
improves our ability to identify men at risk of dying from prostate cancer even further. Based on these findings,
we propose here a germline genomic approach to identify men at risk of dying from prostate cancer. By
leveraging recent computational advances in genomic analysis, we will take a gene-centered approach to
identify genes for which genetically controlled transcriptional alterations and/or functional coding mutations
influence survival time in prostate cancer. Using these genes, along with known genetic risk factors for prostate
cancer and the four kallikrein panel, we will build and test models designed to identify men at risk for clinically
significant prostate cancer in order to better stratify men in the screening context prior to biopsy. Specifically,
we will: 1) Identify genes for which genetically controlled expression level changes and/or rare coding variants
alter the risk of dying from prostate cancer; 2) Determine at what stage(s) of disease progression these genetic
changes operate; and 3) Improve our 4-kallikrein biomarker predictor of lethal prostate cancer through
incorporation of genetic data. This will be achieved by conducting both a transcriptome-wide association study
(TWAS) with prostate specific models and a whole exome sequencing study in a set of well-annotated cohorts
with long follow-up time after prostate cancer diagnosis. Successful completion of these aims will enable
better risk stratification of men prior to prostate cancer diagnosis. We envision these findings being useful in
the screening context, enabling more precise identification of men at high risk of dying from prostate cancer in
the next two decades, thereby reducing death from prostate cancer due to the benefits of early detection while
avoiding unnecessary biopsies and unneeded treatment of otherwise indolent cancers. Furthermore, these
findings will be useful in understanding the biology of lethal prostate cancer as we anticipate these findings will
pinpoint...

## Key facts

- **NIH application ID:** 11010053
- **Project number:** 3R01CA244948-04S1
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** ROBERT J. KLEIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $104,118
- **Award type:** 3
- **Project period:** 2021-01-15 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11010053

## Citation

> US National Institutes of Health, RePORTER application 11010053, Genetic Predictors of Prostate Cancer Survival (3R01CA244948-04S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11010053. Licensed CC0.

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