# PSMA/MR-guided Stereotactic Body Radiotherapy for High Risk Prostate Cancer

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2020 · $310,185

## Abstract

Summary
Localized prostate cancer can be treated in 5 sessions using a precise, targeted form of radiation known as
stereotactic body radiation therapy (SBRT), with low toxicity. Despite these advances, overall outcomes for
aggressive (high risk) prostate cancer remain poor, with 10-year recurrence-free survival of approximately 65%
regardless of treatment modality. Recurrences are typically distant and carry poor prognosis, with 5 year
survival of 25%. We propose to utilize the latest advances in cancer imaging (PSMA Positron Emission
Tomography (PET)/Magnetic Resonance Imaging (MR)) and radiation delivery (MR-guided radiation therapy
with real-time adaptive planning), to deliver a personalized radiation treatment that targets the areas of
greatest risk of recurrence in the prostate with improved precision, and as a result improve clinical outcomes
for individuals with high risk prostate cancer. PSMA PET/MR is a novel imaging modality, not yet widely
available, that augments the tissue detail provided by MR. The combination of PSMA PET with MR results in
improved delineation of intraprostatic nodules and higher diagnostic accuracy for detection of metastatic
disease compared to conventional imaging. PSMA PET/MR imaging data is readily transferable to a MR-based
linear accelerator (MR-LINAC), a novel, innovative platform that allows direct visualization of the tumor during
treatment, and permits real-time individualized correction for motion with online adaptive radiation planning.
Through incorporation of superior pre-treatment imaging, enhanced identification of high risk intraprostatic
nodules at greatest risk of recurrence, and precise MR-guided real-time adaptive delivery of radiation, we
hypothesize that local and distant recurrences can be reduced. We will also utilize PSMA PET/MR and biopsy
at 1 year after SBRT to characterize treatment response and detect disease recurrences earlier. To test our
hypotheses, we will conduct a single arm, phase II clinical trial utilizing PSMA PET/MR guided SBRT with
targeted dose-escalation to dominant intraprostatic nodule(s) on an MR-LINAC. The overarching scope of this
proposal is to harness advanced PET and MR-based imaging and treatment to enhance the therapeutic index
of SBRT in high risk prostate cancer, maximizing treatment efficacy while minimizing toxicity. If successful, this
proposal will guide utilization of emerging imaging technologies (PSMA PET/MR and MR-LINACs are expected
to increase in availability and usage over the next several years) and introduce a novel treatment paradigm
with the potential to significantly improve prostate cancer outcomes.

## Key facts

- **NIH application ID:** 9968796
- **Project number:** 1R01CA249615-01
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Josephine M Kang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $310,185
- **Award type:** 1
- **Project period:** 2020-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9968796

## Citation

> US National Institutes of Health, RePORTER application 9968796, PSMA/MR-guided Stereotactic Body Radiotherapy for High Risk Prostate Cancer (1R01CA249615-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9968796. Licensed CC0.

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