Overall Objectives: To establish a medical conference integrated with ongoing deliberations of the Steering Committee. The mission of this integrated effort is three-fold:
- To educate the key health care stakeholders about the recent advances in precision diagnostics that are transforming patient care, including screening, risk assessment, staging, and treatment;
- To stimulate and maintain a cross-disciplinary clinical and scientific dialogue in order to bridge the current gap between the experts in the in vitro diagnostics (IVD) and in vivo imaging communities; and
- To expedite transfer of promising innovations from laboratories to clinics through the development of the consensus-based educational, clinical and research strategy.
Clinical Scope. To address central challenges in precision care for Prostate Cancer (PC):
- To improve early detection (and conversely, exclusion) and treatment of aggressive PC (Gleason Pattern 4 and above), which is defined by its propensity to progress and cause biochemical failure, recurrence, metastases and deaths;
- To reduce over-diagnosis and over-treatment of low-risk (slow-growing) PC, which is not likely to cause symptoms in a man’s lifetime or reduce life expectancy; and
- To improve staging (including risk stratification), treatment planning and monitoring of PC, including clinically significant, advanced and/or recurrent PC.
Program Components and Outline. The Steering Committee had met on February 16, 2017, considered and recommended the following main program components for the Second Summit:
- Educational and Scientific agenda;
- A session on the cutting-edge industrial innovation, including diagnostic tools that have or are becoming clinically available; and
- A panel on expedited transfer of promising technologies to clinics. This session may include professional organizations developing clinical practice guidelines (e.g., National Comprehensive Cancer Network), research funding entities (e.g., National Cancer Institute/NIH, Department of Defense, private foundations), regulatory (e.g., FDA) and reimbursement organizations (e.g., public and private insurance).
Educational and Scientific Program Highlights. Based on the First Global Summit on Precision Diagnosis, he following new and/or expanded topics were recommended by the Steering Committee:
- Expansion of presentations and discussion on radiogenomics, integrating quantitative in vivo imaging (radiomics) and molecular/genomic testing;
- New session on advanced, lethal PC, including integration of its genomic characterization with imaging – and the impact on the development and clinical utility of drugs and diagnostics;
- New session on the interface between in vitro and in vivo prostate cancer genomic targets – and its potential to facilitate development of both in vitro diagnostics and molecular imaging;
- Expanded discussion of the clinical utility of diagnostic tools throughout the program including:
- Review of the key clinical challenges requiring diagnostic solutions; and
- Framing the debate: Emerging diagnostic tools, their current and potential role in patient care:
- Prior to the first biopsy;
- Prior to the second biopsy;
- Post-treatment (e.g., surgery or radiation); and
- Advanced PC.
Specific Clinical Sessions:
- Screening (including screening intervals);
- Risk assessment prior to diagnosis of PC, including patient selection for imaging and biopsies;
- Staging, including risk assessment after diagnosis of PC – and patient selection for active surveillance vs. immediate treatment (focal, radical, and/or systemic), including –
- Patient selection for genomic tissue analysis;
- Improved prediction of progression, biochemical failure, metastases and mortality;
- Early diagnosis of aggressive, advanced and/or castrate-resistant PC; and
- Individualized treatment planning.
- Monitoring of –
- Active surveillance (including early detection of progression); and
- Treatment, including early detection of response or failure;
- Post-treatment evaluation – guidance of management, detection of progression and recurrence.