Sophia Coraci: Thank you for having me.
Zachary Klaassen: Before we get into your study, just tell us, how did you come up with this hypothesis, taking a very popular biomarker and PSMA PET very commonly used the Decipher genomic classifier and integrating them together?
Sophia Coraci: My whole focus, really, in my work is combining and integrating pathology with radiology. As I am a master's student, my thesis is all about combining and integrating SUV especially into clinically significant oncology. Prostate cancer, as we all know, is a very heterogeneous oncology. Decipher is a great pathology where we are looking at a risk score from high intermediate low grade, and PSMA PET offers the tumor biology on imaging. I really wanted to see if SUV could act as a non-invasive surrogate to patients who maybe can't get biopsies and if they need additional layer of information to the PSMA lesion score.
Zachary Klaassen: The concept's good. We get information on all these patients, but merging them together. Just take a minute to lay out the study design for what you guys presented at ASCO.
Sophia Coraci: My presentation was really focusing on my cohort of 104 patients that had treatment-naive prostate cancer. The PSMA PET was from initial diagnosis, and the biopsy was also from initial diagnosis. They were sent out to Decipher, and the patients that were selected for the study only had the PSMA PET within the 35 days of the biopsy, just to keep consistent with the imaging and pathology to really rule out the aggressiveness of the cancer. We had mainly 50% of the patients have high risk from the Decipher scores, and then a clean separation from low to intermediate.
Zachary Klaassen: You set the study up, you get all the information. What were the key results that you presented?
Sophia Coraci: The key results were really rewarding. We saw that there was a correlation between SUVmax and Decipher score, mainly with the higher PSMA had a higher risk from Decipher. That was awesome to see. That really tells us that PSMA could really tell us about the aggressiveness of the tumor in that biology as well. Also did a stepwise correlation between low, intermediate, and high risk disease. And we saw that, again, as a patient has a higher risk, they have a higher PSMA SUV.
Zachary Klaassen: I see. And you had a really nice cut point. SUVmax greater than or equal to 15 in the prostate was the take-home that I got. What clinical applicability, or how can we take this as an action item into the clinic? How can we use it?
Sophia Coraci: When I was going through the statistics of my data, I really found that a threshold was really important to rule out if a patient was low risk, intermediate, and high risk. What I found was that the SUV of 15 or greater than correlated with a high-risk Decipher score. That's clinically impactful for patients that maybe had PSA or lesion score that were lower and were not indicating high risk. For treatment-wise, they can maybe intensify the treatment planning or monitor the patient a little bit more just to see the metastatic rates or the patient cancer-specific mortality.
Zachary Klaassen: That's great. I think it's really important that where things don't line up, you then have another biomarker in PSMA PET that may tell you something else.
Sophia Coraci: Yeah.
Zachary Klaassen: Great work. Congratulations. Any take-home messages, anything we haven't hit on that you want to discuss?
Sophia Coraci: Just some of my future work with PSMA, this study. We're trying to expand the cohort right now. We're trying to incorporate other genomic factors like TP53 and some other genes, as well as more segmentations on imaging. We're looking forward to seeing-
Zachary Klaassen: That's great. Sounds like it's going to be a very productive master's course and beyond.
Sophia Coraci: Yes, of course.
Zachary Klaassen: Congratulations. Thanks for joining us on UroToday.
Sophia Coraci: Thank you. I appreciate it.