Genitourinary cancers may be the broadest and most common of all malignancies and include everything from the rare but curable testicular cancer to prostate cancer — the most common cancer in men in the United States after skin cancer, and, according to the National Cancer Institute, the second leading cause of death from cancer in men.
Through collaborative multidisciplinary care, education, and clinical, translational, and population research, the Genitourinary Oncology Program is designed to help improve the survival and quality of life of patients.
Our research emphasizes prevention and screening, early diagnosis, and the development of new treatments to improve the overall health of our patients. Many of our studies are looking at targeted treatments and individualized care. Through the support of young and promising scientists, we are making meaningful strides in tackling metastasis and aggressive cancer behavior.
Our team of medical oncologists, urologic surgeons, radiation oncologists, pathologists, radiologists, cancer biologists and drug developers are also working to bring new discoveries directly to our patients by giving them opportunities to participate in cutting-edge clinical trials.
Metastasis Biology and Precision Medicine
Metastasis, the spread of cancer beyond the site of origin, accounts for the majority of lethal cancers in the U.S. While we aim to detect cancer early, before it spreads, our laboratory is also focused on understanding the causes of metastasis, and how to target this process to reduce death and suffering from metastatic prostate cancer as well as other genitourinary cancers.
Because each patient’s cancer possesses unique characteristics that allow for a diversity of behaviors and outcomes, we take a personalized approach to determining the best therapies for each patient. Using precision medicine, we study the patient’s urine or blood-based biomarkers, tissue-based biomarkers, and imaging biomarkers, and are then able to individually tailor their treatments.
Immunotherapies for Aggressive Prostate Cancer
Prostate cancer was one of the first cancers to positively respond to immunotherapy treatment; specifically to the drug sipuleucel-T (Provenge). Our researchers played a central role in the development and approval of this agent.
We recognize that this is just the first step toward a cure for men with metastatic disease, and are continuing to take novel approaches to using the immune system to recognize and destroy prostate cancer, including vaccines, immune checkpoint inhibitors and cancer-killing (oncolytic) viruses.
For example, we are currently investigating in our lab how a modified poliovirus, which has shown early success in treating patients with aggressive brain tumors, might also be used to attack prostate cancer cells. Our goal is to bring this to phase one trials soon.
Biology of Cancer Disparities
The Genitourinary Cancer Program’s extraordinary basic and translational scientists are working in a partnership to better understand the underlying biology of prostate cancer and to improve treatment options.
Researchers at Duke and elsewhere have found that African American men are two times more likely to be diagnosed with prostate cancer than white men and three times more likely to die from prostate cancer than white men. Much of this disparity remains even after controlling for factors related to access to care. In fact, we have identified novel biological differences that drive a more aggressive prostate cancer in African American men.
With these differences in mind, we are developing new and better ways to predict the level of aggression of a patient’s prostate cancer and determine which drugs are appropriate for their treatment.
Ultimately, through our research, we hope to reduce the disproportionate burden of prostate cancer on African Americans and improve clinical outcomes for men of all races with aggressive prostate cancer.
DCI is spearheading clinical trials which are leading to improvements in the treatment of both kidney and prostate cancer, and genitourinary cancer clinical research at Duke also includes a number of investigator-initiated trials, with a focus on locally advanced and metastatic prostate cancer.
One Man’s Journey Leads to An Unforeseen Purpose Helping Many
They say it’s really the journey that teaches us a lot about our destination. Dominic Marrese could have never anticipated 10 years ago when he was diagnosed with prostate cancer that today he would be an outspoken advocate for prostate cancer screening and a committed champion for increased funding to move science forward. More
Duke Cancer Institute constellates the world-class resources of Duke University, Duke Health and the Duke Comprehensive Cancer Center into a collaborative powerhouse. We are poised to drive a paradigm shift in the way long-established cancer centers and institutes have been waging this war.Learn More