Below the Belt Award

The ANZUP TheraP study was a landmark randomised controlled trial of Lutetium- 177-PSMA providing compelling evidence that this novel treatment improves outcomes for patients with metastatic castration-resistant prostate cancer. Together with lead investigators Prof. Michael Hofman, Prof. Andrew Martin, Prof. Ian Davis and the TheraP team, I was the first author of the imaging biomarker analysis (Lancet Oncology 2022). We demonstrated, for the first time, that high tumour uptake on the PSMA PET scan is a predictive biomarker for response to Lutetium- 177-PSMA. We also demonstrated FDG PET is a prognostic biomarker, which can identify patients with worse outcomes and could benefit from treatment intensification. In simpler terms, Lutetium-177-PSMA is a form of liquid radiation injected into a vein. This very targeted treatment finds and sticks to prostate cancer cells, while giving little radiation to normal organs. The PET scans are like a window into the future, done before giving the Lutetium-177-PSMA. PSMA PET scans help us understand how much radiation may be given to tumours depending on how “bright” they are. FDG PET scans reveal which tumours are growing fastest. This PET scan is a tool that can help find patients who have tumours that are more aggressive and may need more intense treatments. In this project, I will address the main limitation of our prior work. Currently, specialised and expensive software is needed to measure the PET biomarkers. Most medical centres need to use human contouring, a time-consuming process that can give different results between users. This limits routine use of the PET biomarkers in most medical centres. I will utilise artificial intelligence (AI) deep learning algorithms to create and validate a single-click solution to measure the PET biomarkers. This innovative approach could improve their access worldwide, and measure accurate PET biomarker values regardless of a centre’s expertise.