Health Disparities

Research Description

Dr. Murphy's group investigates etiologies and modifiable risk factors for health disparities in prostate cancer. They study the biological and environmental mediators of serum vitamin D deficiency and prostate cancer risk. Dr. Murphy's group also assesses the role of HIV infection on the incidence and treatment of prostate cancer. Finally, they evaluate barriers of prostate cancer screening for African American men using community-based participatory research methods.

Publications

• Meza J, Babajide R, Saoud R, Sweis J, Abelleira J, Helenowski I, Jovanovic B, Eggener S, Miller FH, Horowitz JM, Casalino DD, Murphy AB. Assessing the accuracy of multiparametric MRI to predict clinically significant prostate cancer in biopsy naïve men across racial/ethnic groups. BMC Urol. 2022 Jul 18;22(1):107. 
• Murphy AB, Abern MR, Liu L, Wang H, Hollowell CMP, Sharifi R, Vidal P, Kajdacsy-Balla A, Sekosan M, Ferrer K, Wu S, Gallegos M, King-Lee P, Sharp LK, Ferrans CE, Gann PH. Impact of a Genomic Test on Treatment Decision in a Predominantly African American Population With Favorable-Risk Prostate Cancer: A Randomized Trial. J Clin Oncol. 2021 May 20;39(15):1660-1670. 

• Murphy AB, Carbunaru S, Nettey OS, Gornbein C, Macias V, Sharifi R, Kittles RA, Yang X, Kajdacsy-Balla A, Gann P, Dixon MA. A 17-Gene Panel Genomic Prostate Score Has Similar Predictive Accuracy for Adverse Pathology at Radical Prostatectomy in African American and European American Men. Urology. 2020 Jan.

• Carbunaru S, Nettey OS, Gogana P, Helenowski IB, Jovanovic B, Ruden M, Hollowell CMP, Sharifi R, Kittles RA, Schaeffer E, Gann P, Murphy AB. A comparative effectiveness analysis of the PBCG vs. PCPT risks calculators in a multi-ethnic cohort. BMC Urology. November 2019.

• Murphy AB, Nyame YA, Batai K, Kalu R, Khan A, Gogana P, Dixon M, Macias V, Kajdacsy-Balla A, Hollowell CMP, Catalona WJ, Kittles R. Does prostate volume correlate with Vitamin D deficiency among men undergoing prostate biopsy? Prostate Cancer and Prostatic Disease. October 2017.

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Research Description

The laboratory of Edward Schaeffer, MD, PhD, conducts groundbreaking prostate cancer research focused on at-risk populations, diagnosis, treatment outcomes, and the molecular biology of lethal prostate cancer.  As Chair of the Department of Urology at Northwestern Medicine and Program Director of the Genitourinary Oncology Program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Dr. Schaeffer is championing leading-edge explorations that are advancing scientific and clinical care pathways in prostate cancer.

Molecular biology of prostate development and prostatic disease: Dr. Schaeffer proposed the concept that the lineage of a prostate epithelial cell is established early, upon exposure to androgen, and that this lineage affects subsequent re-activation of embryonic growth pathways in pathologic prostatic conditions including BPH and prostate cancer.  This body of work has resulted in an international recognition as a prostate embryologist and established the paradigm of “lineage addiction” of the prostate epithelial cell to androgen signaling.  

Clinical and molecular biology of high risk prostate cancer: Dr. Schaeffer’s clinical and molecular work has brought international recognition to the previously under appreciated observation that aggressive (high risk), localized prostate cancer is frequently lethal and often undertreated. His research  on the clinical-biologic features of men with high risk disease and the molecular underpinnings driving prostate cancers defined a new subset of the particularly lethal cancer, outlined the molecular basis driving them and begun to lead clinical trials designed to improve the oncologic outcomes for these men.

The impact of race on the biology of prostate cancer: African American men with prostate cancer are twice as likely to develop metastasis and die of the disease than Caucasian men. Dr. Schaeffer’s work demonstrated a more aggressive biologic subset of cancers in African American men. His other discoveries include: (1) distinctive anatomic locations of African American tumors, (2) molecular expression signatures of African American cancers that demonstrate decreased reliance on androgen signaling, (3) novel solid tumor gene fusions and (4) divergent biomarkers panels signaling aggressive disease. 

In this video, Dr. Schaeffer shares some of the exciting developments underway at Northwestern to better understand racial disparities in prostate cancer.

Tools to aid in clinical decision-making: One of the greatest challenges in prostate cancer management is identifying patients that will progress to advanced disease following treatment. The Schaeffer lab has developed and validated a genomic signature to predict response to anti-androgen therapies in order to guide treatment selection. The lab is currently refining this analysis to broaden our understanding of the molecular features of those who do and do not respond to treatment. In this video, he shares details about and future directions of this work.

Publications

Weiner AB, Yu CY, Kini M, Liu Y, Davicioni E, Mitrofanova A, Lotan TL, Schaeffer EM. High intratumoral plasma cells content in primary prostate cancer defines a subset of tumors with potential susceptibility to immune-based treatments. Prostate Cancer Prostatic Dis. 2022 May 14.

Weiner AB, Li EV, Desai AS, Press DJ, Schaeffer EM. Cause of death during prostate cancer survivorship: A contemporary, US population-based analysis. Cancer. 2021 Aug; 127(16): 2895-2904.

Weiner AB, Liu Y, McFarlane M, Bawa PS, Li EV, Zhao X, Li Z, Hammoud T, Hazime M, Karnes RJ, Davicioni E, Reichert ZR, Chinnaiyan AM, Lotan TL, Spratt DE, Schaeffer EM. A transcriptomic model for homologous recombination deficiency in prostate cancer. Prostate Cancer Prostatic Dis. 2021 Jul.

Weiner AB, Vidotto T, Liu Y, Mendes AA, Salles DC, Faisal FA, Murali S, McFarlane M, Imada EL, Zhao X, Li Z, Davicioni E, Marchionni L, Chinnaiyan AM, Freedland SJ, Spratt DE, Wu JD, Lotan TL, Schaeffer EM. Plasma cells are enriched in localized prostate cancer in Black men and are associated with improved outcomes. Nat Commun. 2021 Feb 10;12(1):935.

Faisal FA, Murali S, Kaur H, Vidotto T, Guedes LB, Salles DC, Kothari V, Tosoian JJ, Han S, Hovelson DH, Hu K, Spratt DE, Baras AS, Tomlins SA, Schaeffer EM, Lotan TL. CDKN1B Deletions are Associated with Metastasis in African American Men with Clinically Localized, Surgically Treated Prostate Cancer. Clin Cancer Res. 2020 Jan 22.

Spratt DE, Alshalalfa M, Fishbane N, Weiner AB, Mehra R, Mahal BA, Lehrer J, Liu Y, Zhao SG, Speers C, Morgan TM, Dicker AP, Freedland SJ, Karnes RJ, Weinmann S, Davicioni E, Ross AE, Den RB, Nguyen PL, Feng FY, Lotan TL, Chinnaiyan AM, Schaeffer EM. Transcriptomic Heterogeneity of Androgen Receptor Activity Defines a de novo low AR-Active Subclass in Treatment Naïve Primary Prostate Cancer.Clin Cancer Res. 2019 Nov 15;25(22):6721-6730. 

Refer to PubMed for a full list of publications. 

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Research Description

Dr. Amarasekera is a pioneer in the research of health outcomes in urology for men who have sex with men. He has developed a framework for how to optimize treatment for prostate cancer among this patient population.

 His current research interests focus on identifying and addressing urologic healthcare disparities faced by members of sexual minorities. To complement his clinical and research work in this field, Dr. Amarasekera is committed to educating clinicians, residents and medical students on culturally appropriate care for patients from sexual minorities.

In this video, Channa Amarasekera, MD, talks about his recent study examining urologists’ knowledge and attitudes toward patients in sexual minorities and how the Northwestern Medicine Gay and Bisexual Men’s Urology Program is working to reduce these disparities and improve gay and bisexual men’s urologic health.

In this podcast, Dr. Amarasekera discusses prostate cancer treatment considerations for gay and bisexual men. He shares his published study assessing areas of sexual function predicted to be important after treatment and what other urologists need to know about when caring for gay and bisexual patients with prostate cancer.

Publications

Amarasekera C, Wong V, Jackson K, Yura E, Patel M, Manjunath A, Kundu S. A pilot study assessing aspects of sexual function predicated to be important after treatment for prostate cancer in gay men: an underserved domain highlighted. LGBT Health. 2020 Jul;7(5):271-276.

Amarasekera C, Wong V, Yura E, Manjunath A, Schaeffer E, Kundu S. Prostate Cancer in Sexual Minorities and the Impact of HIV Infection. Nature Reviews Urology. 2019 Jul; 16(7):404-421

For a complete list of publications, refer to PubMed.

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