Doctoral Student Receives NCI Award to Study Prostate Cancer Spread and Prognosis

A doctoral student at the University of Arizona is seeking to address one of the unique challenges presented by prostate cancer: prognosis.

Kendra Marr, a fifth-year student pursuing an MD/PhD degree at the UArizona College of Medicine – Tucson, has received a National Research Service Award totaling $174,728 from the National Cancer Institute (NCI) for a project titled, “Smooth Muscle Invasion Selects for Aggressive Prostate Cancer.” She spent nearly two years developing the project throughout a highly competitive grant submission process before it was recently awarded funding.

“This is a dream come true for me,” Marr said. “One of the main goals I had in pursuing a PhD was to learn to write my own grant. I feel like it has been five years in the making, but it is a sense of fulfillment knowing how much hard work I put into this. Now I am energized and motivated to move this research forward.”  

Marr works in the laboratory with Anne Cress, PhD, a UArizona Cancer member in the Cancer Biology Program, who has long studied how tumors metastasize, or move through the body. In studying this, Dr. Cress has been interested in a group of adhesive receptors called integrins, which are adhesion molecules that tumors use to move to a distant site in the body.

“We know a lot about how integrins work and what they do,” Dr. Cress said. “They attach and release like Velcro comes on and off. But we now realize that they are not only adhesion receptors; in fact, they actually sense the biophysical environment and this changes how they work.”

This understanding becomes central to Marr’s research because of the anatomy of the prostate. A small, reproductive gland located at the base of the bladder, the prostate is surrounded by a capsule made of smooth muscle. In order for cancer to spread from the prostate to surrounding tissue or organs, it must pass through the muscle layer.

Marr’s project will investigate what drives a specific tumor to invade through the smooth muscle capsule versus a tumor that does not spread from the prostate and may not require treatment. When cancer escapes the gland, it can extend to the intestine, bladder or bones, which causes increased risk of morbidity.  Conversely, overtreatment can be a concern for patients who receive treatment for a cancer that is considered low risk and would have never caused symptoms. Overtreatment can lead to problems and harmful side effects that could have been avoided.

Prostate cancer is the most prevalent non-skin cancer and second most-deadly cancer for American men. When confined to the prostate, the five-year survival for prostate cancer is near 100 percent. However, that percentage drops to 30 percent if the cancer spreads to a distant site, according to NCI.

“The goal is to improve the standard of care for prostate cancer patients,” Marr said. “We want to close the gap in knowledge for diagnosing a cancer that requires treatment and which cancer may be best to simply watch. If we can find molecular markers or discriminators of indolent disease that is going to remain in the gland versus aggressive disease, then that is what can inform treatment decisions.”

As an MD/PhD student, Marr is developing a balanced combination of knowledge, skills and experiences for both understanding basic science and bridging that to the clinical setting. In addition to Dr. Cress, Marr’s mentors for the project include Cancer Center members Edward P. Gelmann, MD, Benjamin Lee, MD, and Hina Arif Tiwari, MD. Application assistance was provided by the internal Cancer Center grant review support team, led by Keith Maggert, PhD.

“It is important for us to train physician scientists for the next generation of researchers,” Dr. Cress said. “The NCI grant supports that mission and gives someone like Kendra the opportunity to move the field forward. That only happens in a setting like this through the UArizona’s NCI-designated Comprehensive Cancer Center and our College of Medicine.”

Dr. Cress believes that the hard work put forth by Marr can have a “multiplier effect” on others in pursuit of their own research and writing grants. Marr is more than willing to do her part for her peers.

“I have so many incredible mentors,” Marr said. “I can’t thank them enough for helping me get to this point. And I certainly want to be able to support my underclassmen and my program, too. A big wish of mine is to help other students in their journey towards applying for these types of grants.”

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number F30CA247106. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.