Ashley E. Ross, MD, PhD

Ashley E. Ross, MD, PhD

Mary Crowley Cancer Research

Dallas, Texas

Ashley E. Ross, MD, PhD, is Executive Medical Director at Mary Crowley Cancer Research in Dallas, Texas. He also practices as a physician with Texas Oncology Practice Associates and Texas Urology Specialists. He was formerly an Associate Professor of Urology and Oncology at the Johns Hopkins School of Medicine where he led the Brady Urological Prostate Cancer Program and co-directed the Sidney Kimmel Cancer Center’s multidisciplinary prostate cancer clinic. Dr. Ross has been particularly interested in evaluating novel diagnostics and therapeutics and has led trials testing biomarkers for prostate cancer diagnosis, novel imaging modalities for staging, genomic markers to assess risk, and therapeutic trials for high-risk disease and low-volume metastatic disease. Dr. Ross is an Associate Editor of the “Journal of Prostate Cancer and Prostatic Diseases,” “Urology,” and “Annals of Surgical Oncology.” He is on the editorial board of the “British Journal of Urology” and “Urology Practice.” He has been recognized with numerous awards and honors, including the Johns Hopkins Clinical Scientist Award, the Department of Defense Prostate Cancer PTRA Award, the Patrick C. Walsh Prostate Cancer Research Award, and a Prostate Cancer Foundation Young Investigator Award.

Disclosures:

Talks by Ashley E. Ross, MD, PhD

Prognostic and Predictive Markers

Ashley E. Ross, MD, PhD, discusses genomics—prognostic and predictive markers in non-metastatic prostate cancer. He explains outcomes for localized prostate cancer vary widely and clinical decisions are based on disease risk. He points out genomic factors can provide an individualized risk assessment. Dr. Ross shares the principles of risk stratification within National Comprehensive Care Network (NCCN) guidelines that include gene expression testing (e.g., Decipher 13) and describes the Decipher platform.

Dr. Ross shares prognostic data for Decipher that show an 80% accuracy for predicting metastasis, and explains how this information informs clinical decision-making. He explains that markers can help differentiate men on active surveillance (AS) to guide the intensity of the surveillance or the decision to proceed with treatment. In men with unfavorable intermediate risk disease, data shows genomic information can help determine how much androgen signaling inhibition (if any) is necessary with radiation therapy (RT).

Dr. Ross then explains the GUIDANCE trial and explains that NCCN further stratifies high-risk patients by genomics and explains this is the focus of a longer term trial, PREDICT-RT*. He then turns to who should consider RT at prostate-specific antigen (PSA) <0.1-0.2ng/ml and asserts men with low Decipher genomic risk undergoing early salvage radiation should consider avoiding hormonal therapy. Dr. Ross explains PAM50 is a genomic classifier that identifies subtypes of cancer expression which are common across breast, bladder, prostate, and other cancers. He addresses elements of the TITAN trial as well as the ENACT trial. He concludes that individualized risk stratification drives treatment decisions and outcomes, genomics can provide independent prognostic accuracy, and predictive markers for treatment response are in active development.

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Considerations for the Clinical Impact of Next Generation Imaging in Prostate Cancer

Ashley Ross, MD, PhD, Executive Medical Director of the Mary Crowley Cancer Research Center in Dallas, discusses the current and potential impact of PSMA PET imaging on the identification and treatment of localized prostate cancer. He notes how PET PSMA and fluciclovine imaging can increase the accuracy of detecting clinically significant localized disease. Dr. Ross further discusses how PET imaging assists in risk stratification of candidates for treatment of HSPC, nmCRPC using salvage local therapy, metastasis-directed therapy, or intensification of systemic therapy. He also discusses how PET imaging can help identify candidates for cure with local treatments.

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