Matthew R. Cooperberg, MD, MPH

Matthew R. Cooperberg, MD, MPH

University of California, San Francisco

San Francisco, California

Matthew R. Cooperberg, MD, MPH, is Professor of Urology and Epidemiology & Biostatistics and Helen Diller Family Chair in Urology at the University of California, San Francisco. He earned an undergraduate degree in English from Dartmouth College in Hanover, New Hampshire, before pursuing his MD from the Yale School of Medicine in New Haven, Connecticut. Dr. Cooperberg also earned an MPH with a concentration in Health Policy from the Yale School of Epidemiology and Public Health. He joined the faculty at UCSF in 2009, and was named a professor there in 2018.

Dr. Cooperberg’s clinical interests include the diagnosis and management of genitourinary malignancies, as well as minimally-invasive techniques to treat benign and malignant diseases. His research focus is prostate cancer, and in this area he is particularly interested in health services, risk assessment and biomarkers, comparative effectiveness of treatments, and decision support and survivorship. He is also interested in care disparities and in looking at prostate cancer as an international disease.

Dr. Cooperberg has written over 400 peer-reviewed scientific articles and is an investigator on several ongoing federal grants. He has won the Young Investigator Award from the Prostate Cancer Foundation and the American Urological Association Gold Cystoscope Award, and was also named Young Urologist of the Year in 2015. He is a Fellow of the American College of Surgeons and a member of the American Urological Association and the Society for Urologic Oncology.

Disclosures:

Talks by Matthew R. Cooperberg, MD, MPH

Pros and Cons of the ReIMAGINE Trial

Matthew R. Cooperberg, MD, MPH, discusses the strengths and weaknesses of the Risk and Screening arms of the ongoing ReIMAGINE trial. He begins by describing the two arms of the study, ReIMAGINE Screening and ReIMAGINE Risk, and then focuses on the Screening arm, digging into the participant data.

Dr. Cooperberg addresses the sequence of screening tests in the ReIMAGINE trial, and reasserts the value of PSA as an initial screening marker, using supporting evidence from the ongoing STHLM3-MRI trial.

Dr. Cooperberg concludes by explaining that ReIMAGINE Risk will be useful as a biorepository in the future. While ReIMAGINE Screening shows PSA with magnetic resonance imaging (MRI) is better than PSA alone, he reiterates that as a first screen, PSA <1 (or 1.5) is tough to beat. Dr. Cooperberg explains that MRI is useful for helping to guide biopsy and is acceptable as a second screening tool. However, other markers are more effective and less expensive in the United States.

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Updates in Prostate Cancer Biomarkers

Matthew R. Cooperberg, MD, MPH, Professor of Urology and Epidemiology & Biostatistics and Helen Diller Family Chair in Urology at the University of California, San Francisco, addresses prostate-specific antigen (PSA) testing and explains that a PSA below the median has a very strong negative predictive value (NPV) in terms of meaningful cancer. He asserts that, when combined with secondary biomarker testing before biopsy, early baseline PSA can be very effective in terms of risk assessment. He also explains that as research on biomarkers evolves, the field will get closer to being able to use genomic information derived from the primary tumor to make initial and follow-on treatment decisions.

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Forward Progress in Molecular Markers in Prostate Cancer

Matthew R. Cooperberg, MD, MPH, Professor of Urology and Epidemiology & Biostatistics and Helen Diller Family Chair in Urology at the University of California, San Francisco, explores a range of biomarkers used for diagnosis, risk stratification, and guiding treatment for prostate he cancer. He first details pre-biopsy diagnosis or prostate cancer, including PSA, 4K, phi, MyProstateScore, ExoDX, SelectMDx, and mpMRI. Dr. Cooperberg discusses how post-diagnosis biomarkers must be shown to improve on an existing, validated, multivariable model reflecting all available clinical information rather than on a single variable or nonlinear risk grouping, and reviews post-diagnosis options for risk stratification and treatment.

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Biomarkers and Clinical Decisions – Integrating with Clinical Parameters, Imaging & Prognostic Instruments

Matthew R. Cooperberg, MD, MPH, Professor of Urology and Epidemiology & Biostatistics and Helen Diller Family Chair in Urology at the University of California, San Francisco (UCSF), outlines the current role of biomarkers in clinical decision-making for prostate cancer. In the first part of the presentation, he discusses markers for pre-diagnosis evaluation, noting that candidate markers have to improve on an existing multivariable gold standard, have to identify potentially lethal prostate cancer, and should be held to the same standard as other biomarkers. Dr. Cooperberg goes over the tests that are currently available, and considers where markers belong in the testing sequence. He observes that liquid markers have better negative predictive value for high-grade cancer than MRI does, and also emphasizes the continued importance of systematic biopsy. He then explains the emerging UCSF diagnostic sequencing approach, in which patients with an elevated marker receive a biopsy regardless of MRI results. In the next part of the presentation, Dr. Cooperberg looks at the relatively stagnant state of post-diagnosis markers. According to him, risk groups are outdated and need to be replaced. He then summarizes the 2nd San Francisco Consensus Statement on this matter, which says that a putative biomarker must be shown to improve on an existing, validated, multivariable model reflecting all available clinical information, and explains that while some biomarkers meet this criteria, they are not yet standard of care. Dr. Cooperberg concludes that the liberal use of secondary tests to aid decision-making before and after biopsy helps drive balance of risks and harms in favor of early baseline PSA screening with low initial threshold, that MRI can help target biopsy and stage cancer but does not replace need for initial systematic biopsy, and that no test is binary.

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