Prostate Cancer

Each year, there are nearly 300,000 new prostate cancer diagnoses in the United States, accounting for nearly 15% of all new cancer cases—making it the most common cancer among men.

While most prostate cancers are found early and are cured with either surgery or radiation, it remains the second-leading cause of cancer deaths among men in the United States. This subset of patients is diagnosed with advanced prostate cancer that has often spread to other parts of the body.

Prostate cancer is a focus for Indiana University Melvin and Bren Simon Comprehensive Cancer Center researchers. We are working to improve outcomes for localized and metastatic prostate cancer and making sure new diagnostic and treatment options can accomplish a singular goal: curing prostate cancer.

IU is uniquely positioned to make critical advancements thanks to collaborative research among medical oncology, urology, radiation oncology, nuclear medicine, and cardio-oncology teams. Because everyone works together, discoveries move quickly to improve prostate cancer treatment and care for today’s patients.

Another critical component of our team are generous donors like you.

Clinical trials at IU have helped lay the groundwork for FDA approval for new prostate cancer treatment and diagnostic options.

IU was part of the global research effort, including clinical trials, that led to the FDA approval of a new diagnostic test called PSMA-PET imaging. Specifically for prostate cancer, this scan can detect minimal amounts of prostate cancer that have spread from the prostate to other parts of the body. This tool helps physicians accurately stage prostate cancer, giving patients and physicians critical diagnostic information on how early or advanced the cancer is.

With a team science approach, IU’s radiology and nuclear medicine departments led the development of this test and provided critical data for FDA approval in 2020, making it widely available. Mark Green, PhD, Mark Tann, MD, and Michael Koch, MD, the John P. Donohue Professor of Urology, led IU contributions to the PSMA-PET imaging development. Ongoing clinical studies led by Clinton Bahler, MD, will allow researchers to continue refining this tool and its accuracy.

Dr. Bahler is leading a study that uses PSMA-PET imaging before prostate cancer surgery to predict cancer extension and guide nerve-sparing surgery. While the standard of care for prostate cancer surgery uses MRI scans before surgery, this study aims to understand if using PSMA-PET scans prior to surgery could improve quality of life for patients.  This ground-breaking research would not have been possible without support from the Christy Prostate Cancer Research Fund.  This philanthropic investment allowed for clinical trials which ultimately led to the current NIH-funded study evaluating PSMA-PET imaging in real-time prostate cancer surgery.

Another promising approach developed in part at IU targets prostate cancer cells with a targeted radioactive injection. The medicine, known as Pluvicto, finds prostate cancer cells and introduces radiation directly into those cells to kill them.

IU was among the institutions that took the lead collaborating with researchers worldwide and served as a site for Phase 3 clinical studies. Nabil Adra, MD, led the studies at IU and contributed to publications and data that led to the FDA approval in 2022.

Even with FDA approval, Dr. Adra’s research in this area continues. While Pluvicto is very effective for about 50% of patients, he wants to understand why the treatment fails others and find ways to expand its effectiveness.

An IU team led by Dr. Adra is developing a way to predict who will and will not respond. Analyzing information from PSMA-PET imaging, they are predicting who will benefit from this drug and who would be better served with a different therapy. More novel treatments evaluating a newer targeted radioactive injection called actinium will be investigated at IU in an effort to treat patients whose prostate cancer progresses after treatment with Pluvicto. Another study is using a novel hormone therapy that starves prostate cancer cells. This therapy is given in combination with Pluvicto.

From immunotherapy to targeted chemotherapy, IU is conducting numerous clinical trials to expand treatment options for patients with localized or metastatic prostate cancer. Physicians are actively enrolling patients from Indiana and beyond.

A targeted chemotherapy trial led by Dr. Adra and Jennifer King, MD, tests a treatment with the singular mission to seek out prostate cancer cells. This chemotherapy is tagged to an antibody that attaches to cancer cells, targeting only the cancer.

IU researchers are also looking at markers for response or resistance to prostate cancer treatments based on the genetic makeup of a patient’s cancer. Physicians can better tailor treatments by studying the genetic makeup of a patient's cancer cells. Using large datasets of genetic test results, researchers can predict which treatment approach is best for different patient populations.

Adra is leading two Phase 3 trials at IU with new immunotherapy that introduce molecules that force the patient’s immune system to recognize cancer cells and fight them.

For newly diagnosed prostate cancer patients, Adra is leading a study examining intensifying therapy early in prostate cancer with a triplet therapy – meaning it combines three therapies – hormone therapy, hormone-targeted oral therapy and chemotherapy.

Adra is particularly interested in addressing differences among people with prostate cancer. Black men are more likely to develop more aggressive prostate cancer and, consequently, die at a higher rate. The reason for this is complex, and many things could contribute, including social determinants of health such as access to health care and socioeconomic status. Adra has a project to look at the biological and genetic differences among Black and white patients to determine if those are contributing factors.

Dr. Bahler is also leading a clinical trial that uses fluorescent imaging during surgery for real-time guidance to remove prostate cancer tissue and residual cancer cells that extend beyond the prostate. The fluorescent imaging agent makes the cancer green when viewed with a microscopic surgical camera so that surgeons can see what to remove to ensure positive margins. 

Another initiative at IU is the cardio-oncology program that is working to address cardiac health in cancer patients. A recent grant is evaluating cardiac health in prostate cancer patients. The ongoing trial is evaluating cardiovascular disease in prostate cancer patients undergoing hormone therapy.

Your philanthropic support helps build our team of prostate cancer researchers.

Noah Richardson, MD, completed his fellowship at IU in 2025 and then joined the IU School of Medicine faculty to focus on prostate cancer research. He received a Young Investigator Award from the American Society of Clinical Oncology (ASCO) for research he’s leading with Reza Shahbazi, PhD. The award provides a year of research funding to pursue his prostate cancer project.

Prostate cancer is often driven by the androgen receptor (a protein that binds male androgen hormones) and many treatments target this protein. Richardson is studying ways to use lipid nanoparticles — a technology used to deliver COVID-19 mRNA vaccines into cells – to similarly deliver precise gene editing that can knockout the androgen receptor.

Mitochondria are energy-generating structures within cells. Asmaa El-Kenawi, PhD, the Andrew and Peggy Thomson Scholar in the Department of Urology, received a multi-year grant from the Department of Defense to investigate how mitochondria change as prostate cancer develops and progresses. She and her lab are defining and mapping these changes using chemical and analytical approaches. These discoveries are then tested using prostate cancer tissues generously provided by IU patients. Ultimately, these novel characteristics can be used as a diagnostic for early detection of prostate cancer. Both Dr. El-Kenawi and her lab are supported by a gift from Andrew and Peggy Thomson. This support allows Dr. El-Kenawi to effectively study prostate cancer in hopes of improving the care we provide for patients.

Dr. El-Kenawi previously discovered that certain prostate cancer immune cells are rich in cholesterol, a metabolite processed in mitochondria. Cholesterol is broken down by mitochondria to produce energy, but high cholesterol promotes cancer growth in a hormone-driven disease such as prostate cancer. As part of her ongoing research. Dr. El-Kenawi is studying how diet could improve therapeutic responses for prostate cancer.

In a gesture that continues their family’s long history of extraordinary generosity to IU cancer research, W. Gerald and Diane Throgmartin made a significant gift in 2023 to support prostate cancer research. Gerald is a long-term survivor of prostate cancer. He is grateful for the care of Dr. Adra and for the evolution of therapies driven by research that has made his own cancer journey relatively easy.

The gift established The W. Gerald Throgmartin Prostate Cancer Research Fund, honoring Dr. Adra. The fund has supported recruitment of Dr. Richardson and support for his and Dr. El-Kenawi’s research projects.

In 2025, the cancer center launched Outpacing Prostate Cancer: Science and Support for Improved Outcomes, a free educational and social event bringing together patients, survivors, caregivers, and medical professionals. The program featured a panel of experts who shared the latest advances in prostate cancer research, treatment and clinical trials. This annual community event will continue to bring together the prostate cancer community for learning, connection and hope.