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Dr. Slawin has focused his research efforts on translational medicine throughout his career.
One example is the development of a novel vaccine directed againg prostate cancer that is now just entering first in human clinical trials. Another is the discovery of BPH-A and -2proPSA, molecular forms of free PSA that are now on the cusp of FDA approval and that will allow better distinction of the causes of elevated PSA levels in patients. Studies published by Dr. Slawin and his research associates have identified and validated novel molecular markers of prostate cancer progression, and he has developed electronic nomograms that assist physicians in establishing the risk of prostate cancer progression for individual patients.
These are his current research programs: |
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Over the years, outcomes after prostate cancer treatment have steadily improved because of increasing physician skill and experience and the integration of new technologies such as robotic prostatectomy, nerve grafting, cryotherapy, and image-guided approaches to external beam radiotherapy. Numerous published studies have demonstrated that physician experience is a key determining factor in cancer cure rate, complication reduction, and recovery rate after open and minimally invasive approaches to prostate cancer surgery, like robotic prostatectomy.
Dr. Slawin has developed and maintained the secure, online, relational Caisis™ database, which contains all cancer and quality-of-life data available on every patient who has received treatment under his direction while he was the Director of The Baylor Prostate Center, and more recently, since he became Director of the Texas Prostate Center in the Vanguard Urologic Institute.
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The PSA (prostate specific antigen) blood test is an important screening tool for prostate cancer, the most common solid-tumor malignancy in the United States. While an elevated PSA level may indicate the presence of prostate cancer, it doesn’t always because benign conditions can also elevate PSA level.
Since 1998, the FDA has approved a method to obtain more conclusive results. By calculating the ratio of the level of “free,” or unbound, circulating PSA with the standard total PSA level, physicians can better differentiate patients who have prostate cancer from those who do not, with higher ratios indicating a lower risk of prostate cancer. “The PSA test has become like measuring cholesterol,” says Kevin Slawin, M.D. “You used to just get your cholesterol checked, but now we look at the ratio of LDL and HDL cholesterol levels to predict the risk of heart disease. In a similar way, the free-to-total PSA ratio can predict the risk of prostate cancer.”
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The current standard of care for androgen-independent prostate cancer (AIPC) is administration of FDA-approved docetaxel chemotherapy, which yields only a two-month increase in median survival rates and is often accompanied by serious side effects, including fatigue, hair loss, and neuropathy.
In the fall of 2008, researchers at the Vanguard Urologic Institute and Texas Prostate Center at Memorial Hermann - Texas Medical Center will begin participating in a trial to test an innovative vaccine technology expected to offer men an important new treatment option.
The BP-GMAX-CD1 cancer vaccine is specifically designed to circumvent the obstacles researchers believe underlie the failure, to date, of cancer vaccines to fulfill their potential as a potent and safe treatment. Created by Dr. Slawin in collaboration with Baylor College of Medicine researcher David Spencer, Ph.D., the promising new therapy is the first vaccine that can be “activated” precisely at the optimal time and location in the body through administration of an activating agent called AP1903.
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Most patients who have undergone radical prostatectomy surgery for the treatment of prostate cancer, performed either robotically or through an open approach, are followed after surgery with PSA blood testing. Typically, this is performed every three months during the first year, every six months in years two through five, and once a year thereafter. Using a standard PSA blood test, an undetectable PSA level reported to the lower limit of most assays (<0.1 ng/mL) has typically been accepted as indication that a patient is cancer-free. However, in a study reported last year, Dr. Slawin and his colleagues demonstrated that an ultrasensitive PSA assay that reports results down to <0.003 ng/mL enables patients with prostate cancer recurrence to be identified well before the less accurate PSA test can identify them. Further, the additional lead time has provided the opportunity to treat them with salvage radiation therapy when the PSA is lower and the cancer is more likely to respond favorably. |
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 Vanguard Urologic Institute founders Kevin Slawin, M.D., and Tung Shu, M.D., have long been leaders in the development of minimally invasive techniques for radical prostatectomy using the da Vinci® surgical system. The outcomes speak for themselves: minimized damage to tissues surrounding the prostate and excellent cancer control rates that are equivalent to the traditional open approach to radical prostatectomy. Results also include decreased length of stay and decreased morbidity as measured by a more rapid recovery of potency and continence.
But when cancer has spread beyond the prostate, one or both cavernous nerves adjacent to the prostate may require partial or complete removal to ensure a negative surgical margin. The nerves, essential for erectile function and, to a lesser degree, urinary continence, are typically left unrepaired. At the Vanguard Urologic Institute, Drs. Slawin and Shu offer nerve grafting at the time of prostatectomy, providing patients with an increased chance of recovering sexual potency following the healing process.
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Research
