Identifying and Addressing Barriers to Live Primary Prostate Cancer Cell Research in Veterans

Increased comorbidities and unique service-related exposures among veterans may contribute to unique tumor biology that can influence tumor behavior and response to treatment. Research that incorporates live cells from veteran donors can support investigation of the genomic and transcriptomic biology of veteran tumors as well as how those molecular alterations affect tumor function, such as growth, metastasis, and treatment sensitivity. We conducted a systematic literature review to assess veteran-focused prostate cancer studies published in the last decade that incorporate live primary cells. We found that in the past 10 years, 105 prostate cancer studies were published that utilized live primary cells from the general population compared with zero studies utilizing live primary cells from veterans. Analysis of veterans enrolled in a study utilizing live primary cells at the William S Middleton Veterans Affairs demonstrated that 94% of veterans who were presented with a live cell biospecimen donation study ultimately enrolled. Furthermore, survey responses from veterans enrolled in this study showed that 83% of veterans found their research engagement to be a meaningful experience and 70% reported increased healthcare satisfaction as a result of their participation. These findings suggest that the lack of live cell prostate cancer research in veterans seems to be due to a lack of research opportunities for veterans and not a lack of veteran interest in participation Finally, we demonstrate that implementation of an informatics-based patient screening strategy can potentially support more veteran-focused studies by reducing participant screening time by 89%.

Live primary cells are a unique model for prostate cancer research that provides both molecular and functional readouts to support advances in veteran prostate cancer care. We detail the shortage of live primary research in veterans and address potential barriers to future studies incorporating this model.