Kevin Slawin: Taking bench to bedside

By Ross Tomlin

Taking the bench to the bedside is the crucial goal in today's biomedical environment. It is a task that Kevin Slawin, M.D., director of the Baylor Prostate Center and professor of urology at Baylor College of Medicine, seizes with both vigor and creativity.

When not performing robotic prostatectomies or taking residents under his wing, Slawin immerses himself in collaborative translational research. He is also developing proprietary, web-based research software to create a worldwide patient registry with built-in algorithms that predict disease progression according to PSA readings and recommend the appropriate treatment regimen.

"I'm a busy guy," the soft-spoken urologist says.

Vaccine program

The area of research Slawin considers the most exciting is his work on vaccine therapies that stem the spread of prostate cancer.

So far, much of the first generation technology currently available has yet to make a serious impact, primarily because the sheer complexity of the immune system's signaling pathways make them difficult to manipulate. Despite these challenges, Slawin and other BCM investigators already have their sights set on third-generation vaccine therapy.

Human clinical trials testing the new vaccines on patients with metastatic prostate cancer are set for early 2006. Collaborators at BCM include David Spencer, Ph.D., Si Yi Chen, M.D., Ph.D., Cliona Rooney, Ph.D., and Malcolm Brenner, M.D., Ph.D.

"This is true collaborative translational research on how to improve an immune response," said Slawin.

Novel PSA tests

Tests that detect the level of a man's prostate specific antigen (PSA) can be useful, particularly in the United States where prostate cancer is the most common solid tumor malignancy in men. Given that approximately 70 percent of patients who experience PSA-progression after primary therapy will have metastases at some time during the course of their disease, PSA levels remain one of the few markers prostate specialists have to go by when treating patients.

The problem with traditional tests, of course, is that they are not necessarily indicative of the cancer's severity, or even its presence. Fortunately, Slawin and several BCM researchers are developing specialized tests like B-PSA and Pro-PSA in late-stage clinical trials that more accurately differentiate those who have cancer and those who do not.

"PSA is like cholesterol," said Slawin. "You used to get your cholesterol checked, but now you get your LDL and your HDL levels tested and examine those ratios. PSA is quickly becoming the same way."

BPH screening

The challenge of diagnosing benign prostatic hyperplasia (BPH) illustrates why more accurate PSA tests are in demand.

BPH, a condition in which the prostate gland is enlarged, produces the same PSA readings that prostate cancer often does. Although not life-threatening, BPH can cause clinically significant urinary problems in roughly a quarter of all men over 60.

In conjunction with John Levitt, M.D., assistant professor of urology at BCM, Slawin seeks to better understand the mechanisms that cause BPH and develop tests that screen for likely candidates of the disorder. Levitt is in the process of comparing genomic samples of men with normal-sized and enlarged prostates using microarrays.