The Canary Prostate Program, which includes the Prostate cancer Active Surveillance Study (PASS), a large tissue microarray biomarker project, and innovative imaging techniques, is designed to address urgent, high-impact challenges in prostate cancer.
Prostate cancer is the most commonly diagnosed cancer in men in North America and the second most commonly diagnosed cancer in men worldwide (Centers for Disease Control). In this era of prostate-specific antigen (PSA) screening, cancer in its early stages is often identified. According to the American Cancer Society, about 1 man in 7 will be diagnosed with prostate cancer during his lifetime. Most newly diagnosed prostate cancers are indolent, which means that they will never cause harm if left untreated. However, we lack the tools to tell the difference between indolent and more aggressive prostate cancers with a high degree of certainty.
Even though many prostate cancers may never progress or cause harm to the patient if left untreated, most men still undergo primary curative treatment. Treatments often have associated side effects. Overtreatment of prostate cancer is a major problem in this country.
With better biomarker tests (using blood, tissue, and/or urine) and imaging tests to distinguish lethal vs. non-lethal prostate cancer, men will be spared unnecessary treatment and unneeded biopsies while helping those who need immediate treatment for their disease.
Dr. Nelson is involved in detecting the subgroup of lethal prostate cancers and aggressively treating those cases at its earliest stages, while sparing other men needless treatment for a disease that will never impact them.
Progress at a glance
Canary Prostate Program infographic
Check out our infographic to view Canary’s progress in the field of prostate cancer early detection.
In accordance with the requirements of running a large multi-institutional active surveillance study, a large tissue microarray study, and imaging studies, team is composed of physicians who specialize in urologic cancers as well as experts in statistics, imaging, and management of clinical studies.
Members of the team include:
James Brooks, M.D. Stanford University
Peter Carroll, M.D. University of California, San Francisco
Matthew Cooperberg, M.D., University of California at San Francisco
Michael Fabrizio, M.D., Eastern Virginia Medical Scho
Ladan Fazli, Ph.D., University of British Columbia
Ziding Feng, Ph.D. MD Anderson Cancer Center
Sanjiv Sam Gambhir, Ph.D., M.D., Stanford University
Martin Gleave, M.D. University of British Columbia
Daniel Lin, M.D., Canary PASS Director, University of Washington
Jesse McKenney, M.D., Cleveland Clinic
Maxwell Meng, M.D., University of California, San Francisco
Todd Morgan, M.D., University of Michigan
Peter Nelson, M.D., Prostate Team Leader, University of Washington and Fred Hutchinson Cancer Center
Lisa Newcomb, Ph.D., Canary PASS Deputy Director, University of Washington and Fred Hutchinson Cancer Research Center
Tim Randolph, Ph.D., University of Washington, Fred Hutchinson Cancer Research Center
Jeff Simko, Ph.D., M.D., University of California at San Francisco
Ian Thompson, M.D., University of Texas San Antonio Health Sciences Center
Maria Tretiakova, M.D., Fred Hutchinson Cancer Research Center
Dean Troyer, M.D., Eastern Virginia Medical School
Larry True, M.D., University of Washington
Andrew Wagner, M.D., Beth Israel Deaconess Medical Center
John Wei, M.D., University of Michigan
Yingye Zheng, Ph.D., Fred Hutchinson Cancer Research Center
Bringing Biomarkers into the Clinic
Part of the Canary strategy is to develop industry partnerships to validate biomarker panels for the prediction of prostate cancer aggressiveness and bring the biomarkers into clinical use in the near term.
This will give patients and physicians better decision-making tools, which should reduce overtreatment and identify men who may benefit from early treatment. The Canary team is collaborating with several companies that are developing biomarkers, including Genomic Health Inc., OPKO Diagnostics, and Gen-Probe/Hologic. These biomarkers are tested in tissue, blood, and urine, respectively.
Dr. Brooks works in developing biomarkers that predict and separate the early significant cancers that need to be treated, versus the ones that can be safely watched.
Prostate Active Surveillance Study (PASS)
The Canary Prostate Active Surveillance Study (PASS) was launched in 2008 in response to the growing evidence of overtreatment of prostate cancer and a need for tools to tell the difference between aggressive and indolent prostate cancer.
Active surveillance is an accepted standard of care option to manage low-risk prostate cancers. Active surveillance involves careful monitoring by serial prostate biopsy, clinical exam and prostate specific antigen (PSA) tests. If the low-risk cancers show signs of more aggressive behavior during the monitoring, then they can be treated at that time. This spares many men the potential side effects and cost of immediate treatment.
PASS is a multi-center study enrolling men with early-stage prostate cancer who elect to manage their cancer by being actively monitored (with PSA measurements, clinical exams, and repeat biopsies), donating specimens as they are being followed for five years. Intervention such as radiation treatment or surgery is offered if evidence of a more aggressive or growing tumor develops. After five years have passed or after treatment has been received, long-term outcome data continue to be collected.
PASS has enrolled more than 1,100 men, each of whom is being followed for five years. The trial has collected more than 200,000 specimens. Adherence to protocols, clinical information databases, and specimen collections are managed and maintained centrally. Procedures and legal agreements are in place to share data and specimens; PASS distributes specimens from its central facility for use in approved studies. To apply to conduct studies using PASS biological specimens, submit the PASS Project application.
Dr. Lin’s work specializes in biomarker technologies to identity and curatively treat prostate cancer at its earliest stages.
To find out more about prostate cancer, please visit National Cancer Institute or contact the National Cancer Institute’s Cancer Information Service at 1-800-4-Cancer (1-800-422-6237) or TTY: 1-800-332-8615. In Canada, call the Canadian Cancer Society’s Cancer Information Service at 1-888-939-3333
Study Sites and Contacts
Beth Israel Deaconess Medical Center/Harvard Medical School
Andrew Wagner, MD
Eastern Virginia Medical School
Leigh Ann Brand, CCRP
Michelle Ferrari, RN
University of British Columbia
604-875-4111 Ext. 66557
University of California, San Francisco
University of Michigan PASS
University of Texas Health Science Center, San Antonio
University of Washington
Veterans Affairs Puget Sound Health Care System
The Canary Tissue Microarray (TMA) Resource
The Canary Foundation Retrospective Prostate Tissue Microarray Resource is a multicenter, retrospective prostate cancer tissue microarray cohort designed to validate biomarkers of prostate cancer recurrence after surgery.
The resource will confirm the predictive power of previously discovered tissue biomarkers of aggressive cancer. The TMA’s represent over 1,000 patients selected using a rigorous statistical design from six participating institutions in the United States and Canada, capturing the heterogeneity of screening and clinical practices in the contemporary North American population. Standardized clinical data are collected in a centralized database.
New imaging approaches may provide a more sensitive and more accurate approach for the detection of prostate cancers. We are testing two new techniques, enhanced ultrasound using targeted microbubbles and photoacoustic imaging, for their utility in prostate cancer screening.