Stopping Cancer Early – The Best Possible Investment

About the Program

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.

Team

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.

Clinical Studies

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.

Additional Information

Find out more about PASS.

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
617-667-2898

Eastern Virginia Medical School
Leigh Ann Brand, CCRP
757-452-3464

Stanford University
Michelle Ferrari, RN
650-725-5543

University of British Columbia
Jonathan Ma
604-875-4111 Ext. 66557

University of California, San Francisco
Samuel Chadwick
415-885-3679

Imelda Tenggara-Hunter
415-353-7348

University of Michigan PASS
Rabia Siddiqu
734-763-7508

University of Texas Health Science Center, San Antonio
Heather Mullis
210- 567-1172

University of Washington
Chenee Holcomb
206-598-0850

Veterans Affairs Puget Sound Health Care System
Branda Levchak
206-277-4760

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.

To apply to conduct studies using the Canary TMA Resource, submit the Canary Foundation Retrospective Prostate Tissue Microarray Resource Application.

Canary’s Studies in Imaging for Prostate Cancer

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.

Where Canary Science is Happening

  • University of Washington, Seattle, Washington
  • Fred Hutchinson Cancer Center, Seattle, Washington
  • Stanford University, Stanford, California
  • University of California, San Francisco
  • MD Anderson Cancer Center, Houston, Texas
  • University of British Columbia, Victoria, British Columbia
  • University of Texas San Antonio Health Sciences Center, San Antonio, Texas
  • Eastern Virginia Medical School, Norfolk, Virginia
  • University of California, San Francisco, San Francisco, California
  • Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • University of Michigan, Ann Arbor, Michigan
  • Cleveland Clinic, Cleveland, Ohio

Canary Funded Prostate Cancer Papers

Brooks, J.D., et al. Loss of expression of AZGP1 is associated with worse clinical outcomes in a multi-institutional radical prostatectomy cohort. Prostate (2016)

Lotan, T.L., et al. Analytic validation of a clinical-grade PTEN immunohistochemistry assay in prostate cancer by comparison with PTEN FISH. Modern Pathology (2016 )

Tretiakova, M.S., et al. Prognostic value of Ki67 in localized prostate carcinoma: a multi-institutional study of >1000 prostatectomies. Prostate Cancer Prostatic Dis. (2016)

Newcomb, L.F., et al. Outcomes of Active Surveillance for Clinically Localized Prostate Cancer in the Prospective, Multi-Institutional Canary PASS Cohort. Journal of Urology (2015)

Ankerst, D.P., et al. Precision Medicine in Active Surveillance for Prostate Cancer: Development of the Canary-Early Detection Research Network Active Surveillance Biopsy Risk Calculator. Eur Urol. (2015)

Brooks, J.D., et al. Evaluation of ERG and SPINK1 by Immunohistochemical Staining and Clinicopathological Outcomes in a Multi-Institutional Radical Prostatectomy Cohort of 1067 Patients. PLoS ONE (2015)

Troyer, D.A., et al. A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer. Prostate (2015)

Jokerst, J.V., et al. A Magnetic Bead-Based Sensor for the Quantification of Multiple Prostate Cancer Biomarkers. PLoS One (2015)

Lin, D.W., et al. Urinary TMPRSS2:ERG and PCA3 in an active surveillance cohort: results from a baseline analysis in the Canary Prostate Active Surveillance Study. Clin Cancer Res. (2013)

Hawley, S., et al. A model for the design and construction of a resource for the validation of prognostic prostate cancer biomarkers: the Canary Prostate Cancer Tissue Microarray. Adv Anat Pathol. (2013)

McKenney, J.K., et al.The potential impact of reproducibility of Gleason grading in men with early stage prostate cancer managed by active surveillance: a multi-institutional study. J.Urol (2010)

Newcomb, L.F., et al. Canary Prostate Active Surveillance Study: Design of a multi-institutional active surveillance cohort and biorepository. Urology (2009)