Prostate cancer researchers at Fred Hutchinson Cancer Research Center have received a five-year, $6.7 million grant from the National Cancer Institute to support the infrastructure and ongoing growth of the multicenter Canary Prostate Active Surveillance Study, or PASS.
PASS was established in 2008 with funding from the Canary Foundation, a nonprofit that focuses on early detection, particularly in prostate, pancreatic, ovarian, breast and lung cancers.
The PASS cohort, or group of patients under study, provides data and tissue samples from more than 2,100 patients with early-stage prostate cancer. Researchers use the data to better distinguish between low-risk and aggressive prostate cancers, develop biomarkers that can help with early detection, reduce overtreatment and more.
The principal investigator of PASS is Dr. Daniel Lin, director of the Hutch and UW Medicine’s Institute for Prostate Cancer Research. Fred Hutch is the study’s data management and coordinating center.
“PASS was launched with six participating centers in 2008,” said PASS Deputy Director Dr. Lisa Newcomb, a Hutch cancer prevention researcher. “With this grant, we’ll be up to 11 sites. Fred Hutch is the centralized repository — specimens are sent to the Hutch from all the sites — and we have procedures for sharing the data and the specimens among the group [members] and with other researchers.”
The grant is designed to support the infrastructure of the PASS cohort, including the collection of follow-up data, management of the database and management of the biospecimen repository.
“We need to keep those components going so it’s available for research,” Newcomb said.
PASS participants are all early-stage prostate cancer patients who chose active surveillance, not immediate surgery or radiation, to manage their cancer. In active surveillance, patients receive regular PSA (prostate-specific antigen) testing, biopsies and digital-rectal exams to monitor whether the cancer grows or becomes more aggressive.
According to research, more than 30% of men have slow-growing prostate cancer and won’t necessarily benefit from radical treatments that can cause debilitating side effects such as urinary incontinence and impotence. Data from patients with early-stage prostate cancers who choose active surveillance can provide key insights into who’s most at risk from their cancers, and when.
PASS participants share data on demographics, lifestyle, quality of life and long-term outcomes along with biospecimens collected throughout their participation in the study, including germline DNA, blood, urine and prostate tissue.
Newcomb praised the dedication of the men involved and the importance of their data.
“They come to the clinic every six months for up to five years until they have treatment or they’ve finished their five years of active surveillance,” she said. “But we continue to collect data, both PROs [patient-reported outcomes] and PSAs if they have treatment.”
The researchers also collect tumor tissue and data from men whose cancers recur or spread to other organs.
“The clinical data that is collected — and available on any of these active-surveillance patients — is very powerful,” Newcomb said. “But it’s used in bits and pieces. We know we can do more with it. And we’re working on that.”
— Dr. Lisa Newcomb
Using the cohort for risk-prediction modeling, Newcomb said, could help “determine who either harbors or will progress to a bad cancer, which cancers are aggressive and which really aren’t.”
“We want to help identify the men who can go home and not worry about their cancer,” Newcomb said. “We’re looking at both ends of the spectrum — making active surveillance less active and identifying the people who will benefit from treatment early.”
Several research institutions around the country have studies in the works involving PASS data. Industry players — particularly diagnostic companies — have also used the PASS cohort to validate proposed early detection tests. In days to come, Newcomb said the Hutch and its collaborators are embarking on quite a number of projects including some that will drill down into the participants’ genetic data.
“We are thrilled,” said Newcomb regarding the transition from Canary Foundation support to NCI funding.
Fred Hutch has had a longstanding relationship with the Canary Foundation and has been the recipient of many grants from the foundation powering work in early detection. The fifth floor of Fred Hutch’s Arnold Building, home to its Public Health Sciences Division, is named for the foundation.
At present, participating sites for PASS include the University of California, San Francisco; Stanford University; Emory University; Beth Israel Deaconess Medical Center/Harvard Medical School; University of Michigan; University of Texas Health Science Center, San Antonio; Eastern Virginia Medical School; Veterans Affairs Puget Sound Health Care System; University of Washington and University of British Columbia.
Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at firstname.lastname@example.org.