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When to Wait and When to Treat? New Program Will Search for Biomarkers in Men With Prostate Cancer to Help Find an Answer

Saturday, May 3, 2008 General News J E 4
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SEATTLE, May 2 Researchers at Fred Hutchinson CancerResearch Center have a lead role in a new public/private partnership to createthe first systematic surveillance program of men with prostate cancer to lookfor biological clues to help determine when to wait and when to treat thedisease. The project was announced by the Canary Foundation and the NationalCancer Institute.

Peter Nelson, M.D., of the Hutchinson Center's Clinical Research and HumanBiology divisions, will lead the Canary Prostate Consortium. This group of sixinstitutions nationwide will enroll men in a cancer-surveillance study to lookfor biomarkers -- proteins in the blood that could predict prostate-tumoraggressiveness.

The new study is meant to help answer a key question that has vexedphysicians and researchers: When is it best to treat prostate cancer versusobservation or "watchful waiting." For most men with prostate cancer, thedisease never progresses to become a serious health problem, yet most receivesome sort of treatment, such as radiation or surgery. Such treatments can haveside effects, such as impotence and incontinence, which can be worse than thelow-grade cancer. Currently it is challenging to accurately predict wheninactive or slow-growing prostate tumors will become aggressive.

"There's an emerging consensus that we dramatically over treat prostatecancer in general," said Nelson. "The overall prevalence of the disease in thepopulation far exceeds the number of men whose disease progresses to causeserious problems. Yet, there are clearly many prostate cancers that behaveaggressively and patients benefit from treatment. It is a challengingproblem."

In the study, men diagnosed with early-stage prostate cancer will not betreated right away but will be closely followed in an active surveillanceprogram involving regular collection of blood and urine samples as well asprostate biopsies. A new repository for blood and DNA samples will be locatedat the Hutchinson Center. The repository will be funded by the CanaryFoundation. NCI's Early Detection Research Network (EDRN), the federal agencythat is partnering with the Canary Foundation, will establish disease-specificCommon Data Elements, a biospecimen management system and a protocol oversightprogram. The EDRN data management and coordinating center is based at theHutchinson Center under the direction of Zideng Feng, Ph.D., a member of theHutchinson Center's Public Health Sciences Division.

The samples will be tested for candidate biomarkers -- proteins in theblood -- that can signal when indolent disease has progressed to moreaggressive illness. Such biomarkers could help physicians better determinewhen to initiate treatment versus watchful waiting.

Each of the study institutions also has a "retrospective" tissuecollection of samples taken from unrelated studies. These will also beexamined to ascertain the accuracy of predictive biomarkers.

"We are proud to launch this new study with EDRN and with theparticipation of leading research institutes," said Nelson, who is also aprofessor of oncology at the University of Washington School of Medicine."Through collaboration we can make bigger strides in providing better, moreindividualized treatment for prostate-cancer patients."

The Canary Foundation is providing initial funding for the Prostate ActiveSurveillance Study. The five institutions that will enroll patients areUniversity of Washington, Stanford University, University of California at SanFrancisco, University of British Columbia and University of Texas HealthScience Center in San Antonio.

About Fred Hutchinson Cancer Research Center

At Fred Hutchinson Cancer Research Center, interdisciplinary teams ofworld-renowned scientists and humanitarians work together to prevent, diagnoseand treat cancer, HIV/AIDS and other diseases. Our researchers, includingthree Nob
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