Institute for Prostate Cancer Research

Our researchers were among the first to formally evaluate the PSA test’s ability to distinguish between true cancers and benign prostate conditions. They determined that modifying the test to use two types of measurements improved accuracy for men with borderline-normal PSA levels, potentially leading to a significant drop in biopsy-related costs and complications.

Our research found roughly one-third of older men diagnosed with prostate cancer through the PSA test are over-treated and receive surgeries or other treatments even though the disease is not likely to threaten their health.

We’re leading the first multi-institution active surveillance study into finding biomarkers of localized prostate cancer that can determine when to take a wait and watch approach and when to treat the disease more aggressively.

Our researchers have pinpointed molecular features that help predict how prostate cancer cells will behave. These findings could help identify genes to target for new therapies and point to possible blood-based markers of aggressive prostate cancer.

After analyzing 86 different genes, we determined which were turned on in low- or high-grade prostate cancer cells with great accuracy. The study was the first systematic attempt to distinguish which molecular features can objectively predict how prostate cancer behaves, leading doctors to more appropriate therapies.

Scientists are investigating the use of tracermolecules in lighting up minute tumors. So far, we’ve used this approach in mice to understand how aggressive prostate tumors spread to bones and other tissues. By learning which types of cells contribute to the development of aggressive disease, scientists hope to detect aggressive prostate cancer earlier, and treat it more effectively.

Researchers determined survival rates are comparable for both radiation by seeds or external beam, and prostate-removal surgery by open or robotic approaches. Since both forms of treatment carry potentially disruptive side-effects, we use multiple institutional databases to conduct comprehensive studies of sexual, bowel and urinary function among men who undergo these treatments, in addition to comparing their effectiveness at cancer control.

In some cases, cancer treatment requires doctors to remove the nerves controlling erections. We’re the leading national center for using and improving nerve graft techniques to enhance erectile return.

We’re investigating better ways both to teach and perform robotic surgery using simulation.

Research shows that different and more extensive removal of pelvic lymph nodes improve surgical results. We continue to adopt and improve these newer approaches for men with more serious cases of local disease.

Radiation therapy after surgery for local recurrence, while effective, can be improved by altering the radiation fields.

In an effort to find treatment options with fewer side effects, we’re investigating new ways of destroying localized cancer with electrical fields or special light activation approaches.

Muscle wasting, weight loss and fatigue are significant problems for advanced prostate cancer patients. Researchers investigating the causes and possible treatments for these symptoms, including clinical trials of new drugs that may help prevent the muscle wasting that occurs with hormone therapy.

Our team is one of a few in the world conducting “rapid autopsies” on deceased prostate cancer patients. Similar to cadaveric transplant organ acquisition, this procedure allows us to harvest tissue otherwise unavailable to researchers, especially metastases to the bone. These biospecimens have helped investigators learn more about the molecular profiles of the kinds of cancers that kill. We’ve also collected one of the world’s largest blood and tissue banks for prostate cancer, which is essential for developing and stratifying prostate cancers into distinct categories amenable to specific therapies.

A diverse team of scientists is developing highly specialized, genetically engineered mouse models to understand the molecular mechanisms that cause prostate cancer to develop and progress.

Researchers have established more than 25 human prostate cancer lines that grow in specialized immune-suppressed mice, allowing researchers around the globe to conduct studies of cancer progression and critically test new therapies prior to their introduction in patients.

Our researchers have improved methods for capturing prostate cancer cells in the blood and bone marrow. Studies of these cells have identified genetic abnormalities that may indicate how prostate cancer cells metastasize to the bone. Further analysis of these cells could provide opportunities for targeting and preventing bone metastasis, reducing mortality rates.

Prostate cancer spreads and grows primarily in bone. We’re world leaders in understanding the relationship between bone metabolism and prostate cancer growth.

Reducing blood levels of testosterone and other androgens that come from the testis can temporarily suppress tumor growth. In determining why the effect is temporary, researchers studied rapid autopsy tissue and animal models. They discovered the cancer cells gradually develop the capacity to produce their own androgens. These findings can inform the development of a new group of more effective anti-hormone drugs.

Researchers have shown how insulin-like growth factor, or IGF, and similar hormones help prostate cancer grow. Based on the effectiveness of new therapies in animals, our researchers were the first to develop in-man studies targeting this IGF pathway.

All new therapies, biomarkers or other medical discoveries are tested in patients through clinical trials. This complex and demanding process requires a high degree of compassion and medical expertise, as well as communication and organizational skills.

We have two integrated clinical trials teams: one focused on developing and testing therapies for advanced disease; the other developing and testing therapies designed to be used with surgery and radiotherapy for treating localized prostate cancers.

Many of the clinical trials are unique to Seattle. Several new studies involve the first evaluation of new therapeutic treatments in people. Other trials are conducted with leading national clinical trials groups involving the major cancer centers in the United States and abroad.

Our trials include some of the most innovative therapies under evaluation, including one of 10 National Cancer Institute-funded prostate cancer Specialized Programs of Research Excellence (SPORE). As a result, our physicians participate in new therapy trials often available only to that group, allowing patients to receive new treatments as quickly as possible.

IPCR researchers are also members of the Department of Defense Prostate Cancer Clinical Trials Consortium and have access to many trials conducted by this special group of 12 leading prostate cancer centers in the United States.

Molecular studies in localized disease:

• Neoadjuvant therapies have been slow to reach many cancer patients because their success could only be judged after many years of follow-up. Our researchers helped pioneer a faster approach to evaluating these therapies. At the time of the primary surgery or before radiation therapy, physicians take a cancer specimen for molecular analysis. Scientists can evaluate efficacy more quickly by looking at the way molecules in the cancer specimen react to the therapy.
• The team has conducted large neoadjuvant molecular studies of chemotherapy drugs and newer hormone therapies. Many more molecular neoadjuvant studies are in the planning stages.
• Every tumor (and patient) has unique characteristics, dictated by gene variations. The molecular analyses of cancers provide an opportunity for researchers to develop a personalized approach to treating and following a patient’s particular cancer.

Innovative treatments for advanced disease:

• Suppressing testosterone and administering chemotherapy prolong survival for men with advanced prostate cancer, but most cancers eventually develop resistance to these interventions. IPCR investigators have conducted Phase I, first-in-human trials designed to block tumors’ resistance mechanisms.
• Encouraging results from novel studies targeting the Insulin-like Growth Factor-1 Receptor and clusterin have led to clinical trials designed to improve the longevity of men with advanced prostate cancer.
• Our teams also participate in trials involving therapies developed elsewhere, such as Provenge, abiraterone and MDV-3100.