2011 IMPaCT Meeting Video (Text Version)
James Kiefert, EdD; Us TOO International; Consumer Integration Panel Member: When I was diagnosed with prostate cancer at age 50, I didn't even know that I had a prostate and I went in for a physical exam and my wife, who was with me, said "You test him for everything. You know, he hasn't had an exam in so many years." And so the doctor said, "Oh, we've got this new test called the PSA." Well, she says, "Oh, do that too."
The test results came back and the doctor called me and he said, "By the way Jim, your PSA is 39." He said, "I don't think that's very good, can I get back to you?" I chose to have surgery -- I had a radical prostatectomy, but they found that there was some extra capular extension, so about a year and a half later I had 35 sessions of radiation on the prostate bed, and usually the PSA will go down to undetectable after that kind of treatment, but it didn't. And that's when the urologist called my wife and I in and said, "Jim you failed the two major treatments for prostate cancer and you probably have one to three years to live and I would suggest you get your life in order." Well, that was in 1990. I've been with the PCRP program for about 5 years now. I think one of the most exciting parts of this is that it gives me hope and encouragement.
My philosophy about living with prostate cancer is that I might have prostate cancer, but prostate cancer doesn't have me.
OPENING GRAPHICS: Department of Defense Prostate Cancer Research Program, Innovative Minds in Prostate Cancer Today
E. Melissa Kaime, MD; Captain, United States Navy; Director, CDMRP: The Prostate Cancer Research Program was established in 1997 with an initial appropriation of 45 million dollars. Since that time, Congress has appropriated over one billion dollars to this program allowing us to make over 2,000 awards. This has made this program the second largest investor in prostate cancer research. The Prostate Cancer Research Program is focused on scientific innovation that's going to have a huge impact on the field and move the field forward.
Maha Hussain, MD, FACP; University of Michigan; Integration Panel Member: What sets it apart is that the number one objective for it is prostate cancer. So this is not a general funding mechanism where prostate cancer is one of the focus areas. This is very much focused on prostate cancer. The other aspect of it, it tackles different areas and subtleties in researching the disease, issues of disparity, issues of training young investigators both in the clinic and in the laboratory, fostering team science at different levels, addressing critical areas in genetics and so on.
Leland Chung, PhD; Cedars Sinai Medical Center; Integration Panel Member: This program is very different in my mind because they have the primary consideration of the patient's survival and also patient's quality of life issues. And because of that they take a very translational approach.
Westley Sholes, MPA; California Prostate Cancer Coalition; Consumer Integration Panel Member: One of the key features that I point out for this program is the fact that we can be more innovative, we can do more out-of-the-box thinking, and we can act a lot quicker, and we can modify what we do a lot quicker than many of the traditional programs.
One of the most unique factors is the fact that I'm here as a consumer.
Peter Nelson, MD; Fred Hutchinson Cancer Research Center; Principal Investigator: As a clinician, I have a pretty good idea of things that are relevant, at least I think so. But many of the more basic scientists, it's their first exposure to actually interacting with a patient or somebody with the disease or that's close to the disease.
Benjamin Floyd, PhD; Prostate Cancer Network Group; Consumer Integration Panel Member: My first question is, when scientists are reviewing proposals is, "OK, what's the impact of what you are going to do?"
Hussain: This is probably the closest you can get to a real-time, direct interaction and input to bring in everyone involved on one table to sit down and talk about what matters. What matters from a scientist's perspective, from a doctor's perspective, from a patient's perspective. All of that I think adds to the depth of the process and the importance of the products that come out of this process.
Alvin Chin, JD; Virginia Prostate Cancer Coalition; Consumer Integration Panel Member: It allows me an opportunity to meet the scientists who do the research and also represent consumers -- consumers out there that want better treatments and a better quality of life.
Floyd: If you look at a consumer like myself going to a prostate cancer networking group or support group, I can go back to them and say, "Believe you me, there are people out here who are just as concerned as you are, and they are doing a lot of what I would call out-of-the-box thinking to get at a cure for a very difficult disease."
Robert Vessella, PhD; University of Washington School of Medicine; Principal Investigator: If the idea is good, if it's creative, if it's innovative, the DOD Prostate Cancer Program is an ideal place to submit your application. There have been several times when we have had either a young investigator or a more seasoned investigator submit a grant and it's a "wow" phenomenon. It's really exciting; it's innovative.
Sholes: If you have something that's new, could have very, very high impact, where you may not have had enough time to develop a lot of data, but the idea is very unique and is considered to be a high potential in terms of its impact, well then it doesn't matter so much to us that there's not a lot of background data.
Angelo DeMarzo, MD, PhD; Johns Hopkins University School of Medicine; Principal Investigator: So it is paradoxical in a sense when you go to big agencies to look for funding for your research that they almost already want you to have it be done before you even get the money. Now obviously if it is an innovative idea, by definition it's new and so it's a little bit risky, so what the PCRP allows is fairly small amounts of money to be directed at innovative ideas that could be high risk but potentially high gain.
THE BEST AND THE BRIGHTEST
James Mohler, MD; Roswell Park Cancer Institute; Principal Investigator: Among the DOD award mechanisms that I think are the most innovative, I'm a big believer in career development awards. The hardest thing is to get somebody started, and the second hardest thing is, once they've gotten started, to keep them going.
Donald Tindall, PhD; Mayo Clinic; Integration Panel Member: This is the program that has consistently backed young investigators and has really given young investigators their first opportunity to start growing in science.
Natasha Kyprianou, PhD; University of Kentucky; Integration Panel Chair: An investment in human capital is really one of the primary intellectual commitments of PCRP that has manifested for the last 10-15 years, and we see these careers of these young people now being the major players in the field.
DeMarzo: We are interested in getting engineers, and microbiologists, and physicists and mathematicians, and obviously physician scientists and supporting them in their careers. So we are very focused on trying to get the next generation of new investigators, and there are several mechanisms designed specifically to entice them to undergo prostate cancer research.
Vessella: Team science is really critical and important to moving the field of prostate cancer forward, or any field of cancer forward, in my opinion.
Tomasz Beer, MD, FACP; Oregon Health and Science University; Principal Investigator [Graphic: The Prostate Cancer Clinical Trials Consortium logo]: The most important grant that we have actually is the PCRP Clinical Consortium Award, which allows us to very closely collaborate with 12 other major centers that are highly focused on prostate cancer research, which has markedly accelerated our ability to test new ideas and move treatments forward now so that patients can benefit from them.
Hussain [Graphic: The Prostate Cancer Clinical Trials Consortium logo]: The clinical trials consortium in my view is one of the biggest successes of the PCRP. Obviously, I am a bit biased about it because I am an investigator in it. But, the beauty of it -- it allows us to more efficiently bring in novel drugs and combinations, promising type biomarkers, and put them to the test in real time in the clinic, accrue much faster, and try to get the answer whether this is a go or no go, which ultimately if positive will help change the standards of care for treating this disease.
Mohler [Graphic: The North Carolina-Louisiana Prostate Cancer Project (PCaP) logo]: We are the recipients of a DOD Prostate Cancer Research Program Consortium Award. We have a consortium of 11 universities and three governmental agencies that conduct a study to attempt to put into three different buckets the reasons for racial disparity in prostate cancer mortality. [Graphic: PCaP logo and Text: Analyzing Racial Differences: 1) Health care systems interactions, 2) Diet and biology, 3) Tumor characteristics]
FOCUSING ON HEALTH DISPARITIES
Jeannette Bensen, MS, PhD; University of North Carolina, Chapel Hill; Principal Investigator [Graphic: PCaP logo]: 2,000 men agreed to answer questionnaires, allowed us to look in their medical records so that we could understand more about their diagnosis and treatment, and they also provided us with some biological samples, including blood and tumor specimens from their surgical procedures.
Mohler: This has created a big bio-repository of interview information and biological specimens. We've immortalized most of the mens' white blood cells, so we have a limitless amount of DNA for future study.
Bensen: We are early in the analysis of both the data and the biologic samples. But we have made some interesting findings and we have several publications and we're anticipating many more.
DeMarzo: We know very clearly that men who are African American ancestry have a much higher rate of prostate cancer and a rate of death due to prostate cancer that exceeds those in other populations.
Floakemi Odedina, PhD; University of Florida; Principal Investigator: When we look at black men--and this is a real innovative side of it -- what has come up in our research program is that you cannot look at black men as a homogeneous group because [of] disparities and when you look at the incidence and the mortality from cancer, it's actually different depending on your country of birth.
[Graphic: Did you know that African American men are...60% more likely to develop prostate cancer, and twice as likely to die from prostate cancer compared to Caucasian men]
One of the key areas that I focus on is to look at the behavioral factors that really impact the behavior of black men and then use different interventions within the community to be able to improve their health especially relative to prostate cancer.
THE PCRP IMPACT MEETING
Keifert: The IMPaCT meeting is like the World Series for prostate cancer. It's exciting as you go to these sessions and you hear the best and the brightest researchers talking about what they've done to help improve the quality of your life.
Nelson: I find that probably the most important thing for me personally is just simply being able to engage in discussion with like-minded investigators and opportunities for sidebar conversations about scientific results and planning the next interactions.
Hussain: It spans all the way from early discovery in to the end of life issues and survivorship and so on. So I think it's a very rich meeting.
Nelson: It's one-stop shopping for the kind of entire field at that particular moment.
TRULY MAKING AN IMPACT
Mohler: I think the DOD Prostate Cancer Research Program has had a tremendous benefit to the research community of America, and especially the cancer patients of America.
Odedina: I have seen so many innovative ideas, so many discoveries whether it's basic sciences or behavioral interventions, and that when you do go back you would see that the initial funding actually came from DOD.
Mohler: They have funded high-risk research, have allowed novel agents to be tested through their clinical trials network, supported two high-risk consortiums, and have made it quicker for something developed in the laboratory to come to the bedside.
Nelson: I'm not sure you can even absolutely measure its impact. It's been tremendous, spanning the training of young investigators at the very earliest stages of their career all the way through to established investigators building networks of clinical trials, for example.
Beer: We have a new drug approved this year. We have half a dozen very promising drugs in Phase III studies. We're realistically looking at every year or two treatment standards changing; that's unprecedented. It's not the way it was when I was getting started. And so it is a time of great change and great opportunity. We're making strides, but there's a lot more to do.
MOVING TOWARD THE VISION
Vessella: This particular program really wants to see the best ideas come forward. Don't hold back. Don't be afraid to ask that question "what if."
DeMarzo: The message that I would like to give to potential PIs and especially new PIs is submit, submit, submit to the DOD PCRP program. If you have a great new idea, submit it. We are looking for new, innovative ideas, especially from young investigators.
Beer: Until we can eradicate this disease, or at the very least make it possible for men to live their lives unaffected by the disease, there's more work to be done.
Keifert: I see some of the best and brightest scientists working on a cure, working on a way to eliminate prostate cancer. I see them dedicating their life to it. So I find it very encouraging, very hopeful.
Nelson: It IS a difficult disease and often times it's tragic as well, but we ARE making headway. Being able to see the patients, understand what's happening with their disease, take it immediately back to the laboratory to be able to study it in detail and then to turn around and explain to a patient what may be happening and how we can target their tumor more specifically, I find to be a very unique engagement in this whole process. You know in my own research that's what, you know, keeps me up to all hours of the night, thinking about, you know, what's going on in a particular patient's disease or in the field. So I find it very exciting and I think it's a very unique situation and very rewarding.
IMPaCT Logo and Tagline: Transforming Research from Discovery to Cure