The role of pathology in new prostate cancer research

Dr. Theodorus Van der Kwast in the Laboratory Medicine Program’s glass slide library, where specimen samples are securely archived for future review and analysis.

Laboratory Medicine Program’s (LMP) Dr. Theodorus Van der Kwast is the lead pathologist in the Canadian Prostate Cancer Genome Network (CPC-GENE) Sequencing Project, which recently discovered a new gene signature in prostate cancer that may help determine disease aggression and specialized treatment.

The study involved the molecular profiling of 74 patients and aims to eventually include surgical samples from 250 patients with prostate cancer. Dr. Van der Kwast, Genitourinary Pathologist, LMP, plays an essential role in acquiring specimens for research, and in this study focuses on patients diagnosed with an intermediate risk prostate cancer. This means the tumours behave quite variably – some with a very slow growth, others that are more aggressive, and a small subset even fatal.

“It’s not easy to collect that number of fresh, frozen specimen samples, especially with such specific criteria,” said Dr. Van der Kwast, who acquired samples from Biospecimen Services, as well as a separate biobank in Quebec. “As a pathologist, we need to ensure we have the highest quality specimen, and that each one meets the same criteria as the last.”

Once all 74 specimen samples were collected, Dr. Van der Kwast and assisting pathologists began studying each specimen individually – making sure there’s a large enough sample of the tumour with the necessary tumour cellularity, and that each specimen is characterized appropriatley, including tumour differentiation grade. After carefully analyzing each of the 74 patient specimens, five individual patients were selected for further investigation.

“I believe that pathology plays such a vital role in this type of cancer research because we are the ones laying the groundwork or the foundation for the rest of the research to come,” says Dr. Van der Kwast. “As lead pathologist, I need to ensure all our samples are very well defined, and the pathology data is able to support the research findings. It’s an essential part of any medical research done at the cellular level, and it requires true collaboration from the pathologists and the rest of the research team to make our work successful.”

“Without any one of us the project would fall apart.”

The research for the CPC-GENE sequencing project will work towards developing a diagnostic test to identify whether a specific cancer gene is present in a patient, and will help determine the aggression of the disease and the likelihood of it spreading outside the prostate during treatment. In addition, the molecular-genetic data of the CPC-GENE project will be made publicly available for the international community.

“It’s incredible research that our team has accomplished, and the pathology data we’ve collected is going to help advance other research projects, and new findings around the world,” says Dr. Van der Kwast. “We plan to publish the genomic data from each specimen so new studies can collaborate with our research, and we can work together to advance our understanding of prostate cancer on an international level.”

CPC-GENE is a member of the International Cancer Genome Consortium (ICGC), which collects the genomic data from cancer research all over the world. The consortium works as a central database for all types of cancers and allows researchers to compare genomic data, develop new findings, and conduct new research with the assurance that each specimen is reviewed by a pathologist.

“In some ways, all research teams work competitively against each other. But we also need each other to advance our findings, and to advance the diagnoses and treatment options available to patients,” says Dr. Van der Kwast. “Compiling the genomic data and making it available to others is exactly how we need to collaborate. It’s a great forum for pathologists and an exciting step forward for pathology.”


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