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Effort to fund endowed chair for Dr Paul Lange, prostate-cancer research pioneer

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Passing the leadership baton is usually accompanied by fanfare and fond farewells, but for Dr. Paul Lange, who co-founded the Institute for Prostate Cancer Research (IPCR) and built it over nearly three decades into one of the most prestigious research institutions of its kind in the world, it was a low-key transition befitting his style.

       Dr. Paul Lange
But once word of his retirement at the beginning of 2017 spread among his friends and admirers in the medical community and well beyond, there was a growing agreement that one of the true pioneers in prostate cancer research and treatment would not be permitted to quietly step aside.

Thus commenced an initiative by those friends to raise the $2.25 million to create an endowed chair in his name, designated to the development of future leaders in prostate-cancer research. Those friends include a cadre of men in the region whose prostate treatments or surgeries were performed by Lange, as well as many, like me, who came to know Lange and learn of his impact on prostate cancer after their surgeries.

In fact, because Lange learned a few years ago that he had prostate cancer and decided to have a prostatectomy, a bond of sorts developed between him and many others of us who, like him, turned to Dr. William Ellis, the UWMC prostate surgeon who is frequently referred to his patients as The Top Prostate Doc.

An example of the reaction to the endowment effort came at a recent breakfast meeting where I advised a prominent Eastside businessman (who will remain nameless) about the endowed-chair campaign and he said "Great idea! I'm in for 100(assuming I understood the three zeroes following)."

It was Lange who, among other leadership roles with prostate cancer innovations, was instrumental in bringing to prominence the blood test with the now universally known initials PSA to assess the presence of prostate cancer. In addition to working closely with the firm that developed the test, he was said to have been present the day the FDA approved it.

When Lange first learned of the endowed-chair effort, he was described as "especially excited." Those who know Lange know it wasn't because of any ego gratification about having the development of a chair in his memory but because of the role the funds would play in retaining the talent to create the research in the battle against the disease.

As Lange has told me on numerous occasions, the IPCR, despite its world-class prominence, is urgently in need of further private support to keep it in the forefront as one of the leading research entities."

IPCR ranks in the top 10 in the country for federal funding and is in the top five in prostate-cancer funding, with Lange estimating that over the years at least $60 million, mostly from NIH, has come to IPCR.
 
But ironically, IPCR has dramatically lagged in raising the private funds that the NIH views as a key to its own funding decisions.
"We are significantly behind the eight to 10 of the top prostate-cancer research institutions in the country in keeping up with private fund raising, which is essential if we are to retain a world-class team and explore new ideas that need to be developed because they are not yet advanced far enough for the NIH to fund," says Lange.
Dr. Daniel Lin 
Dr. Daniel W. Lin, who has been Chief of Urologic Oncology in the Department of Urology at the University of Washington and recipient of numerous awards from his scientific peers, was tapped early this year to succeed Lange as director of IPCR. Lange has not yet actually retired from his work at the institute, only from the top roles.

"One of Paul's greatest attributes has been his ability to motivate young scientists in their early research careers, inspire them to pursue novel investigations, and encourage them during the inevitable ups and downs of all scientific endeavors," Lin told me.

"Paul had the insight and energy to bring together researchers and clinicians from across the Pacific Northwest to apply for federal grants as a collaborative research enterprise and to form  the IPCR that continues to push the boundaries of prostate cancer discovery and progress," Lin added.

Lange, MD, and Robert Vessella, PhD, had already been a team at the University of Minnesota for a dozen years when they decided in 1989 to accept an offer to come to the University of Washington to launch the collaborative effort that a few years later would officially become the IPCR. By then he had helped it become an unusual collaboration between the University of Washington School of Medicine and the Fred Hutchinson Cancer Research Center.
The unusual team of Vessella, an academic prof, and Lange, a medical doctor, went on to build a world-class team and guide leading-edge research that have made Seattle a nexus for prostate-cancer research.

As I wrote in a Harp I did on the 25th anniversary of the IPCR in 2004, "In a sense, Lange and Vessella were medical opportunists in deciding to focus on a cancer for which they thought there might be a light at the end of the tunnel."
At the time there was basically no funding available for prostate-cancer research and, as Lange recalled for that column: "No one really cared at the time about an old man's disease."
But far from being "an old man's disease," the number of younger men diagnosed with prostate cancer has increased nearly six fold with more than 10 percent of new prostate cancer diagnoses in the U.S. being in men younger than 55.
And significantly, the disease is often much more aggressive in younger men, compared with a usually slower progression in older men.
It's routinely said of accomplished leaders that their contributions are too many to list, but in Lange's case several are too important not to list because they frame essential chapters in the role IPCR has come to play on the global prostate-cancer research stage.

One was a partnership that emerged in 1992 with Leroy Hood, who had recently arrived at the University of Washington, with funding from Bill Gates Jr, to found and chair the Molecular Biotechnology Department.
The other was the relationship that Lange helped bring about between The Hutch and the University of Washington Medical School, viewed as so noteworthy as to be almost unique.
Hood, already internationally prominent as developer of the automated DNA sequencer that was a key to the human genome project, recalled in an interview for the 2004 column how he and Lange, both then heading departments at UW, got together at a retreat in 1992 to discuss how genomics could be applied to prostate-cancer research.
"We decided to work together and I outlined on a napkin at dinner a genomic approach to prostate-cancer research," Hood recalled for me. "Then Paul and I agreed to help Michael Milkin, as he created a series of seminal meetings on the genomic approach to prostate cancer."
"Lee was hugely instrumental in putting us in the national spotlight," Lange said. "Thanks to a variety of influences, Lee decided to devote a large part of his translational research efforts to prostate cancer. The support of the Michael Milkin organization to the tune of about $12 million over the years was largely due to the participation of Lee and his group in our research efforts."
Dr. Pete Nelson     
And one of the important developments from the relationship was the recruitment of Dr. Pete Nelson to prostate cancer research from Hood's lab where Nelson was working on another cancer. He has since then been Lange's key research leader at IPCR, where his work has garnered international honors and recognition.
As Nelson, who has assumed the role of IPCR Research Leader, noted to me: "Paul created IPCR at a time when there were few bridges between The Hutch and UW and certainly to engage the two in community philanthropy was the kind of bond that just isn't seen."

"I'd be hard pressed to name two medical research institutions in the world that raise funds together," added Nelson, whose IPCR role is noteworthy because he has continually turned down opportunities at the top research institutions in the nation to remain here.

"Paul masterfully engaged scientists, administration, and community leaders to come together in establishing research priorities and allocating resources into the science that would most rapidly impact patients," Nelson said. "Through this effort, he was even able to obtain funding from the State of Washington that supported prostate cancer research."
A third initiative by Lange and Vessally that was disease altering was the creation early on of what they called a "rapid autopsy program" in which metastatic cancer cells that are still living are removed from more than 20 bone sites of patients within a couple of hours after death.

This Rapid Autopsy Program, the first of its kind in the world and still one of only a few in operation, has now been ongoing for over 20 years. More than 150 such autopsies have been done, resulting in one of the largest tumor banks on metastatic prostate cancer in the world.
"It is quite safe to say that several of the major treatment advances in the field that have extended the survival of men with advanced prostate cancer were fueled by the UW-IPCR Rapid Autopsy Program," Nelson said. "Biospecimens have been shared with numerous investigators throughout the world--at academic centers as well as pharma and biotech companies, usually with the none-to-minimal cost to them."
Of the initiative to gather the funds to create the endowed chair in Lange's name, Nelson told me it "will serve as a lasting and living legacy that will be used to support young scientists who embody Paul's curiosity, tenacity, creativity, and drive to eliminate prostate cancer."

Lange has repeatedly predicted that prostate cancer "will be controlled if not mostly cured" in his lifetime, reducing the disease from the second leading cause of cancer death among men to a minor cause. And he believes the IPCR will figure prominently in this achievement.
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Lange-Vessella partnership that became IPCR lured to Seattle 25 years ago

It's been a quarter century since the unusual team of an academic prof and a medical doctor was lured to Seattle to launch what would became the Institute for Prostate Cancer Research (IPCR), where a world-class team and leading-edge initiatives have made Seattle a nexus for prostate cancer research and care.

 

Paul Lange, M.D. and Robert Vessella, PhD, had already been a team at the University of Minnesota for a dozen years when they decided in 1989 to accept an offer to come to the University of Washington to launch the collaborative effort that a few years later would officially become IPCR. By then it would be a collaboration between University of Washington Medical Center and the Fred Hutchinson Cancer Research Center.

 

Paul Lange, M.D.

In a sense, Lange and Vessella were medical opportunists in deciding to focus on a cancer for which they thought "there might be a light at the end of the tunnel," despite the fact that at that point there was basically no funding available for prostate-cancer research. "No one really cared at the time about an old man's disease," Lange recalled.

 

Appropriately but coincidentally, the 25th anniversary of the Lange-Vessella partnership in Seattle comes as IPCR is in the midst of a $20 million fund-raising campaign aimed at creating an innovative program for individualized treatment of prostate-cancer sufferers around the state.

 

Plus it was recently announced that IPCR will be part of a team of prestigious institutions to participate in a $10 million grant from the Stand Up to Cancer program, which is supported by the American Association of Cancer Research and the Prostate Cancer Foundation.

 

Robert Vessella, Ph.D

IPCR will be partnering with Harvard, University of Michigan, Sloan Kettering and London University, names that indicate the role that IPCR has come to play in prostate-cancer research around the world.

 

The image that has developed since the UWMC and The Hutch collaboration became formal as IPCR in about 2000 is such that there's a growing sense that it could well be the place where a cure for the disease, now certainly when rather than if, comes about.

 

IPCR ranks third in the country for federal funding, with about $10 million in 2012, and is in the top five in prostate-cancer funding, Lange says. Over the years, he estimates, at least $60 million, mostly from NIH, has come to IPCR, a number made more impressive by the fact it doesn't include the 50 percent "institutional overhead" that UW takes from the original grant amount. The Hutch takes 60 percent.

 

But ironically, IPCR has dramatically lagged in raising the private funds that the NIH views as a key to its own funding decisions.

 

"We are significantly behind the eight to 10 prostate-cancer research institutions in the country in keeping up with private fund raising, which is essential if we are to retain a world-class team and explore new ideas that need to be developed because they are not yet primetime enough for the NIH to fund," says Lange.

 

Thus the importance of the fund-raising campaign now under way called ACT-SMART, which seeks to raise $20 million over five years from private sources to create relationships with a dozen or more medical facilities around the state in developing individualized treatment programs for residents of various communities.

 

The goal of ACT-SMART is to sequence the whole genome of patients and their prostate cancers, focus on the most important abnormal genes in the cancer and then devise a targeted individualized treatment program, then patients are sent home to have their individualized treatment carried out in their hometown medical facility.

 

"We are going to use genomic medicine to determine what the patient's genes show, then develop targeted therapies aimed at the specific cancer," Lange said, noting that eventually the program will be extended to Oregon, then Idaho and Montana.

 

A couple of developments in the early '90s assured IPCR's emergence as a world-class institute in the field of prostate-cancer research and cemented a pre-eminent role for Lange and Vessella as globally recognized leaders in the quest for answers to prostate cancer.

 

One of those developments came in 1992 with an innovation called "rapid autopsies" that has attracted the attention of researchers both nationally and internationally as well as pharmaceutical companies. It's a process in which cancer tissue that has metastasized is removed from the bodies of a deceased prostate-cancer victims with the same speed and precision as organs are removed for transplant.

 

The roughly 100 such autopsies that Lange's team has performed since the process was pioneered at IPCR, and which are conducted at only one other institution in the county, allow harvested cancer cells to be implanted in mice. Lange says about 15 percent of the implants take, becoming what are referred to thereafter as "tumor avatars," and producing thousands of samples.

 

Another key development in 1992 was a partnership that emerged with Leroy Hood, who had recently arrived at the University of Washington, with funding from Bill Gates Jr, to found and chair the Molecular Biotechnology Department.

 

Hood, already internationally prominent as developer of the automated DNA sequencer that was the key to the human genome project, recalled in an interview how he and Lange, both heading departments at UW, got together at a retreat to discuss how genomics could be applied to prostate-cancer research.

 

"We decided to work together and I outlined on a napkin at dinner a genomic approach to prostate-cancer research," Hood recalls. "Then Paul and I agreed to help Michael Milkin, as he created a series of seminal meetings on the genomic approach to prostate cancer."

 

"Lee was hugely instrumental in putting us in the national spotlight," Lange said. "Thanks to a variety of influences, Lee decided to devote a large part of his translational research efforts to prostate cancer. The support of the Michael Milkin organization to the tune of about $12 million over the years was largely due to the participation of Lee and his group in our research efforts."

 

Hood continued to work with Lange and Vessella until he left UW in 2000 to found the Institute for Systems medicine, which he still heads.

 

It was in 1993 that Lange and Vessella began discussing with researchers at The Hutch the idea of teaming to form an institute. And that was also the year that the first grant, from the NIH O'Brien Center, was received, for $2.8 million in direct costs over a five-year period, at the end of which it was renewed again for another five years.

 

Lange routinely ascribes human characteristics to the cancer he seeks to conquer, possibly viewing the opponent whose ways occupy much of his attention as a worthy foe. Thus he characterizes the PSA test, which he helped gain approval for in testimony on its benefits before the FDA on several occasions in the early '90, as "allowing us to know what the cancer is thinking."

 

And in explaining to a listener that the prostate cancer his team deprived of the testosterone it needed to survive soon began a comeback, Lange's voice rises to exclaim: "It learned to live without it!" Then he continues to explain, replaying the excited frustration he likely felt at the time, as further research determined "no, it learned to make its own testosterone! Like the cancer said 'hey guys, we're going to get really sick if we don't do something about this!.'"

 

But that finding was a research victory because it indicated that the understanding that cancer needed testosterone to survive was accurate.

 

Perhaps by attributing those human characteristics to his foe, the victory over prostate cancer, when it comes, will feel more personal and thus more satisfying for Lange, whose personal battle included his having to undergo surgery for his own prostate cancer a few years ago.

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Nation-leading prostate-cancer research center in Seattle launches major private-funding effort

The Institute for Prostate Cancer Research (IPCR) has been largely unknown in its Seattle-area home despite the fact it's recognized nationally as being at the leading edge of efforts to solve the mysteries of prostate cancer. But this is the year when a concerted fund-raising initiative may dramatically boost the visibility of the Institute, and thus attract the private funding to enhance its ability to impact prostate cancer.

 

The 30-scientist collaborative effort by University of Washington Medical Center (UWMC) and Fred Hutchinson Cancer Research Center has made Seattle the nexus for prostate cancer research and care. And it could well be the place where a cure for the disease, if and when that comes about, is discovered.

 

If that sounds like a credibility stretch, in view of the lack of local awareness for the Institute, consider that dozens of peers nationally as well as pharmaceutical firms are beating a path to the door of the Institute seeking cooperation and partnerships.

  
Paul Lange
Dr. Paul Lange
  

 

Dr. Paul Lange, the UWMC surgeon and researcher who guided creation of the Institute and has helped oversee the nearly unique initiatives that have attracted national peer attention, says unabashedly: "Everyone in the world knows we're one of the best, except Seattle."

 

Evidence of that as fact rather than hyperbole may be that Dr. Peter Nelson, Oncologist at "The Hutch" who chairs the Institute's scientific steering committee, was wooed last fall by John's Hopkins, which described him as "the best in the nation," to head prostate cancer research there. But Nelson preferred to remain at The Hutch and be involved with the Institute's research.

 

Peter Nelson
Dr. Peter Nelson

   

 

A key Institute innovation that has attracted the attention of researchers not just nationally but internationally is called "rapid autopsy," a process in which cancer tissue that has metastasized is removed from the body of a deceased prostate victim with the same speed and precision as organs are removed for transplant.

 

The roughly 100 such autopsies that Lange's team has performed since the process was pioneered at IPCR, and which are conducted at only one other institution in the county, allow harvested cancer cells to be implanted in mice. Lange says about 15 percent of the implants take, becoming what are referred to thereafter as "tumor avatars," and producing thousands of samples.

 

Lange says "the cancer tissue has been very pivotal for many IPCR discoveries" and notes that the tissue has been shared with 50 other institutions to advance their own research, with the only requirement that they share the results of their research.

 

And now a group of prominent business and community leaders, most of them men who are prostate-cancer survivors, is mapping the first fund-raising initiative for the Institute. The group, called the Community Leaders Council, got their first report this week on the early results of efforts during the "quiet period" leading up to a key public event in December, a report that indicated the first $3 million of a $20.6 million goal has been pledged.

 

I asked Lange how he'd respond to those who wonder about the heavy focus on this private funding initiative when UWMC is among the top four or five institutions in terms of federal grants and funding.

 

"Government funding only supports a fraction of resources needed for constructing and maintaining a team such as ours," he replied. "For example much of the equipment, support of pilot projects, almost all of the substantial monies needed to develop the avatars, all of the funding for the rapid autopsy project was funded by private monies."

 

"All of the major prostate cancer groups, such as Harvard,Memorial Sloan-Kettering Cancer Center, John's Hopkins, University of Michigan have raised significantly more than we have because of the volume of private money. We cannot remain one of the top centers without more support."

 

The major December event for the fund-raising effort's coming-out party is the breakfast created by Steve Fleischmann, after his own prostatectomy 10 years ago, as the nation's first fund-raising event for prostate-cancer research, That first breakfast raised more than $700,000. It's now a biennial breakfast that has grown to attract hundreds of survivors and supporters.

 

Only prostate-cancer survivors are permitted to be table captains, so, as Fleischmann, founder and chairman of Fleischmann Office Interiors, jokes to associates and friends who ask to be table captains: "this is one event you don't want to be a table captain for."

 

Steve Hooper, founder of Bellevue-based early stage venture fund Ignition Partners and chair of the Council, says "the breakfasts let us expose the whole notion of prostate cancer to broader awareness."

 

"Men need to get to know their PSA as well as they know their golf score," says Hooper, who like Fleischmann was diagnosed with prostate cancer at age 47. Lange was surgeon for both Hooper and Fleischmann, as well as many of the other members of the Council.

 

Ironically, Lange's own prostate-cancer surgery was performed by Dr. William Ellis, whom Lange mentored and who became chief of staff of UW Medical Center, and is one of the most sought-after prostate-cancer surgeons at UWMC.

 

The five-year fund-raising effort has been named Act Smart and is broken into six components, each with a description, philanthropic support needed to carry out and a budget summary.

 

John Rudolf, president of Glacier Peak Capital and a member of the council, notes that prostate cancer "doesn't have an identifying pink ribbon to mark survivors and supporters, but people are starting to share their experiences as survivors and talk about the importance testing. There's a lot more open discussion about the disease."

 

Asked how close researchers are to finding a cure for prostate cancer, Lange, 72, replies with a chuckle: "I'm pretty sure it'll happen while I'm still cheering from the stands rather than after I'm pushing up daisies."

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