AO Project
Mapping of Heterogeneity in Early Prostate Cancer

About our Project:

Prostate cancer is an over-diagnosed disease. Most men die with prostate cancer rather than from prostate cancer. Less than 10 per cent of men die within five years, as they have low risk cancers and are monitored. This active surveillance approach only works if we can accurately catch men who have higher risk disease and give them aggressive treatment. The ability to detect high risk disease early improves their survival. Recently, the PRECISE prostate cancer trial demonstrated that MRI-guided targeted biopsy with just a few biopsies was better than a grid pattern of 12 biopsies done with ultrasound in finding aggressive cancer. This means that the previous random sampling of 12 needles could be reduced to fewer regions and be eliminated altogether in some men reducing the biopsy side effects. However, it is recognized that MRI guided biopsy can still miss cancers by sampling the wrong subregion of a cancer leading to misclassified cancers. Driven by these concerns, our group has developed a molecular signature test named “PRONTO”, for use with prostate biopsy specimens showing the ability to detect hidden high-risk disease. 


This project aims to determine if MRI-guided targeted biopsy, together with the PRONTO molecular signature test can better detect hidden, high-risk prostate cancer cases compared to the current method, which involves ultrasound and multiple biopsies and associated risks for patients.

Project Impact:

If successful, the combined PRONTO molecular signature test and an MRI guided biopsy could help ensure that men who have a biopsy and a positive MRI are more accurately identified as having aggressive prostate cancer allowing for improved clinical decision making.


Sarah Barker, PhD
Program Manager, Diagnostic Development

Project team 

Dr. Jane Bayani,

Dr. Melanie Spears

 Dr. James Mainprize
Sunnybrook Research Institute

Dr. Martin Yaffe
Sunnybrook Research Institute

Dr. Masoom Haider
Mt. Sinai Hospital

Dr. Theodorus van der Kwast

Dr. Anne Martel
Sunnybrook Research Institute

Dr. Laurence Klotz
Sunnybrook Research Institute

Dr. David Berman
Queens’ University