Prostate cancer is the most common cancer in men with 40,000 new cases each year and 10,000 deaths in the UK. It is often slow-growing, but more aggressive forms of the disease are hard to treat. Scientists and clinicians in Cambridge are working together to understand the molecular changes that occur before and during the early stages of prostate cancer.
As part of a comprehensive high quality surgical service, Addenbrooke’s Hospital runs the largest prostate cancer surgery service in the UK. Robotic surgery has reduced average in-patient stays from six days to one and results in much improved quality of life following surgery. Almost all prostate operations are carried out using this technique at Cambridge, compared to a national average of 20%.
Imaging tumour response
Cambridge has the only Biopsee MRI-Transrectal fusion (Heidelberg) machine in the UK which overlays MRI images with ultrasound guided prostate biopsies. We are currently working to incorporate PET imaging with testing of different tracers and MRI to non-invasively detect response to treatment in high grade tumours. We are using imagery to monitor the response to new drugs in trials on men about to have radical surgery.
Prostate cancer trial – PROMPT
The largest randomised control trial of surgery, radiotherapy and active monitoring of localised prostate cancer, which will produce a risk-based gold standard of management.
Managing prostate cancer risk
ProtecT is the largest ever randomised clinical trial of over 100,000 participants funded by the National Institute for Health Research (NIHR). It is being run by the Cambridge Cancer Centre, Oxford University and Bristol University. The trial is assessing the effectiveness of surgery, monitoring and radiotherapy in screen-detected prostate cancer. The associated collection of tissue samples is being amassed in the Cambridge Cancer Centre.
We are carrying out studies of the protein receptor for the male sex hormone, the androgen receptor (AR), which is critical to prostate cancer development and growth. We have identified AR regulated genomic signatures that predict outcomes, which is exciting because it may be possible to identify which men are likely to progress after radical treatment and how to target aberrant molecular pathways to improve treatment. We have developed the concept of ‘window trials’, which are studies done using imaging and biological end-points in men treated with short courses of novel drugs prior to surgery or radiotherapy. These studies are important for patients, science and for pharmaceutical companies.
Current open trials in Cambridge
The table below lists the current open trials for urological cancers coordinated by the Cambridge Cancer Trials Centre (last updated January 2016).
|Trial name||Trial description||Contact|
|A Phase 1-2 Study of Onapristone in Patients with Advanced Castration-resistant Prostate Cancer||A Phase 1-2 Study of Onapristone in Patients with Advanced Castration-resistant Prostate Cancer||Dr Simon Pacey|
|CaNCaP02 - CAmbridge Neoadjuvant CAncer of the Prostate Study 2||A study into the pharmacodynamic biomarker effects of AZD2014 (an mTOR1/2 inhibitor) given prior to Radical Prostatectomy||Dr Simon Pacey|
|IMPACT||Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted Screening in BRCA1/2 mutation carriers and controls - IMPACT||Dr Danish Mazhar|
|NCRN - 2484 / SPARTAN - ARN-509 in non-metastatic castration-resistant prostate cancer||SPARTAN - A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase III Study of ARN-509 in Men with Non-Metastatic (M0) Castration-Resistant Prostate Cancer||Dr Danish Mazhar|
|PA-ART||Preliminary Assessment of Advanced Magnetic Resonance and Transrectal Ultrasound fusion targeted re-biopsy (in Prostate Cancer)||Dr Ferdia Gallagher|
|PROSPER: MDV3100-14||A Multinational, Phase 3, Randomized, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Enzalutamide in Patients With Nonmetastatic Castration-Resistant Prostate Cancer||Dr Danish Mazhar|
|Stampede||Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy||Dr Danish Mazhar|
|The PACE Study||PACE - International Randomized Study of Laparoscopic Prostatectomy vs Robotic Radiosurgery and Conventionally Fractionated Radiotherapy vs Radiosurgery for Early Stage Organ-Confined Prostate Cancer||Dr Martin Alexander|
|UK Genetic Prostate Cancer Study||UK Genetic Prostate Cancer Study (formerly the Familial Prostate Cancer Study)|
|The UK Genetics of Testicular Cancer Study||Identification of testicular germ cell tumour susceptibility genes||Dr Michael Williams|
|VIABLE||A Randomised, Double Blind, Multicenter, Parallel-Group, Phase III Study to Evaluate Efficacy and Safety of DCVAC/PCa Versus Placebo in Men with Metastatic Castration Resistant Prostate Cancer Eligible for 1st Line chemotherapy||Dr Danish Mazhar|
If you would like further information about how to take part in any of the clinical trials listed here that are open to recruitment, please talk to your cancer specialist as patients usually need to be referred by their doctor.
Cambridge Cancer Trials Centre contact for prostate, bladder and testicular cancer trials: Dr Danish Mazhar