The PROMIS of MRI scans before biopsy revealed at US cancer conference

Exciting results from the long-anticipated PROMIS trial were announced for the first time today at the American Society of Clinical Oncology conference in Chicago – one of the world’s biggest cancer conferences. The trial looked at whether giving men who are referred to a urologist for suspected prostate cancer a multiparametric magnetic resonance imaging (mpMRI) scan before doing a first biopsy could help rule out the disease without the need for the invasive procedure.

The results still need to be confirmed in a peer-reviewed publication before we can be sure, but this first glimpse certainly looks exciting. The research team, led by Professor Mark Emberton and Hashim Ahmed from UCL, found that using mpMRI before a first biopsy would allow a big group of the men who are currently referred for biopsy to avoid it. The mpMRI was sufficient to safely rule out the possibility of clinically-significant prostate cancer in these men without having to take a tissue sample.

This could be great news for men and an important leap forward in our mission to improve prostate cancer diagnosis. Not only are prostate biopsies often painful, they can also lead to serious infections. Finding a way to safely rule men out of this unpleasant procedure when they don’t have significant prostate cancer would be a big step forward. It's also likely to help reduce the number of men being treated for cancers that would never harm them, as these men would be less likely to be diagnosed in the first place.

The PROMIS trial also showed that having an mpMRI scan before a standard, random TRUS biopsy didn’t improve the number of aggressive prostate cancers detected by itself. However, if urologists could use the results of the MRI scan to help them accurately target where in the prostate to aim the biopsy needles, this might result in more aggressive cancers being diagnosed straight away. Whether or not MRI-guided biopsy will be possible in a standard clinical setting though is not yet clear, and we need a bit more information to be able to say whether visually guiding the biopsy needles based on the knowledge gained from an mpMRI scan is accurate enough.

So what do these results mean for men with suspected prostate cancer? We want men to benefit from these results by being spared unnecessary biopsies as soon as possible after they’re published in a peer-reviewed journal. But we know that unless hospitals have everything set up to do this right, then there’s a chance that it could actually do more harm than good. That’s why we need to balance getting it implemented as quickly as possible with making sure that everything is in place to do that.

To do that, we’ve been working with a number of different clinical experts and professional bodies for some time to make sure that everything that needs to be in place before nationwide roll-out is done as speedily as possible. You can read more about the work we’ve been doing already on our mpMRI webpage, or read our blog for more discussion of our plans.