Major new research programme kickstarts precision medicine revolution for incurable prostate cancer

We’re all unique. Just like no two men are exactly the same, no man’s cancer is the same either. What makes his cancer cells tick, how his cancer grows and – most importantly – how his cancer responds to treatment varies enormously.

When a woman is diagnosed with incurable breast cancer, doctors conduct a series of tests to establish the ‘type’ of advanced breast cancer she has, and in turn they’re able to decide exactly which drugs will work best to fight her disease.

However, men with incurable prostate cancer don’t get the same deal and are instead treated with a ‘one size fits all’, blanket approach. Some men respond incredibly well and continue to lead a good quality of life for many years. But others aren’t so lucky.

Our most ambitious funding to kickstart precision medicine

That's why, with the help of over 100 prostate cancer experts in the UK, we’ve launched our new precision medicine research programme. Our most ambitious research funding to date, it aims to find out exactly what drives each individual man’s cancer and which drugs will work best to stop it in its tracks.

To kick off the programme, we’ve awarded £1.4 million to a nationwide study to develop targeted treatment pathways for men with advanced prostate cancer which is not yet resistant to hormone therapy. Co-funded by Prostate Cancer UK, the Movember Foundation and the Distinguished Gentleman’s Ride, the study aims to do three key things:

• Identify changes in the DNA make-up of prostate cancer cells not yet resistant to hormone therapy that are responsible for driving the cancer cell growth.
• Develop a test that can easily detect these genetic changes.
• Then establish which drugs best target the genetic changes and prevent the cancer from spreading further.

Game-changing research to prolong men’s lives

"Every man’s prostate cancer is unique to him and so – not surprisingly – the way men respond to treatments varies enormously," says Dr Iain Frame, our director of research. "Clinicians are in effect left to treat patients ‘in the dark’, with little idea as to which treatments will work best for which men.

"However, this new research programme could be game-changing, providing clinicians with the much clearer picture they desperately need. It will enable them to go straight to the right treatment for each individual man, saving precious time for those men who often have little time left."

Men diagnosed with advanced prostate cancer are typically treated with hormone therapy, and move on to life-extending treatments – such as docetaxel, abiraterone and enzalutamide – once hormone therapy has stopped working. But in this initial study of our precision medicine programme, we'll focus specifically on men with advanced prostate cancer before it has become resistant to hormone therapy – which is the first time ever that this precision approach has been used to treat men at this stage of disease.

We know from other studies involving men with advanced prostate cancer, like STAMPEDE, that starting additional treatments alongside hormone therapy before they become resistant to it can prolong their lives – sometimes significantly. So we want to build on these findings and establish which treatment combinations work best for which men, whilst also developing new drugs to help extend more lives.

Over 100 UK hospitals and investigators involved

The study is being co-lead by researchers at the Institute of Cancer Research in London and Queen’s University Belfast, and involves investigators at over 100 hospitals across the UK.

"They will use state-of-the-art technology to study thousands of tumours and develop tests that tell doctors which drug or combination of drugs will work best for an individual patient," says Dr Gert Attard, from the Institute of Cancer Research.

"By targeting treatment, we aim to maximise effectiveness whilst minimising unnecessary side-effects and financial costs from the use of ineffective drugs. We're committed to improving our treatment approaches and achieving long-term disease control for the majority of men and – for an increasing proportion – complete cure from their disease."

The lead researchers are hopeful that they’ll be a position to open the first arm of the trial up to patients from as early as next year.