New research funded by Prostate Cancer UK has discovered a blood test that can predict which men's cancer won't respond to certain hormone therapy, so they can pick the treatment that works for them while saving the NHS potentially huge sums on otherwise wasted drugs.

4 May 2017

A promising new blood test could allow personalised treatment for advanced prostate cancer for the first time.

Researchers, led by Dr Gerhardt Attard (pictured above) at the Institute of Cancer Research and funded by Prostate Cancer UK with support from the Movember Foundation, have developed a cheap blood test that could one day be used to identify cancers that are resistant to abiraterone and enzalutamide.

These two hormone therapy drugs are offered to men when their prostate cancer becomes resistant to other hormone therapy treatments. While we know that not all men benefit from these drugs, it has not been possible to tell who they are in advance.

Currently, men are given enzalutamide or abiraterone for 12 weeks before the doctor can determine if it is having an effect. But Dr Attard's test could spare some men with advanced prostate cancer the wasted time and side effects of an ineffectual treatment, while also saving thousands of pounds for the NHS.

"We have developed a robust test that can be used in the clinic to pick out which men with advanced prostate cancer are likely to respond to abiraterone and enzalutamide, and which men might need alternative treatments," says Dr Attard, who trialled the test on 265 men and published the results of his study in the journal, Annals of Oncology.

"Our method costs less than £50, is quick to provide results, and can be implemented in hospital laboratories across the NHS."

How the new blood test works

The blood test picks out loose pieces of DNA from the cancer and looks for changes to the Androgen Receptor. This protein prompts the cancer cells to grow, making it a key target for drugs – but genetic mutations can make it resistant to enzalutamide and abiraterone.

With the list price of a months’ supply of abiraterone at more than £2,000, using the new test to identify cancers that are genetically resistant to the drug before administering it could save the NHS huge sums in wasted treatment.

"A man with incurable prostate cancer does not have time to waste taking drugs that will not work for him," says Dr Iain Frame, Director of Research at Prostate Cancer UK.

"To stop prostate cancer from being a killer, we need to move away from a one-size-fits-all approach to treatment. This test could be a significant step towards that and we’ll be watching its development very closely.

"Thanks to our supporters, we are ramping up investment in prostate cancer research to get the right drug for the right man at the right time."

Further trials necessary and already underway

At Prostate Cancer UK, we recognise that we need to get promising results from research into clinical use as quickly as possible to make a real difference to men. And that’s exactly what we’re doing with this technology by funding the PARADIGM trial through one of our Movember Foundation Translational Awards.

Already underway, PARADIGM will allow Dr Attard to run further clinical trials and collect all the scientific data necessary to persuade health regulators to make his blood test available to all men with hormone-resistant prostate cancer.

It comes at the same time as another group of researchers from the Institute of Cancer Research reported using a similar genetic test to track the response and resistance of prostate cancer to olaparib, a drug currently used to treat ovarian cancer. So we're funding research to find out if it could also benefit certain men with advanced prostate cancer.

Both of these new studies show just how much potential there is for tailoring treatment choices to each man's cancer. This type of precision medicine is a key priority for Prostate Cancer UK and – thanks to your support – we will continue to fund more research in this area to make it a reality for men everywhere.

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