New test could see better targeted treatment for men with advanced cancer – sparing thousands the side effects of chemotherapy

Men with advanced prostate cancer could soon see their treatments become more tailored to them, as research we funded in partnership with Movember shows a test can spot which men are most likely to benefit from docetaxel chemotherapy. 

Docetaxel is the most commonly used chemotherapy for men with advanced prostate cancer. It can extend lives, but not every man responds equally to it – and, right now, clinicians have limited tools to figure out who will and who won’t respond. 

With this test, however, men who are less likely to respond well to docetaxel chemotherapy could instead opt for other treatments that may help them more, and avoid experiencing the drug’s side effects unnecessarily. 

We’re now funding further research to improve the way we use docetaxel, including when men should start taking it, so that men can receive more tailored treatments as soon as possible.

Clues in men’s biopsies

The test, called Decipher Prostate and developed by the company Veracyte, is already used in the US to work out which men with localised prostate cancer are likely to see their disease spread.  

Published in the journal Cell, this new research could see the test help even more men get the right treatment for them.  

The test looks at the activity level of 22 genes in prostate cancer cells. These cells are collected when a man undergoes a biopsy as part of being diagnosed. 

In this case, the researchers looked at biopsy samples from men who were taking part in the long-running STAMPEDE study. STAMPEDE aims to find the best way to treat men with advanced prostate cancer, and has been following up on men for an average of 14 years.  

By plotting each man’s test score against the length of time he survived, the research team found men fell into two main groups. 

Men who got high scores on the test were 36 per cent less likely to die over the course of the study when they added docetaxel to their existing hormone therapy.  

In contrast, men who had low test scores saw their risk of dying fall by less than 4 per cent when they took docetaxel alongside their existing treatments. 

Delivering real impact for men

The next step for the research is to see whether the test can predict which men are going to do better on docetaxel – and not just highlight patterns in existing data. 

That’s why, as part of our latest round of Transformational Impact Awards, we are funding a team to look at how and when men with advanced prostate cancer should take docetaxel – including further research into the Decipher Prostate test. 

Simon Grieveson, our Assistant Director of Research, said: “Around 10,000 men are diagnosed with advanced prostate cancer every year in the UK. 

“We're thrilled to have supported this innovative research in partnership with Movember which could help to predict upfront which men will benefit most from the addition of chemotherapy - helping some men live longer, while others can avoid the side effects of unnecessary treatment.  

“This is a fantastic example of charities, academic researchers and industry collaborating to deliver real impact for men affected by prostate cancer.” 

Personalising chemotherapy decisions

Professor Gert Attard, Director of the UCL Cancer Institute and a lead researcher on this research, said: “The STAMPEDE trial has resulted in several changes to the way patients presenting with advanced prostate cancer are treated.  

“Now, for the first time, we’ve identified groups of patients recruited to the trial who had very different benefit from treatment. The ability to personalise chemotherapy decisions based on the Decipher Prostate test will greatly enhance patient care and outcomes. 

“By identifying which patients are most likely to have a survival benefit from chemotherapy, we can avoid unnecessary side effects." 

Dr Emily Grist, a lead researcher of this study at the UCL Cancer Institute, added: “I believe our study is a milestone in efforts to re-classify prostate cancer into distinct molecular groups. The long-term impact will be bespoke treatments based on tumour molecular profiles that should improve outcomes for patients.” 

This research is only possible because of you.

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