Research to transform prostate cancer diagnosis

Introduction

The current diagnostic pathway for prostate cancer is failing men. Every year, over 9000 men across the UK are diagnosed only after their cancer has metastasised and spread widely around their body. Those men, as a result of their late diagnosis, miss any opportunity for curative treatment and have a very significantly reduced life expectancy compared to men diagnosed with cancer that is still contained within the prostate (or even prostate cancer that has spread but only within the pelvic region).

We need to make significant changes to the current pathway that deliver more benefit (find more clinically important prostate cancers before metastasis) and do less harm (fewer unnecessary biopsies, fewer diagnoses of clinically insignificant prostate cancers that result in anxiety and overtreatment). To radically change the diagnostic pathway, it is clear that a major investment is needed to test the most promising approach (or approaches) in a large-scale prospective trial that provides definitive answers upon which to base future practice change.

At the same time, it is not certain that even the best of the contenders will offer a level of performance needed to bring about screening for prostate cancer. Therefore, we need a study that is flexible enough to add new comparisons as diagnostic approaches emerge, and which collates biosamples from the men recruited in order to power future discovery. 

We are now seeking to fund this research: a modern trial designed to provide definitive evidence for diagnostic approaches that could replace the current pathway, with flexibility to include or add future interventions or comparisons (or elements downstream of initial diagnosis,such as refinements to our ability to prognosticate or predict optimum treatments), and the collection of biosamples to power discovery and future-proof the trial.

Our ambition for this funding call

We believe that the best way to make the profound and rapid progress we need in diagnosis of prostate cancer is to fund a single large collaborative effort. We therefore encourage researchers to come together to inform, design and deliver this ambitious programme. To enable this we have worked with the National Cancer Research Institute (NCRI) to support a consortium and protocol development meeting to be held on 24 May 2022. More details about the meeting are available here.

Taking inspiration and learning from the successful STAMPEDE governance arrangements we anticipate a core leadership group, plus larger investigator group, with multiple workpackages each led by one or more members of that team. We anticipate that the trial, or platform, set up initially will be large enough, ambitious enough and flexible enough to answer multiple questions either from the outset and/or through the addition of supplementary arms / comparisons or studies with additional funding from Prostate Cancer UK or other funders before the end of the initial trial.

Budget

Partnerships

We are keen to make progress as quickly as possible in this key strategic area of need and believe that the way to do that is to work in partnership as widely as possible. We will continue to have funder-to-funder conversations with relevant organisations but would welcome applicants also exploring and introducing opportunities for partnerships to support this programme.

Partnerships with existing or emerging infrastructure and programmes will be essential to leverage expertise and funding already committed, reduce duplication and, crucially, maximise the likelihood of success.

We are aware that several companies have prostate cancer diagnostic assays that require further evidence from large-scale prospective trials such as this, and we are keen to engage with those companies. We encourage companies who may be interested in this initiative to engage with the charity as early as possible so that we can discuss options and put you in contact with the applicants if relevant.

Process

Applications will be assessed by a funding Committee of unconflicted experts. We anticipate an iterative process which may involve meetings between applicants and the committee. Final sign off will be by Prostate Cancer UK trustees informed by the Director of Research and the Funding Committee.

We expect that through this process applicants may have to respond to (and adjust their plans to address) committee feedback. The process we design will be to identify the best option (if we receive multiple applications) and subsequently to refine that proposal to the point that our funding committee considers that it has a good chance to provide definitive evidence aligned to this call and recommends that we fund it. As we intend to fund a single large collaborative group, we may ask applicants to enter into discussion with other groups also submitting applications to avoid, if possible, multiple competing bids.

Timeline

Consortium and protocol development meeting: 24 May 2022

Application forms go live: no later than 31 May 2022

Application closing date: 31 August 2022

Initial committee recommendation: October/November 2022