Helping doctors see sooner when treatment isn’t working

Treatments for advanced prostate cancer can work well for many men, often keeping their cancer under control. But when a treatment stops working, doctors need to know as soon as possible so they can consider other options.

With your support, we funded Dr Anuradha Jayaram, Professor Gert Attard, and colleagues at University College London, who found that a new blood test could provide an earlier warning that a treatment is no longer working instead of relying on PSA testing alone.

The team looked at circulating tumour DNA (ctDNA) – tiny fragments of DNA released into the bloodstream by prostate cancer cells, like footprints left behind by the cancer.

If treatment is working, those footprints quickly become harder to detect.

Following 114 men receiving treatment for newly diagnosed advanced prostate cancer, the team found that ctDNA could provide an earlier clue about how well treatment was working than PSA tests alone, helping doctors find out sooner when a man's cancer was no longer being kept under control.

The researchers found that ctDNA could provide an earlier clue about how well treatment was working. But they also showed that PSA still has an important role to play - combining ctDNA and PSA results gave a clearer picture than either test alone.

This could help doctors make decisions sooner about the best next step for each man and bring us closer to more personalised care.

From research idea to access for all

Idea

Men with advanced prostate cancer don't all respond to treatment in the same way. Researchers wanted to find a way of finding out, as soon as possible, when a man's cancer was no longer responding to treatment and other treatment options may need to be considered.

Lab research

Prostate cancer can leave behind 'cancer footprints' in the bloodstream. Researchers developed a test to look for ctDNA and see whether it could provide an earlier clue about how well treatment was working.

Clinical trial

In the PARADIGM study, combining ctDNA with PSA results gave a clearer picture of how well treatment was working than PSA results alone. Men whose ctDNA remained detectable after treatment started were more likely to see their cancer progress.

Approved for use

Before this type of blood test can be used routinely in the NHS, researchers need to show that using it helps doctors choose the right treatment at the right time.

The PARADIGM study showed that ctDNA can provide an early indication of how well treatment is working. The next step is to test whether doctors can use this information to make treatment decisions sooner.

Access for all

If larger studies confirm these findings, doctors could use blood tests like this alongside PSA results to find out sooner when treatment is no longer working, helping more men receive the right treatment at the right time and bringing us closer to more personalised treatment for advanced prostate cancer.

If you'd like to learn more about the science behind this research, you can read Dr Anuradha Jayaram and colleagues' published study.