Turning cancer clues into better treatment choices

Treatments like chemotherapy and hormone therapy can help men with advanced prostate cancer live longer. However, they don’t work in the same way for every man. Some men see big benefits, while others experience side effects without much improvement.

That’s why, with your support, we funded researchers to work towards a more personalised approach to treatment. In partnership with Movember, we supported a team using biomarkers – biological clues in a man’s cancer – to help predict which treatments are most likely to work for him.

The STRATOSPHere project, led by Professor Gerhardt Attard at University College London, studied thousands of samples from men who took part in the CRUK and MRC‑funded STAMPEDE trial. The team explored how different cancers behave and which treatments are most likely to help each man. This work led to the development of two tests.

The first is the Decipher Prostate test. This test can identify men whose cancer has spread but is still responding to hormone therapy, helping doctors identify who's most likely to benefit from chemotherapy. Men with a high Decipher score had a 36% lower risk of death after five years when they received chemotherapy. Men with a low score experienced side effects but little benefit, suggesting other treatments may be a better fit for them.

The second test is the ARTERA AI tool, which looks for clues in a man’s biopsy sample to help predict whether he's likely to respond well to abiraterone - a hormone therapy that blocks the production of testosterone. For men predicted to respond, adding abiraterone reduced the chance of dying within five years from 17% to 9%. For men not predicted to respond, outcomes were already very good with standard treatment, suggesting abiraterone may not add much extra benefit.

Together, these findings bring us closer to truly personalised prostate cancer care – helping each man get treatments that are right for his cancer, while avoiding unnecessary side effects.

From research idea to access for all

Idea

Professor Attard and his team wanted to understand what makes each man’s cancer behave the way it does. By studying samples from the STAMPEDE trial, the team looked for clues that could guide doctors towards treatments most likely to help each man, and to avoid treatments that may not offer much benefit.

Lab research

The researchers prepared samples from men who took part in the STAMPEDE trial. After carefully processing and digitising them, they used the Decipher and ARTERA AI tools to look for clues. This early lab work helped the team explore whether these tools could guide more personalised treatment decisions in the future.

Clinical trial

In the STRATOSPHere project, the Decipher and ARTERA AI tools were tested on samples from men who had already received treatment. This testing helped researchers see how well the tools could predict which treatments work best for different men.

These findings showed real promise, and highlighted the need to test the tools further to make sure they can safely and reliably guide treatment decisions in everyday care.

Approved for use

Before new tools can be used routinely in the NHS, strong evidence is needed to show they work and can be relied on. That’s why we're funding further clinical trials to build the evidence doctors need to use these tools with confidence.

If approved, these tools could help doctors make more informed treatment decisions, ensuring each man receives the treatment most likely to work for his cancer.

Access for all

To help move these tools closer to routine use, we're funding two follow‑on studies.

The INTENSIFY trial is testing whether the Decipher Prostate test can identify men who would benefit from chemotherapy earlier. While the VANGUARD PATH trial is testing the ARTERA AI tool in NHS hospitals to help guide treatment choices.

These studies are a crucial step towards making personalised prostate cancer treatment available to men across the UK. If successful, they could help more men get the right treatment from the start, while avoiding unnecessary side effects.