A blood test to select best treatment for men with early-stage disease

What you need to know 

• Prostate cancer spread can be difficult to detect at earlier stages of disease, which can result in many apparently localised cases re-occurring after surgical removal of the prostate.
• We’re funding Professor Yong-Jie Lu and Mr Greg Shaw to investigate whether cancer cells released into the blood can be detected early in the treatment pathway and indicate whether the cancer has begun to spread outside of the prostate.
• The results of this project will inform future clinical trials which could help guide therapy decisions, so men can receive the best possible treatment for their cancer.

Earlier signs of cancer spread

Surgery is an effective treatment for prostate cancer if the cancer is still contained within the prostate. However, the early signs of spread, known as metastasis, can be difficult to detect. This results in some men undergoing surgery when their cancer has already spread, which means it is more likely to come back. If picked up earlier, metastatic prostate cancers can be treated more effectively with other therapies. 

Circulating tumour cells (CTCs) are the seeds of metastasis, as cells are shed from the tumour into the blood stream. If these CTCs can be detected early, they could be a useful indicator that the cancer has spread outside the prostate. Professor Lu and Mr Shaw want to confirm this and study genetic changes in these cells.

If found to be an indicator of prostate cancer progression, this information could be developed into a test that helps doctors select the best treatment for men at an earlier stage of the disease.

Finding clues in the blood 

CTCs can be released into the blood at a very early stage of cancer development and are present in the most aggressive cases of prostate cancer. 

To understand the role of CTCs in predicting prostate cancer progression, the team will recruit 200 patients who are about to undergo surgery for their prostate cancer. Blood samples will be taken before and after their surgery, which will then be analysed to see if any CTCs are present. If so, the genes from these cells will be analysed to see which are switched on and off. As part of this project, these patients will be monitored for at least 3 years to see whether their cancer returns after their surgery. 

Next steps before a clinical trial 

This project will improve our understanding of CTCs in the early stages of prostate cancer. It will confirm whether characteristics of these cells can determine whether the cancer has already begun to spread and therefore be used to guide treatment options.

If successful, the data on CTC detection, genetic changes and long-term monitoring of patients will be used to further develop the accuracy of the CTC test. The team will then pursue clinical trials to evaluate the use of CTC analysis in deciding the best treatment for men with high-risk localised prostate cancer.

In the long term, they hope the CTC test will help save the lives of men with prostate cancer and avoid harm from unnecessary treatment.

Grant information

Reference – MA-CT20-011   

Researcher – Professor Yong-Jie Lu & Mr Greg Shaw

Institution – Queen Mary University of London 

Award - £749,527