Making precision medicine even more precise

What you need to know

  • Our work with Professor de Bono helped identify the first precision medicine for advanced prostate cancer – a drug called olaparib that works against specific genetic changes in the cancer
  • Some cancers respond in different ways to olaparib and now Prof. de Bono’s team are studying samples from men who took part in a clinical trial to understand why
  • The results will help create new tests to find the men who will get the most benefit from this drug
We will develop tests, from biopsies and blood, that will identify men who will get the most benefit from precision medicines like olaparib. This will make sure that no man is left behind from treatment that could work for him.
Professor Johann de Bono

A revolution in precision medicine is just beginning in prostate cancer, where each man can get a treatment suited to his particular cancer. This project will help to create new tests for a drug that may soon be the first precision medicine approved for advanced prostate cancer.

Building on past success

Precision medicine is the idea of giving treatments that are tailored to the particular genetic changes that are driving the cancer’s growth. This will help to improve survival compared to a ‘one-size-fits-all’ approach and is already common practice in other cancer types.

About a third of advanced prostate cancers have genetic faults that affect their ability to repair damage to DNA. These cancers are often highly aggressive. Previous research, part-funded by us, showed that an ovarian cancer drug olaparib can shrink tumours and improve survival in men with DNA repair mutations. Olaparib is now set to become the first precision medicine for prostate cancer.

Effects in different men

The previous work suggested that not all men with DNA repair mutations benefit to the same degree from olaparib treatment. Prof de Bono and his team want to find out why that is.

They believe that the cancers often contain a mix of cells with different mutations, meaning that olaparib might only work against some of the cancer cells and have no effect on others. This still has the benefit, however, of ‘pruning’ the most aggressive cancer cells in the tumour, even if the cancer overall does not appear to shrink.

Making the most of existing samples

To study the effects of the drug, Prof de Bono will use biopsy and blood samples taken from men who took part in the TOPARP clinical trial of olaparib. These samples will allow the team to develop new tests for identifying men where olaparib will be effective or where a combination of treatments might be better.

Grant information

Reference - MA-ETNA19-006

Researcher – Professor Johann de Bono

Institution – The Institute of Cancer Research

Award - £500,327