Finding the right level of treatment for locally advanced cancers
What you need to know
- Thanks to recent research, men with locally advanced prostate cancer are given extra treatments to reduce the risk of the cancer relapsing
- Professor Gerhardt Attard hopes to find out which men may not need this intensive therapy and prevent them from suffering unnecessary side effects
- If there is a genetic signature that can predict the risk of relapse, it could be used to create a test to help inform treatment decisions
"We hope to create a genetic test that can help us treat men more precisely. If successful, it could help us identify men who are less likely to see their cancer return and may not need extra treatments, preventing them from suffering unnecessary side effects."
It is often difficult to find the right balance between over-treatment and under-treatment in medicine; either option can cause harm. Professor Attard hopes to use genetic changes in biopsy samples to find a new way to choose the right level of treatment for men with locally advanced prostate cancer.
Intensified treatments for locally advanced prostate cancer
Prostate cancer that has just started to spread outside the prostate is known as ‘locally advanced’. These cancers are at high risk of surviving radiotherapy and hormone therapy, so additional treatments such as chemotherapy or abiraterone are now often also given by doctors.
Results from the STAMPEDE clinical trial showed that these additional treatments can lower the risk of the cancer relapsing. However, many men with locally advanced cancer would not have died from their prostate cancer anyway. These men experienced the side effects of the intensive treatment but experienced no benefit.
Selecting the right level of treatment
Prof Attard and his team want to create a test to find out which men are more likely to benefit from additional treatment for their locally advanced prostate cancer. To do this, they will study biopsy samples from 450 men who took part in the STAMPEDE trial.
Looking for DNA changes
The researchers will look for large changes in the DNA of the cancer samples, such as deletions and duplications of long sections. Then they will analyse these changes for any patterns seen across men with similar outcomes following treatment. The patterns will then be tested as a genetic ‘signature’ in samples from another 450 men from the STAMPEDE trial to see how reliable they are at identifying locally advanced cancers that are less likely to relapse.
If successful, this genetic test could then be used to inform treatment decisions for men with locally advanced prostate cancer.
Grant information
Reference – MA-ETNA19-009
Researcher – Professor Gerhardt Attard
Institution – University College London
Award - £404,986