Choosing the best treatment for men with hormone therapy-resistant prostate cancer

Every man’s prostate cancer is different; however, we currently treat them like they are all the same, meaning some men respond much worse to treatment than others. Professor de Bono and his team want to make treatment more personalised for men with advanced prostate cancer, so that they only receive the treatment that is best for their cancer. This will involve finding ‘biomarkers’, or certain genes or proteins in each man’s cancer, that give clues about what treatment will be best.

Professor de Bono will begin by looking at biomarkers in tumours and blood samples from over 1000 men with advanced prostate cancer, collected in a previous study, and 600 new patients, who will be monitored over the course of three years in a study called MAESTRO. They will see if any of the biomarkers are good predictors of how the prostate cancer responded to treatment, whether it became resistant, and how the cancer progressed. The team also hope that some of these predicting biomarkers can be detected from the blood, rather than from tumour biopsies, so that they could be used in a non-invasive test to diagnose or monitor men with advanced prostate cancer.

Of the 600 new patients, those who are suitable will be asked to take part in a second trial called PERSEUS, where they will be given a specific treatment based on their biomarkers. The team hope that this will show that using personalised treatment is better than the ‘one size fits all’ approach that is currently used.

Potentially nine different treatments will be tested against the biomarkers. These treatments are designed to target different Achilles’ heels found in various men’s cancers including defects in DNA repair, stress from replication and response to male hormones.

If the project is successful, the team hope that their biomarkers can be used by doctors to diagnose men and monitor their progress, as well as indicate which treatment would be the most effective. This should reduce the number of unnecessary treatments and improve the length of time men with advanced prostate cancer survive. 

Grant information

Reference - MA-PM16-002
Researcher - Professor Johann de Bono
Institution - Institute of Cancer Research
Award - £1,300,957.00