Can PSMA PET scans improve the way we treat high-risk prostate cancer?

Grant information

Reference: MA-TIA23-006
Researchers and institutions:
Professor Hashim Ahmed, Imperial College London
Dr Adam Brentnall, Queen Mary University of London
Professor Rhian Gabe, Queen Mary University of London
Mr Martin Connor, Imperial College London
Professor Tara Barwick, Imperial College NHS Trust
Award: £1,893,036

What you need to know

• Existing scans don’t always pick up whether prostate cancer has spread, meaning men may not receive the treatment they need to keep the disease under control.
• This research aims to find out if a new imaging test called PSMA PET/CT can improve the way we stage and treat high-risk prostate cancer, compared to current imaging methods.
• Men in this study will be randomly assigned to receive either the new PSMA PET/CT scan or standard imaging tests, with their cancer treatment tailored based on the imaging results.

• If successful, this new test could help men who are at highest risk get the best possible treatment for their cancer.

What will the researchers do?

Some men’s prostate cancer is considered high-risk, meaning it has a higher chance of spreading to other parts of the body. Detecting this spread accurately is crucial for deciding which treatment option is best.

This research project aims to see if a new type of imaging test, called PSMA PET/CT, can improve the detection and treatment of high-risk prostate cancer compared to the standard imaging tests currently used.

Today, doctors use two separate imaging tests to check if prostate cancer has spread: a CT scan (which takes detailed pictures of the inside of the body) and a bone scan (which looks for cancer in the bones). These tests are done on different days and might miss some areas where the cancer has spread, leading to less effective treatment plans.

The new imaging test, PSMA PET/CT, combines both types of scans into one. It uses a tracer that is injected into the body and highlights prostate cancer cells wherever they are, so that the scanner can see them. This means it can potentially detect more areas of cancer spread in one go.

To find out if PSMA PET/CT is better, the researchers will randomly divide the men with high-risk prostate cancer into two groups. The first group will have their treatment directed by the current standard imaging tests (CT scan and bone scan). The second group will have their treatment directed by the findings of the new PSMA PET/CT scan. In this group, patients will have their normal care but also have additional treatment to areas of cancer that has spread.

The researchers will follow these men over time, checking in at 24 and 48 months after the initial scan to see how well their cancer is controlled and if there is any spread of the disease.

By comparing the results between the two groups, the researchers hope to find out if PSMA PET/CT leads to better cancer control. If the new test proves more effective, it could become the standard method for staging high-risk prostate cancer, helping to improve treatment plans and outcomes for many patients. If not, the study will confirm that the current standard imaging is good enough, preventing unnecessary use of the more expensive PSMA PET/CT test.

How will this benefit men?

This research is crucial because it tackles a significant challenge in treating high-risk prostate cancer: accurately determining if and where the cancer has spread.

For men with high-risk prostate cancer, this research could mean more accurate diagnoses and more effective treatments, potentially catching and treating cancer outside the prostate before it can grow and spread further.

For men whose prostate cancer has not spread further, it could help avoid unnecessary extra treatments.