What you need to know
- Focal therapies can target cancer and leave the rest of the prostate intact, resulting in fewer side effects.
- Before being rolled out as a widely available treatment, focal therapies need to be proven to be as effective as standard treatments like radiotherapy in large clinical trials.
- We’re funding Professor Ahmed to trial focal therapy in a small group of men, to help inform a larger study that could bring the treatment to men across the UK.
If we can confirm focal therapy is an effective treatment for cancer whilst also maintaining a low side-effect profile, the potential impact to men with prostate will be immense. Overall, this would maintain not only their life expectancy but also quality-of-life.
New focal therapies could treat cancer and leave men without side effects
For men with prostate cancer that requires treatment, they will usually be offered surgery or radiotherapy that treats the whole prostate, rather than just the areas that have cancer. Although effective at dealing with the cancer, these treatments can leave men with serious side effects, like incontinence and erectile dysfunction.
Recently, new treatments have been developed, collectively called focal therapies, which specifically target tumours and leave the rest of the prostate intact. Early studies suggest that focal therapy has promising results on treating prostate cancer, and causes few side effects. However, focal therapy is not yet offered to many men as a treatment option, as we cannot be sure that it is more effective than traditional treatments like radiotherapy.
Focal therapy must be proven against standard treatments
Professor Ahmed wants to confirm this, by directly comparing focal therapy with radiotherapy. This will involve randomly splitting men with prostate cancer into either a group that receives focal therapy or radiotherapy, so that both groups are the same except for the treatment they receive. The researchers will then see if there is any difference in the progression of prostate cancer or side effects between the two groups.
Small trial will inform larger study
Hundreds of men need to take part in the study to make sure the results are reliable, but before time and money is invested in a large clinical trial like this, the researchers need to be sure that men will want to participate. They will test this by first conducting a smaller trial of 60 men. They will also interview the men and doctors involved in this small study, to find out how its design can be improved for the large trial. Finally, the researchers predict that some men will want to choose focal therapy, instead of being randomly assigned to a group, and so they will run a second trial where everyone gets focal therapy, but some men are given extra medications first. This second randomised trial will test whether the cancer outcomes of focal therapy can be improved.
Funding for large study will help bring focal therapies to men
If the studies are a success, then the team will try to secure funding for a larger trial. This would aim to confirm that focal therapy is an effective treatment for prostate cancer, and causes fewer side effects than standard treatments. Their second trial may show that focal therapy can be made more effective with a short course of medications beforehand, reducing the need for further cancer treatment after focal therapy.
Reference - RIA17-ST2-012
Researcher - Professor Hashim Uddin Ahmed and Mr Taimur Shah
Institution - Imperial College London
Award - £485,966.00