New ways to treat prostate cancer before surgery, and who they’ll work best for

During the last year, Dr Heavey has been perfecting a technique of keeping prostate cancer samples alive in the lab for a couple of days. In her Fellowship, Dr Heavey plans to use these samples to test new drugs and drug combinations. She thinks this will be a very effective pre-clinical model of new prostate cancer treatments. This is because it is a ‘direct from patient’ human sample, so of immediate and direct relevance to the type of prostate cancer the drugs are being designed to treat. Also, unlike using human prostate cancer cells or cell lines, it keeps the tumour within its surrounding tissue. This is a huge benefit, because it’s becoming more and more clear that it isn’t just important to look at the cancer cells when designing a new treatment, or looking for new biomarkers, but also at all the other cells surrounding it.

In this Fellowship, Dr Heavey will concentrate on testing new drugs that target the action of a gene called PIM, which is involved in prostate cancer development and progression. It also interacts with several other genes known to be important for prostate cancer growth, like PI3K and the Androgen Receptor. Because of this, Dr Heavey will test how well drugs that act against PIM work in combination with drugs targeting PI3K and/or the Androgen Receptor, since she thinks this is likely to work better than targeting PIM alone.

She also plans to test whether new imaging techniques, including mpMRI and VERDICT MRI (which is a more sophisticated version of mpMRI), can be used to measure how the cancer samples respond to treatment. This will give her a good idea of whether doctors could use these imaging techniques to monitor how well men respond to treatments like this without needing to take repeat biopsies.

If her results prove positive, Dr Heavey thinks that these drugs could be used to treat men diagnosed with prostate cancer who have chosen to be treated with surgery. She hopes this would shrink the cancer before treatment, making it possible for surgeons to leave more of the surrounding prostate tissue and nerves intact without risking leaving any cancer behind. This would help reduce side effects such as incontinence and erection problems. She also thinks it’s possible that giving these drugs immediately before and after surgery could reduce the risk of the cancer coming back, because it would act as a ‘belt and braces’ approach to making sure that all cancer cells were either removed by the surgery or killed by the drug.

However, as with most prostate cancer drugs, Dr Heavey suspects that these ones will work better for some men than others. So for the final part of her Fellowship, she will travel to Cold Spring Harbour Laboratories in New York to learn a brand new state-of-the-art technique for measuring gene activity in whole tissue samples. She will look at all the treated samples, as well as untreated samples, and see which genes are turned on or off in response to treatment. She will also see whether these genes are more or less active in some cancers than others and whether this corresponds to treatment response. If it does, this will give her clues as to which genes to look at before treatment to see if she can predict which men, and which cancers, this treatment is likely to work best for.

Grant information

Researcher – Dr Susan Heavey
Institution – University College London
Grant award – £309,792
Reference – TLD-PF16-004