Results to change prostate cancer treatment ‘worldwide’

Radiotherapy and novel hormone treatments for more men will help thousands with prostate cancer.

Research fellows working in the Urology research team at The Christie have helped to discover that radiotherapy is very effective when used to help men with limited secondary cancer when they were first diagnosed. Previously, these men were thought to be incurable.

The team have also shown in a separate analysis of data from the same trial that new hormone treatments are highly effective for all men with this type of disease. The hormone treatments were previously only available for a limited number of men whose cancer had spread, also known as metastases. This is something which is likely to change the worldwide licence for the use of this class of drugs.

These findings will improve the quality of life and survival for thousands of men around the world who develop this type of high risk prostate cancer.   

These are findings from STAMPEDE, a ground-breaking UK based prostate cancer clinical trial. Results from this phase of the trial were reported in two presidential plenary presentations at the European Society for Medical Oncology conference (ESMO) in Munich in October 2018. One of these reports of results was published in Lancet Oncology and the second report is currently in submission for publication.

Metastatic prostate cancer treatment

In the first of the reports, Mr Alex Hoyle, Urology Registrar and Research Fellow for the Genito-Urinary (GU) Research Group, based at The Christie, carried out an analysis of data from STAMPEDE. He studied nearly 2,000 scans from patients whose data was published last year in a ground-breaking report in the New England Journal of Medicine.

Alex Hoyle’s work showed that the novel drug Abiraterone could be given to all prostate cancer patients with newly presenting metastases rather than just a limited number of them. This means that up to 40% more men will be eligible to receive this drug, with life prolonging benefit. This will affect thousands of men around the world.  

The second report looked at whether radiotherapy to the prostate could help men with metastatic disease at first presentation. This was a completely new approach in treatment.

The overall result of this trial of over 2,000 men found that if radiotherapy was used in all patients with standard anti-androgen therapy, there was no beneficial effect. However, the pre-planned analysis of men whose prostate cancer hadn’t spread as much showed this treatment had substantial benefit. 

This result came directly from a further analysis of all the patient’s scans conducted by Dr Adnan Ali, Oncology Research fellow working alongside Alex Hoyle as part of the GU Research Group and FASTMAN Centre of Excellence Prostate Cancer Programme. His work means that whilst the overall trial results were negative, this subgroup of men, comprising up to one third of all prostate cancer patients presenting in this way will now receive life prolonging therapy. This result will once more change practice and outcome around the world.

The Christie’s impact on STAMPEDE

Two research fellows at The Christie, Alex Hoyle and Adnan Ali, worked on STAMPEDE in conjunction with Salford Royal and the MRC Clinical Trials Unit team at University College London.

Alex and Adnan work as part of the overall prostate research programme within the GU Cancer Research Group and as part of the FASTMAN Centre of Excellence Prostate Cancer Research Programme.

Noel Clarke, Consultant Urological Surgeon at The Christie and Salford and Professor of Urological Oncology at Manchester University is Head of the GU Cancer Research Group and joint Lead for the FASTMAN team. He has been a co-principal investigator of the STAMPEDE trial since it started in 2005.

Professor Clarke said that Alex Hoyle and Adnan Ali’s work was critical to the successful outcome in these two elements of this unique clinical trial.

“Without Alex and Adnan’s work, these treatments wouldn’t be made available for patients worldwide,” Professor Clarke said. “It was described in the National press as a ‘monumental change for prostate cancer treatment’ and I would echo those sentiments”.

The Christie remains as a major contributor to STAMPEDE, which is recognised as the world’s leading prostate cancer trial. The Christie is now the main repository for all STAMPEDE scans and the MCRC Biobank is one of two national bio-repositories for all the prostate cancer tissue collected on over 10,000 prostate cancer patients in the study.

The prostate cancer research teams at The Christie will continue to investigate all facets of prostate cancer biology to help improve survival rates for this lethal form of the disease.