Clinical & Translational Trials (Urology/Oncology)
Our focus is in innovations in clinical trials for better detection, diagnosis and risk stratified management of primary prostate cancer.
Cambridge has led on a number of practices changing urological trials in Prostate Cancer to improve diagnostics and risk stratification: We completed the first UK multicentre trial to assess the value of combing biomarkers with imaging to refine the number of men who need tertiary investigations for suspected prostate cancer
We have developed a new prostate biopsy device (CamPROBE) which is a simple low-cost alternative to transrectal biopsies. A recent completed multi-centre trial has shown that this is effective as transrectal biopsies for cancer diagnosis, but without any infection or sepsis risk.
Other recently completed urology trials include the PREDICT Prostate patient study(ISRCTN 28468474) study, the TAPS01 (NCT03365297)
Other completed translational trials include:
Barrett T, Gill AB, Kataoka MY, Priest AN, Joubert I, McLean MA, Graves MJ, Stearn S, Lomas DJ, Griffiths JR, Neal D, Gnanapragasam VJ, Sala E. DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: a feasibility study. Magn Reson Med. 2012 Mar;67(3):778-85.
Goodburn RJ, Barrett T, Patterson I, Gallagher FA, Lawrence EM, Gnanapragasam VJ, Kastner C, Priest AN. Removing rician bias in diffusional kurtosis of the prostate using real-data reconstruction. Magn Reson Med. 2020 Jun;83(6):2243-2252. doi: 10.1002/mrm.28080.
Barrett T, Lawrence EM, Priest AN, Warren AY, Gnanapragasam VJ, Gallagher FA, Sala E. Repeatability of diffusion-weighted MRI of the prostate using whole lesion ADC values, skew and histogram analysis. Eur J Radiol. 2019 Jan;110:22-29. doi: 10.1016/j.ejrad.2018.11.014.
Lawrence EM, Warren AY, Priest AN, Barrett T, Goldman DA, Gill AB, Gnanapragasam VJ, Sala E, Gallagher FA. Evaluating Prostate Cancer Using Fractional Tissue Composition of Radical Prostatectomy Specimens and Pre-Operative Diffusional Kurtosis Magnetic Resonance Imaging. PLoS One. 2016 Jul 28;11(7):e0159652. doi: 10.1371/journal.pone.0159652.
Lawrence EM, Gallagher FA, Barrett T, Warren AY, Priest AN, Goldman DA, Sala E, Gnanapragasam VJ. Preoperative 3-T diffusion-weighted MRI for the qualitative and quantitative assessment of extracapsular extension in patients with intermediate- or high-risk prostate cancer. AJR Am J Roentgenol. 2014 Sep;203(3):W280-6. doi: 10.2214/AJR.13.11754.
Lawrence EM, Gnanapragasam VJ, Priest AN, Sala E. The emerging role of diffusion-weighted MRI in prostate cancer management. Nat Rev Urol. 2012 Jan 17;9(2):94-101. doi: 10.1038/nrurol.2011.222.
3. TAPS01 – https://clinicaltrials.gov/ct2/show/NCT03365297
To test if short-term use of apalutamide can reduce image defined tumour volumes in men with detectable lesion on multi-parametric Magnetic Resonance Imaging (mpMRI) and being managed by Active Surveillance. The trial evaluated the tolerability and side effect profile of men on AS using short term apalutamide and patient acceptability as a therapeutic strategy, as well as determining feasibility of a larger prospective randomised trial of apalutamide. Recruitment and follow up completed successfully in 2020.
Prostate oncology trials at Cambridge are focused on exploring neo-adjuvant therapies in primary aggressive cancers by setting up a platform for window studies. Recently completed trials include the pharma supported CANCAP 02/03 studies.
Our partner – Dr. Simon Pacey specialises and leads this chapter.