Defining treatment paradigms in prostate cancer; the UK as a dominant force - past, present, and future

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• Professor Malcolm Mason, NCRI Prostate Cancer Clinical Studies Group and School of Medicine, Cardiff University
• Tuesday 14 April 2015, 12:00-13:00
• CRUK CI Lecture Theatre.

If you have a question about this talk, please contact Mala Jayasundera.

Host: Dr Simon Pacey

Later this year, the first results of the UK STAMPEDE trial, the largest clinical trial in prostate cancer in history, will be presented. Whatever the results, they will be a defining moment in the first-line treatment of men with metastatic prostate cancer. Next year, the first results of the UK ProtecT trial are expected, and they, too, will define worldwide practice. These two landmark studies are the latest in a series of trials from the UK that have impacted on this disease worldwide. It was not always thus; in the early 1990s, though there were some good studies, a virtual absence of high quality evidence resulted in Clinical hubris and even nihilism towards research. The spectacular failure of the MRC PR06 study seemed to set the seal on prostate cancer – which by 1997 was regarded by the MRC as being ‘bad news’! However, three randomised trials (PR03, PR04 and PR05 ) did recruit and subsequently reported successfully. The UK Group (then the UKCCCR Prostate Cancer Group) embarked on a collaborative, intergroup study with the NCIC , the final report of which has just been published. This trial and others has revolutionised thinking about non-metastatic disease, firmly establishing that local therapy does indeed impact on survival. However, many challenges remain: metastatic disease is incurable, and if we are to truly impact on this, new approaches will be needed. The NCRI group are currently developing a stratified-medicine approach, in the proposed STRATOSPHERE trial, which will be a formidable challenge, just as the adaptive trial design in STAMPEDE was ground-breaking in its day. I believe that we will also learn about the biology of prostate cancer from clinical trials, just as the pioneering studies with Abiraterone shattered the concept of ‘hormone refractory’ disease, teaching us that even in advanced stages, many prostate cancers remain addicted to signaling from the androgen receptor. To achieve this, we must foster the closest possible collaboration between clinical and non-clinical scientists, something that the UK is uniquely able to do.

This talk is part of the Cambridge Oncology Seminar Series series.

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