Current Trials in Prostate Cancer

1
Current Trials in Prostate Cancer

• Malcolm Mason

2
Prostate Cancer Research comes of age?

• Aetiology/prevention studies
• Diagnosis/screening/early disease studies
• Treatment of relapsed disease
• Treatment of advanced disease/new systemic agents

3
Prostate Cancer Research comes of age?

• Aetiology/prevention studies
• Familial studies (RMH)
• Diagnosis/screening/early disease studies
• ProtecT
• CHHIP
• Treatment of relapsed disease
• RADICALS
• Treatment of advanced disease/new systemic agents
• Patch
• Stampede
• Phase IIs

4
Prostate Cancer Research comes of age?

• Aetiology/prevention studies
• Familial studies (RMH) (US !!)
• Diagnosis/screening/early disease studies
• ProtecT US !!
• CHHIP (US !!)
• Treatment of relapsed disease
• RADICALS US !!
• Treatment of advanced disease/new systemic agents
• Patch (US !!)
• Stampede US !!
• Phase IIs US !!

5
The Current UK Trials Portfolio
6
(No Transcript)
7
(No Transcript)
8
PATCH Hypothesis

• Oestrogen administered in a way that avoids
  first pass hepatic metabolism could be an
  effective therapy for prostate cancer without the
  high incidence of CVS toxicity

9
Trial Design
Diagnosis Locally advanced, metastatic or
relapsing prostate cancer about to start androgen
deprivation therapy
Randomise 21
Transcutaneous Oestrogen Patches
LHRH analogues
Transcutaneous Oestrogen Patches
10
The ProtecT study(Prostate testing for cancer
and Treatment)
233,000 Invitations Men 50-69 years
116,500 (50) attendees Prostate check clinic
12,815 (11) Raised PSA
2,050 (16) Localised
Advanced cancer
Randomisation min 60
Active Monitoring 410-683
Radical Prostatectomy 410-683
Radical Radiotherapy 410-683
Preference 0-830
Annual research follow-up
11
Acceptance of allocation by arm
12
STAMPEDE
Systemic Therapy in Advancing or Metastatic
Prostate cancer Evaluation of Drug Efficacy
Now open to recruitment
13
Trial Design
14
In Development RADICALS
15
Other highlights

• Forthcoming CHHIP 3rd stage
• Awaited Results of MRC PR07/ NCIC PR3

16
Novel agents

• New chemotherapeutic agents
• Epothilones
• New biologicals
• Growth factor/STIs
• Antagonists of anti-apoptotic agents
• HDAC inhibitors

17
Novel agents the next STAMPEDE?

• Docetaxel/Prednisolone plus
• Oblimersen
• Bevacizumab
• Clusterin antisense
• Atrasentan
• Vitamin D
• All being tested separately!

18
Novel agents the next STAMPEDE?

• Docetaxel/Prednisolone plus
• Oblimersen EORTC
• Bevacizumab CALGB
• Clusterin antisense NCIC
• Atrasentan SWOG
• Vitamin D Various
• All being tested separately!

19
Prostate Cancer in Wales punching above our
weight!!

• Human tissue for research
• Wales Cancer Bank
• Active Monitoring studies
• Non-drug interventions
• Neo-adjuvant studies
• With tissue available after RP

20
The Cardiff MDT
21
(No Transcript)