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Image: Professor Ros Eeles, who is one of the six co-leads of the TRANSFORM trial. Credit: The Institute of Cancer Research, London.
Prostate Cancer UK has today announced details of a £42 million screening trial, which aims to find the best way to screen men for prostate cancer and double the number of lives saved.
The TRANSFORM screening trial is co-led by six of the world’s leading prostate cancer researchers – including Professor Ros Eeles from The Institute of Cancer Research, London.
Previous trials using PSA and biopsy to screen for prostate cancer have shown that it is possible to prevent 8 per cent and 20 per cent of prostate cancer deaths depending on how regularly men are screened. TRANSFORM will test new approaches which have the potential to more than double this impact and reduce prostate cancer deaths by 40 per cent. With more than 12,000 prostate cancer deaths in the UK alone this could mean thousands of men saved each year in the UK, and many thousands more worldwide.
The biggest prostate cancer screening trial for 20 years
The trial could see its first results in as little as three years and is predominantly funded by Prostate Cancer UK, as well as the National Institute for Health and Care Research (NIHR) and Movember, who have together committed £17.5million towards the trial. From next year, the trial will begin to recruit hundreds of thousands of men from across the UK.
TRANSFORM will bring together six of the world’s leading prostate cancer researchers, alongside 16 co-applicants from across the country, to take on the biggest prostate cancer screening trial for 20 years. Professor Ros Eeles will lead a team at the ICR to discover how targeted genetic screening could help to save lives, building on decades of research into the genetic markers of prostate cancer.
The other five lead researchers are Professor Hashim Ahmed, Imperial College London, Professor Mark Emberton, University College London, Professor Rhian Gabe, Queen Mary University of London, Professor Rakesh Heer, Imperial College London, and Professor Caroline Moore, University College London.
Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, and Consultant in Clinical Oncology and Cancer Genetics at The Royal Marsden NHS Foundation Trust, said:
“We have already identified more than 400 genetic variants that are inherited and associated with a risk of prostate cancer in diverse populations.
“TRANSFORM is a game changer because it will allow us to rigorously test genetic markers on a large scale in men from diverse ancestries. This could give us the information we need to use genetic risk scores to identify men at risk of aggressive cancer who will need regular tests, while sparing men at low-risk from having unnecessary biopsies and treatments.”
‘This trial could change practice globally’
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, which commissioned the screening trial, said:
“Prostate cancer is the most common cancer without a screening programme and it’s about time we changed that.
“We know that earlier diagnosis saves lives, but previous trials haven’t been able to prove that enough men would be saved using PSA tests alone, while they did show that these old screening methods caused significant unnecessary harm to men. We must now prove that there are better ways to find aggressive prostate cancer that will save even more lives while causing less harm.
“That’s why I’m so delighted and proud to announce TRANSFORM. This is the research that will get us there. It’s the biggest research investment we’ve ever made - but by putting this money in now, we expect to double the number of men that could be saved by screening, while at the same time reducing any harm caused.
“This could save thousands of men’s lives every year in the UK alone. But it won’t just be the UK – this trial could change practice globally - so we’re into tens of thousands of men saved each year. This is a pivotal moment in the history of prostate cancer research and we’re proud to be leading the way, and to be supporting some of the best researchers in the world to make it happen.”
Prostate Cancer UK worked in consultation with the National Screening Committee and National Institute for Health and Care Research (NIHR) to make sure the trial will provide the evidence needed to revolutionise prostate cancer diagnosis. It will compare multiple methods of screening, and compare these against how men are tested now, to find the safest, most accurate and most cost-effective way to screen men for prostate cancer.
The massive scale of the trial will also enable the team to create a bio bank of samples, images and data at a scale never seen before in prostate cancer. This will be available to all kinds of cancer researchers and is predicted to spur a wave of new discoveries and provide a platform to prove the accuracy of the next generation of diagnostics.
Crucially, the trial has been designed flexibly and will be able to incorporate promising new testing methods at any stage of the process.
Tackling increased prostate cancer risk in Black men
Samuel Nelson, 64, from Essex, was diagnosed with prostate cancer in 2017. As a Black man he was at higher risk of the disease and has a strong history of prostate cancer in his family and has three sons, who will be at greater risk in the future. He said:
“I have three sons who will be at higher risk. It would be wonderful to know there was a process to check them regularly.”
“For me, getting a screening programme is so important. Black men are twice as likely to get prostate cancer. My dad died of prostate cancer, my uncle had it too and because it’s in the family, me, my four brothers and my three sons all have an even higher risk.
“When I learned this, I started being regularly tested and that’s how I was diagnosed. But I wouldn’t have known – I had no symptoms. And so many men don’t know about prostate cancer, so catching it in time for them to be cured is often down to luck. It would be wonderful to know there was a process to check my sons regularly and that they’d be reminded with an email or a message. I don’t want it to be down to luck for them.”
One in four Black men will develop prostate cancer – double the risk of other men. To make sure the trial provides definitive evidence that will reduce their risk of dying from the disease, at least one in 10 of the men who are invited to participate in the trial are Black men. This is vital as previous trials have not included enough Black men to adequately demonstrate the harms and benefits of screening for these men – despite their significantly higher risk.
The team will make the trial as accessible as possible, recruiting through GPs across the whole UK, and across the wide age group that can be expected to be screened for prostate cancer. Men will be invited from next year, although it will not be possible to volunteer.