INNOVATE
Research type
Research Study
Full title
CombIning advaNces in imagiNg with biOmarkers for improVed diagnosis of Aggressive prosTate cancEr
IRAS ID
180426
Contact name
Shonit Punwani
Contact email
Sponsor organisation
Joint Research Office
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
We plan on using imaging, blood and urinary biomarkers to improve the diagnosis of aggressive prostate cancer. We will address two interlinked problems.
1) With other cancers (e.g. breast), doctors determine where tumour is located with imaging, which guides biopsy and treatment. UCL has led the way in establishing a similar pathway for prostate cancer using mp-MRI before biopsy to guide accurate sampling, but due to economic constraints the NHS is unable to fully adopt this strategy. We are currently unsure which patients will benefit most from having an MRI and current methods of patient selection e.g. raised blood test (PSA) are unreliable. Despite the fact that novel, inexpensive blood and urine tests are available which may provide a better performance than PSA, they are not routinely used, as they have not been fully tested in large clinical studies.
2) Although MRI represents a huge leap forward in our ability to visualise prostate cancer, around 40% of men who have the test demonstrate indeterminate findings, which means we are unsure whether aggressive cancer present or not. This can then lead to further repeat MRI studies and unnecessary biopsies, which are associated with risks, patient discomfort and additional costs. We therefore propose to improve MRI performance by adding a new MRI technique called VERDICT to the scan protocol. Based on our previous work, we expect that this will allow us to image the prostate in much greater detail and reduce the number of equivocal imaging results.
We will therefore test (i) whether a strategy of selecting patients for mp-MRI using blood and fluidic markers works; and (ii) whether we can improve the diagnostic accuracy of mp-MRI. We expect the combined effect will improve care and make mp-MRI before biopsy economically viable for universal NHS adoption.
Lay Summary of Results (see uploaded final report)
REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/2099
Date of REC Opinion
23 Dec 2015
REC opinion
Favourable Opinion