National rates of prostate cancer are rising. It’s predicted that 372,000 Australian men will be living with the disease by 2040.
Many of these diagnoses will be classified as having a favourable intermediate risk (FIR), meaning they are unlikely to experience metastasis or death from their disease, even without treatment.
Despite this, more than 80% of prostate cancer patients in Australia with lower risk of disease progression are still subjected to radical treatment with either surgery or radiation. These methods are expensive and have significant concomitant risks of long-term morbidity.
Professor Niall Corcoran and Professor Christopher Hovens from the University of Melbourne are developing the world’s first prospective, randomised clinical trial using genomic testing and predictive disease modelling to reduce the burden of prostate cancer, which evidence suggests is over-diagnosed and over-treated in early disease.
The study will determine whether genomic testing can be used to identify men at lower risk of disease progression, and track and manage their prostate cancer without the need to resort to heavy treatment.
Patients will be monitored to determine if they experience similar rates of metastasis to those undertaking the current treatment model, while also tracking their anxiety levels and quality of life.
The hope is that by using genomic testing at the time of diagnosis to identify men with a lower risk of disease progression, we can reduce the number of men receiving extensive treatment without compromising their long-term health outcomes.
The trial will be sponsored and managed by the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), a cooperative cancer clinical trials group dedicated to investigator-initiated research in genitourinary cancers.
This study builds on previous research conducted by Professor Corcoran and Professor Hovens, including a pilot study made possible with a Victorian Medical Research Accelerator grant, matching philanthropic funding from RULE Prostate Cancer and Western Health Foundation, and support from the Australian Prostate Centre.
It utilises the TAGC Genomics Platform to perform targeted sequencing on a bespoke germline capture panel analysed by the Bioinformatics Platform.
The Health Economics Platform is also engaged in evaluating the cost-effectiveness of utilising genomic tests to determine risk level and aid in the active surveillance of prostate cancer patients.
