PSMA PET/CT trial will scan up to 1000 men in the UK
A new kind of scan that could be key to improving the treatment of high-risk prostate cancer is about to be tested in a new £1.89 million clinical trial led by Professor Hash Ahmed and funded by Prostate Cancer UK.
Accurately detecting if and where high-risk cancers have spread is crucial for deciding which treatment options are best for each man. But current scans often miss cancers that have spread, and inconclusive scans may lead to over-treatment.
A PSMA PET-CT scan uses a radioactive tracer to detect prostate cancer. It combines a positron emission tomography (PET) scan with a computed tomography (CT) scan. Research has already shown that this technique can see more, and smaller, cancer that has spread than the current imaging techniques – which involve a combination of a CT scan and a bone scan.
But it is unclear if PSMA PET/CT definitively sees all of the cancer spread and can enable more accurate treatment decisions by identifying men with aggressive, or high-risk prostate cancer. The AVIDITY trial will test this once and for all, following men for longer than previous trials.
Led by Professor Hashim Ahmed from Imperial College London, the trial will recruit men from over 30 centres around the UK. The trial is also being co-led by Mr Martin Connor and Professor Tara Barwick from Imperial College London, as well as Professor Rhian Gabe and Dr Adam Brentnall from Queen Mary University of London.
They will randomly divide the men with high-risk prostate cancer into two groups. One will receive treatment based on what the current standard imaging tests (CT scan and bone scan) show. The other group will receive the treatment based on the findings of the new PSMA PET/CT scan. Up to 1000 men will be recruited for the trial. Both groups will have their cancer treatment decisions made based on the imaging results they receive.
The researchers will follow these men over time, checking in at 24 and 48 months after the first scan to see if there is any cancer spread and if any men have developed metastatic cancer. If the new scan proves more effective, it could become the standard method for staging high-risk prostate cancer and guiding more accurate treatment for men.
Professor Hashim Ahmed of Imperial's Department of Surgery and Cancer, who is leading the trial, said: "We know that the way we currently look for prostate cancer spread in men, using a CT and a bone scan, can miss things. A PSMA PET/CT scan means we can look at everything at once and detect smaller lesions, reducing the risk that we miss some cancer spread.
"Whilst the new PSMA PET/CT scan does show up more areas, we do not yet know whether changing treatment based on the new scan actually makes a difference to survival. AVIDITY will give us the answer."
"Receiving funding from Prostate Cancer UK is allowing us to undertake this crucial work, which could see a change to standard methods of imaging and result in men receiving more personalised treatment plans. We hope that the trial will show us the best way to image high-risk cancers, and if current methods need to change."
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said: "Knowing that your prostate cancer is likely to spread can be deeply unsettling. Men in this situation need certainty that they are going to get the best treatments at the right time based on their actual cancer, as preventing spread is likely to remove the possibility that prostate cancer will become terminal.
"By combining the best of the CT and bone scans that we use now and following the men on this trial over time, we'll be able to tell which scanning method is best for controlling cancer spread. This could vastly improve treatments for men with high-risk prostate cancers.
Prostate cancer is a complex, but common cancer. Over 12,000 men die from prostate cancer every year in the UK. One way we can reduce that number is to fund the research that delivers more accurate diagnosis and more precise treatment.
Prostate Cancer UK is supporting the research with £1.89mn from its Transformational Impact Awards. Dr Hobbs added: "Our Transformational Impact Awards were designed to fund groundbreaking, globally impactful research like this. We are hugely excited to support this trial and to deliver the results that may allow men to navigate prostate cancer successfully giving them longer, fuller lives."
