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SUMMARY:Defining treatment paradigms in prostate cancer\; the UK as a domi
 nant force - past\, present\, and future - Professor Malcolm Mason\, NCRI 
 Prostate Cancer Clinical Studies Group and School of Medicine\, Cardiff Un
 iversity
DTSTART:20150414T110000Z
DTEND:20150414T120000Z
UID:TALK57082@talks.cam.ac.uk
CONTACT:Mala Jayasundera
DESCRIPTION:Later this year\, the first results of the UK STAMPEDE trial\,
  the largest clinical trial in prostate cancer in history\, will be presen
 ted. Whatever the results\, they will be a defining moment in the first-li
 ne treatment of men with metastatic prostate cancer. Next year\, the first
  results of the UK ProtecT trial are expected\, and they\, too\, will defi
 ne worldwide practice. These two landmark studies are the latest in a seri
 es of trials from the UK that have impacted on this disease worldwide. It 
 was not always thus\; in the early 1990s\, though there were some good stu
 dies\, a virtual absence of high quality evidence resulted in Clinical hub
 ris and even nihilism towards research. The spectacular failure of the MRC
  PR06 study seemed to set the seal on prostate cancer – which by 1997 wa
 s regarded by the MRC as being ‘bad news’! However\, three randomised 
 trials (PR03\, PR04 and PR05) did recruit and subsequently reported succes
 sfully. The UK Group (then the UKCCCR Prostate Cancer Group) embarked on a
  collaborative\, intergroup study with the NCIC\, the final report of whic
 h has just been published. This trial and others has revolutionised thinki
 ng about non-metastatic disease\, firmly establishing that local therapy d
 oes indeed impact on survival. However\, many challenges remain: metastati
 c disease is incurable\, and if we are to truly impact on this\, new appro
 aches will be needed. The NCRI group are currently developing a stratified
 -medicine approach\, in the proposed STRATOSPHERE trial\, which will be a 
 formidable challenge\, just as the adaptive trial design in STAMPEDE was g
 round-breaking in its day. I believe that we will also learn about the bio
 logy of prostate cancer from clinical trials\, just as the pioneering stud
 ies with Abiraterone shattered the concept of ‘hormone refractory’ dis
 ease\, teaching us that even in advanced stages\, many prostate cancers re
 main addicted to signaling from the androgen receptor. To achieve this\, w
 e must foster the closest possible collaboration between clinical and non-
 clinical scientists\, something that the UK is uniquely able to do.
LOCATION:CRUK CI Lecture Theatre
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