FORECAST
Research type
Research Study
Full title
Evolutionary forecasting of prostate cancer recurrence
IRAS ID
230542
Contact name
Andrea Sottoriva
Contact email
Sponsor organisation
Institute of Cancer Research
Clinicaltrials.gov Identifier
2119, CHHiP CCR number (part 1); 2482, CHHiP CCR number (part 2); 04/MRE02/10, CHHiP REC reference number ; 3635, DELINEATE trial CCR number; 06/MREO2/4, UKPCGS REC reference number; 0848 , UKPCGS CCR; 05/Q0108/365, RAPPER REC reference number; 2723, RAPPER CCR; 11/LO/0510, DELINEATE REC reference number
Duration of Study in the UK
6 years, 0 months, 1 days
Research summary
A significant proportion of localised or advanced-localised prostate cancers can be cured with radiotherapy or radical prostatectomy. Nevertheless, a substantial group of patients have recurrence. Predicting relapse is difficult and current clinical standards for risk stratification are inadequate to determine the preferred treatment for individual patients. Therefore, novel prognostic biomarkers are necessary. We propose to identify new types of prognostic biomarkers based on the dynamic features of tumour evolution by combining genomic profiling with mathematical modelling. We propose to forecast prostate cancer recurrence within the IMRT clinical trial (CCR 1766) which recruited 486 prostate cancer patients. We will first perform genomic profiling of a discovery set of 62-100 patients and validate our findings against the rest of the IMRT cohort. We also aim at using the CHHiP (CCR 2119 and 2482) and DELINEATE (CCR No: 3635) clinical trial samples for cross-cohort validation. Our study will take 6 years: on years one/two we will gather the tissue specimens and perform the genomic profiling, on year three/four/five we will develop the mathematical models to measure the dynamic evolutionary features and on year six we will assess their prognostic value and validate our predictions. Ultimately, we aim at providing clinicians with solid mathematical tools, applicable to standard patient biopsies available in the clinic, which can be used to forecast the future course of the disease. For example, patients with poor predicted prognosis may benefit from adjuvant docetaxel applied early with ADT. Patients with good predicted prognosis will avoid the toxicity associated with 3 years of post-radiotherapy ADT. This could lead to up to 10,000 patients a year in the UK receiving less unnecessary treatment and up to 4,000 patients a year benefiting from additional neoadjuvant or adjuvant treatment
REC name
West of Scotland REC 5
REC reference
17/WS/0257
Date of REC Opinion
6 Dec 2017
REC opinion
Favourable Opinion