PSA Dynamics for Prostate Cancer Patients
Research type
Research Study
Full title
Personalisation of the risk-benefit ratio for prostate cancer patients undergoing radical radiotherapy
IRAS ID
316790
Contact name
Alan McWilliam
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
4 years, 0 months, 31 days
Research summary
Prostate cancer is the most common form of cancer in men in the UK, and treatment is currently given based on risk-models that consider various tumour characteristics. These models have limited consideration for potential microscopic spread, which cannot be seen with conventional imaging. Additionally, individual biology, response to different treatment modalities, or response to radiotherapy dose over time is not considered. Consequently, patients can be over- or under-treated, and a third of patients see their cancer return, indicated by a rise in hormone prostate specific antigen (PSA), within five years.
Our project aims to study patterns of PSA to detect cancer returning sooner than current practice. We will retrospectively analyse large cohorts of data from men with prostate cancer to improve the way that patients are selected for treatment, specifically radiotherapy, by developing better risk-models to predict whether a patient's cancer will return. PSA trajectories of prostate cancer patients will be modelled and similar trajectories grouped together and tested against outcome. Differences in trajectory between treatments (e.g., radiotherapy, surgery, systemic therapy, active surveillance), forms of recurrence, and times to recurrence will be studied.
For patients given radiotherapy, trajectories will be linked to the radiotherapy dose distribution to see if there are any associations between dose, PSA trajectory and outcome. This will allow us to study patterns of treatment response and failure over time and develop spatially resolved anatomical risk maps. These will describe a risk function depending on an anatomical location and allow us to better understand tumour behaviour and improve personalisation of radiotherapy.
The study will include data from patients who have multiple PSA measurements (>3) and a minimum of four years follow-up following a diagnosis of prostate cancer 2005-2019. This study involves the analysis of pseudonymised existing data only and will not require the involvement of individual participants.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
24/YH/0166
Date of REC Opinion
27 Aug 2024
REC opinion
Favourable Opinion