Research
strategy

2015––2025

10 years
to tame

We have a bold ambition: to tame prostate cancer within a decade.

This is underpinned by our ambitious research strategy, which sets out how we will invest in the most innovative ideas to accelerate the development of new tests and treatments to benefit all men with, or at risk of, aggressive disease.

Prostate cancer is not a single disease, but is made up of many different types of cancers, each with its own specific molecular make up. As cancers grow and spread, they evolve, so detection and treatment of metastatic tumours is even more difficult than we originally thought.

This means that we need to be smarter in how we detect and treat prostate cancer at every stage. We need to develop personalised approaches for every man, and his
particular cancer.

Ultimately, we want no man to die from prostate cancer.

We want more men with aggressive prostate cancer to be diagnosed early, before it spreads outside the prostate, so that fewer slip through the net with advanced disease. We will also work towards better treatments for localised disease, and more effective, well-tolerated treatments for advanced prostate cancer.

We know that we won’t be able to do this alone, so we aim to influence (and work in partnership with) other organisations with similar goals.

Meanwhile, we will focus our resources on three key areas where we can have the biggest impact:
● better diagnosis
● better treatments
● better prevention
Tackling these three areas will make the most difference to men with, or at risk of, prostate cancer.

Importantly for a Research strategy of this scale, we can be confident that these outcomes are eminently achievable through our robust and multi-pronged research programme.

We’re excited about this challenging and ambitious journey...

And we look forward to you joining us along the way.

Better
diagnosis

Men tell us they want to know whether a cancer needs treatment or not when they are diagnosed.

We want to increase the proportion of men whose clinically significant prostate cancer is detected before it spreads outside the prostate.

And we want to reduce the number of men who undergo unnecessary biopsies, and are diagnosed with, and treated for, harmless prostate cancers.

It has so far been impossible to implement a national screening programme, or to make a reliable call for every man about whether his cancer needs treatment or not.

The reason? We don’t have a dependable, widely applicable and easy way to assess an individual man’s risk of significant prostate cancer.

We will fund research that aims to turn our knowledge of biological and genetic markers into tools to improve the diagnosis of clinically significant disease. We will also fund research to develop tests to determine whether a prostate cancer needs immediate treatment.

We will support research to develop and test a tool to predict a man’s risk of significant prostate cancer.

We will also continue to support research that would enhance such a tool. This is likely to be through discovery, validation and translation of other markers associated with the presence of clinically significant prostate cancer, and/or with an increased risk of developing it.

Ideally, we will get to a position where we only diagnose prostate cancers that need to be treated and neither diagnose, nor treat, clinically insignificant cancers.

The foundations to help us distinguish clinically significant from insignificant cancers early in the diagnostic pathway already exist. So in this area, our early focus will be on translational research.

This is where we will build strong collaborative links with other organisations and key stakeholders to help us achieve success.

● Designed, tested and evaluated a risk-based assessment tool that can be used within the NHS to improve early detection of clinically significant prostate cancer and reduces the number of men who undergo unnecessary biopsies.

● Funded research into the discovery and validation of new biomarkers and molecular changes that could feed into, or complement, this risk tool.

● Developed imaging as an effective, consistent and accessible tool for prostate cancer diagnosis.

● Helped discover which markers (biological, genetic, epigenetic and imaging) show most promise for use in diagnosis and prognosis of clinically significant prostate cancer and funded research to build on these discoveries.

● Established partnerships to ensure that research results are translated to health benefits for men as quickly as possible.

Better
treatments

We've entered a new era of prostate cancer treatment, but there's still lots to do.

Within 10 years, we’re likely to make the biggest difference to men by making the most of the treatments we already have.

This includes optimising drug dosage and delivery, identifying the most effective treatment combinations, and clarifying the benefits or otherwise of sequential drug or treatment use.

We still don’t know whether some treatments could be even more beneficial if applied earlier in the treatment pathway. We need to discover whether giving treatments for advanced disease to men with high-risk localised disease could increase cure rates.

Alongside this, we’ll continue to fund high-quality early stage research focussed on the discovery and development of new therapies.

We will also exploit ongoing work in other cancer types or disease areas, which will help us to introduce effective treatments more quickly and more cheaply than would be possible by developing new treatments completely from scratch.

We will also explore the possibility of shortening the timeline for clinical trials of both new and existing treatments, for example by investigating whether intermediate measures can replace overall survival as a clinical endpoint.

There are now a number of treatments available, and more in the pipeline. But we don’t know enough about which treatments work best for each man.

We need to support research that will help stratify men according to the treatments that will work best for them.

We believe that this personalised medicine approach will be achieved by using knowledge of the molecular variations within and between prostate tumours to predict how individuals will respond to different treatments.

We will make it a priority to translate this evidence into clinical benefit as early as possible.

● Effective targeted treatments, with minimal side effects, that are available to every man regardless of age, ethnicity or where he lives.

● Established the optimal use of existing treatments.

● Funded high quality, innovative early-stage research that will eventually lead to new first-in-field treatments for prostate cancer. We will also have ensured the timely transfer of research to other funders to develop, if appropriate.

● Supported the development of new drugs, and the repurposing of existing drugs for use in prostate cancer.

● Developed new tests to predict treatment response based on an individual’s molecular make-up and that of his prostate cancer.

● Developed imaging as an effective and consistent tool to monitor responses to treatment.

● Ensured that intermediate endpoints are validated, accepted by regulators, and used in clinical trials to help speed up the development and appraisal of new treatments.

Better
prevention

Successful prevention needs a deep understanding of how prostate cancer starts and develops.

We will fund research into the basic biology of the disease, if it’s clear that it will add significantly to our understanding and inform future work on prevention.

We will also support research into prevention of prostate cancer recurrence after initial treatment.

A number of clinical trials into prostate cancer prevention are ongoing, and we don’t intend to duplicate these efforts by commissioning our own large-scale clinical trials. We need more information about prostate cancer prevention before we can act.

Therefore, we will keep a watching brief for scientific developments, particularly around preventative immunotherapies, dietary and lifestyle interventions, and chemoprevention strategies.

Further research into prostate cancer prevention is a longer-term priority for us. We will target this research towards men at highest risk of significant prostate cancer.

As conclusive evidence emerges, we’ll work in partnership with other funders, governments and industry to help men adopt appropriate diet and lifestyle changes that could minimise their risk of prostate cancer.

● Funded research to investigate whether there are any events that trigger prostate cancer growth and whether those early events may be preventable.

● Collated any strong evidence about modifiable risk factors, like diet, exercise or environmental exposure, that might reduce prevalence at a population level.

● Supported research into prevention of prostate cancer recurrence after successful initial treatment.

● Implemented the results of research into prevention of prostate cancer recurrence, to improve cure rates from radical treatments.

● Gained a far greater understanding of the genetic changes (inherited or acquired) that drive prostate cancer to become aggressive, and how we could potentially target these changes to prevent deaths from prostate cancer.