The plan of work and lead researchers for the £42million TRANSFORM trial to find the best way to screen men for prostate cancer and prevent prostate cancer deaths have been announced by Prostate Cancer UK. TRANSFORM will be the biggest prostate cancer screening trial for 20 years, bringing together six of the world’s leading prostate cancer researchers and their teams, with the Queen Mary team led by Professor Rhian Gabe. Recruitment of hundreds of thousands of men from across the UK will begin next year, with first results expected in as little as three years.
Previous trials using PSA and biopsy to screen for prostate cancer showed that it is possible to prevent 8-20% of prostate cancer deaths, depending on screening intervals. TRANSFORM will test new screening approaches with the potential to greatly improve early detection and treatment pathways. With over 12,000 prostate cancer deaths in the UK, this could mean thousands of men saved each year, and many thousands more worldwide.
Prostate Cancer UK worked in consultation with the National Screening Committee and National Institute for Health and Care Research (NIHR) to ensure that the trial will provide the necessary evidence to revolutionise prostate cancer diagnosis. It will compare multiple methods of screening against current testing methods, to find the safest, most accurate and most cost-effective way to screen men for prostate cancer. The size of the trial will enable the team to create a bio bank of prostate cancer samples, images and data at a scale never before seen, to be available to cancer researchers. The flexible trial design will enable researchers to incorporate promising new testing methods at any stage of the process.
In the first stage of the trial involving ~12,500 men over three years, researchers will compare potential screening options including PSA blood tests, faster versions of MRI scans (Prostagram) and genetic testing, to identify those at higher risk. These approaches will be compared with the current NHS diagnostic process to select the best performing methods to take forward into the second, larger stage of the trial. In stage two the researchers will then test the most promising option or options in up to 300,000 men to provide the definitive evidence for the best way to screen men for prostate cancer. The team will follow hundreds of thousands of men over at least 10 years to track the impact of these screening approaches on the number of lives saved and overall quality of life, and to assess how many men might experience harms associated with potentially unnecessary biopsies and treatment.
Professor of Biostatistics and Clinical Trials at Queen Mary University of London, Rhian Gabe said: ‘The UK has led the way in developing cancer screening programmes through rigorous, robust research. However, despite it being the second most common cause of cancer death in UK men, there still isn’t a screening programme for prostate cancer. TRANSFORM is an exciting opportunity to evaluate promising and innovative screening strategies for the early detection of prostate cancer on a national scale, with the ultimate aim of preventing deaths from prostate cancer. I’m so pleased to be working with Prostate Cancer UK and a brilliant team of fellow researchers to deliver it.’
The six lead researchers for the trial, who represent four of the UK’s biggest research centres and will work alongside 16 co-applicants, are: Professor Rhian Gabe (Queen Mary University of London), Professors Hashim Ahmed and Rakesh Heer (Imperial College London), Professor Rosalind Eeles (Institute of Cancer Research), and Professors Mark Emberton and Caroline Moore (University College London). The trial has been backed by the National Institute for Health and Care Research (NIHR) and Movember, who have together committed £17.5million towards the trial.