Research - clinical trials for prostate cancer

Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are carried out on patients are known as clinical trials.

Clinical trials may be carried out to:

• test new treatments, such as new chemotherapy drugs, gene therapy or cancer vaccines
• look at new combinations of existing treatments, or change the way they are given, to make them more effective or to reduce side effects
• compare the effectiveness of drugs used to control symptoms
• find out how cancer treatments work
• see which treatments are the most cost-effective.

Trials are the only reliable way to find out if a different type of operation, chemotherapy, radiotherapy, or other treatment is better than what is already available.

Taking part in a trial

You may be asked to take part in a treatment research trial. Trials help to improve knowledge about cancer and develop new treatments. You will be carefully monitored during and after the study.

Usually, several hospitals around the country take part in these trials. It's important to bear in mind that some treatments that look promising at first are often later found to be not as good as existing treatments, or to have side effects that outweigh the benefits.

If you decide not to take part in a trial your decision will be respected and you do not have to give a reason. There will be no change in the way you're treated by the hospital staff and you will be offered the standard treatment for your situation.

Blood and tumour samples

Many blood samples and tumour biopsies may be taken to help make the right diagnosis. You may be asked for permission to use some of your samples for research

into cancer. If you're taking part in a trial you may also be asked to give other samples which may be frozen and stored for future use, when new research techniques become available.

These samples will have your name removed so you can't be identified.

The research may be carried out at the hospital where you are treated, or it may be at another hospital. The samples will be used to increase knowledge about the causes of cancer and its treatment, which could improve the outlook for future patients. This type of research takes a long time, and results may not be available for many years.

Our information about current research explains the trials looking at treatment for prostate cancer.

Current research into treatments for prostate cancer

There are several trials looking at the treatment of prostate cancer.

Early prostate cancer

Photodynamic therapy (PDT)

PDT is being tried in a few hospitals as a treatment for cancer that has come back in the prostate after initial treatment. A light-sensitive drug is given by injection into a vein.

There is a delay between the drug being given and the next stage of treatment. This allows time for the drug to concentrate in the cancer cells. In the second stage of treatment, a laser light is shone directly on to the cancer. The light activates the drug and the cancer cells are killed. After the treatment, patients are sensitive to light for up to three weeks and need to stay in dim light. It is not yet known how effective PDT is for prostate cancer.

Combination treatments

If you have prostate cancer that has spread to the bones, and is no longer responding to hormonal therapy, you may be able to take part in a trial looking at the benefits of combining the chemotherapy drug docetaxel (Taxotere®) with a new drug called ZD4054.

This new drug is a type of biological therapy. It works by blocking growth receptors on cancer cells called endothelin receptors, and is given as a tablet. Half of the men in the trial will be given docetaxel and ZD4054 and the other half will be given docetaxel with a dummy drug (a placebo).

If prostate cancer spreads to the bones, you may receive treatment with a bisphosphonate, such as zoledronic acid (Zometa®), the chemotherapy drug docetaxel (Taxotere®) and a type of radiotherapy called strontium 89. The treatments are usually given on their own. A trial is looking at different combinations of these treatments to see which combination works best.

Bisphosphonates

A trial is under way to see whether the bisphosphonate ibandronate could be used instead of radiotherapy to control pain from bone secondaries. Other trials are researching whether bisphosphonates can help to prevent or delay the spread of prostate cancer to the bones. Bisphosnates that may be used include clodronate (Bonefos® or Loron®), ibandronate and zoledronic acid (Zometa®).

Abiraterone

A new type of hormonal therapy called abiraterone acetate is being researched as a possible treatment for men with advanced prostate cancer where hormonal therapy is no longer working. It is currently only available to men in the UK who take part in a clinical trial.

The male hormone testosterone stimulates prostate cancer cells to grow and hormonal therapies can help to slow down the growth. Most hormonal therapies either stop the production of testosterone in the testicles or block it from connecting with the cancer cells. Abiraterone works in a different way. To produce testosterone the body needs an enzyme called cytochrome P17.

Abiraterone works by blocking the enzyme so that testosterone can't be produced.

Results from small research trials have shown that abiraterone can reduce the PSA level for a while in some men with advanced prostate cancer. Results from other research trials are expected soon. There is a large trial looking at using abiraterone in combination with a steroid called prednisolone. This stopped recruiting new participants in April 2009, and it will be a few years before the results are known.