Results from multi-centre trial involving the Mount Vernon Cancer Centre and the Lister hospital points towards improved treatment regimen for patients with advanced prostate cancer

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Long-term hormone therapy has been the standard of care for advanced prostate cancer since the 1940s. STAMPEDE is a national multi-centre randomised controlled trial using a multi-arm, multi-stage platform design. It recruits men with high-risk, locally advanced, metastatic or recurrent prostate cancer who are starting first-line long-term hormone therapy.

The chief investigator is Prof Nick James from the Birmingham Hospitals University NHS Foundation Trust and to date over 7,000 men from across the country have been recruited in to the trial involving 107 NHS trusts from across the UK. Here at the East and North Hertfordshire NHS Trust, 135 patients were enrolled at Mount Vernon (108) and the Lister (27). This meant that out of the 107 centres, the Trust was ranked 14th highest overall in terms of entering patients and the best of the five NHS trusts involved in the East of England.

On 21 December 2015, the Lancet published online the survival results from the trial for three research comparisons testing the addition of zoledronic acid, docetaxel or their combination to standard of care versus standard-of-care alone. Although the addition of zoledronic acid showed no evidence of survival improvement for this group of patients, docetaxel chemotherapy, given at the time of long-term hormone therapy initiation, showed evidence of improved survival accompanied by an increase in short-term side effects.

The paper concluded that docetaxel treatment should become part of standard-of-care for adequately fit men commencing long-term hormone therapy.

The STAMPEDE trial is one of many national and international studies covering a wide range of cancer subtypes in which clinical teams from the Mount Vernon Cancer Centre are involved, which enables its patients to enter and participate in this important research locally.

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With regard to STAMPEDE, the lead consultant from the cancer centre is Dr Rob Hughes:

“Although the principal investigator, I worked closely with six of my consultant urology oncologists – Professor Peter Hoskins, Dr Peter Ostler, Dr Roberto Alzoni, Dr Charlotte Westbury and Dr Nicola Anyemone – whom all recruited their patients in to the trial. Also the input of the research nurses and data managers at both the Lister hospital and Mount Vernon was vital as without their assistance, the trial could not have been run at the cancer centre.

“The results published through the Lancet in December were promising, providing all clinicians with a new treatment approach for suitable patients with advanced prostate cancer.

“Delivering such research that leads to changes in clinical practice requires a large highly motivated team, working well together. Not only was this case for our contribution to STAMPEDE, it serves to show the benefit to our patients of taking part in such national and international trials. We hope that its success will encourage other people to take part in other trials when need future patient participation is sought.”

In addition to the research paper published in the Lancet, the team at the MRC Clinical Trials Unit at University College London – who formed part of STAMPEDE – has produced two short videos on the trial’s results – one each for patients and health workers.