Queen’s University Belfast researchers, in partnership with the Belfast Trust, are leading a clinical trial evaluating a new combination of two radiotherapy treatments in men with advanced prostate cancer (PC), where the cancer has spread to the bones.
The ADRRAD trial, for Androgen Deprivation Therapy, Pelvic Radiotherapy and Radium-223 for presentation T1-4 N/1 M1B adenocarcinoma of prostate, has already started at the Northern Ireland Cancer Center, Belfast, and is funded by Friends of the Cancer Centre and Bayer Pharmaceuticals.
The trial will treat PC patients with bone involvement (an estimated 10 percent of such cancers) over 18 months with two current forms of radiotherapy, Volumetric Modulated Arc Therapy (VMAT) to target PC cells in the pelvis, and Radium 223 to target the disease in the bones.
VMAT is an externally delivered type of radiation therapy that manipulates beams to adapt to the shape of the tumor, delivering a more precise dose of radiation and limiting damage to surrounding tissue. Radium 223 is a recent ‘bone-seeking’ drug, a type of internal radiotherapy that is administered intravenously. Once inside the bones, the drug releases radiation that travels minimally – about 2 to 10 cells deep, or less than a millimeter – to deliver a high dose of cancer cell-killing radiation close to tumor deposits on bone.
Advanced PC patients are commonly treated with hormone therapy that intends to diminish a tumor by limiting how much testosterone reaches cancer cells. If the new approach is successful, it has the potential to change how advanced prostate cancer is treated.
“This trial represents a really exciting shift in how we think about prostate cancer — away from aiming to prolong life for men with advanced prostate cancer, towards taking the first steps to stopping the disease in its tracks once and for all. The scale of what we can achieve when we work together as funders, clinicians, scientists and men must not be underestimated. We are on the brink of remarkable breakthroughs in prostate cancer research, and this trial could be one of them,” Dr. Iain Frame, director of Research at Prostate Cancer U.K., said in a press release. “That’s why we mustn’t falter now. If we continue investing in world class research like this, within ten years, the world of prostate cancer research and treatment will be a far more hopeful place for men with and at high risk of the disease.”
Currently, an estimated 8,500 men in Ireland have been diagnosed with prostate cancer, and about 250 die of the disease each year.
“This is the first trial of its kind anywhere in the world. It is hoped that combining the two forms of radiotherapy will be more effective than existing hormone treatment in targeting prostate cancer cells at multiple sites and extend the life expectancy of men whose treatment options are otherwise limited. We expect results from the initial trial within two years, with the view to then embarking on a larger trial with a greater number of patients,” said Professor Joe O’Sullivan of Queen’s University, who is leading the trial. “This trial is a crucial development in the fight against prostate cancer, which is the most common type of cancer among men in Northern Ireland. Three men here are diagnosed with this disease every day. Thousands are living with the illness, which unfortunately claims one life every hour across the UK. Queen’s, Belfast Trust and Northern Ireland are at the forefront of global efforts to develop more effective treatments for all types of cancer. The ADRRAD trial is an excellent example of the potentially life-changing and life-saving impact of this work.”