The first men have been invited to take part in the Prostate Cancer UK’s TRANSFORM trial, kicking off the biggest prostate cancer screening study in a generation. The £42m trial is being co-led by UCL, Imperial, Queen Mary University of London, and the Institute of Cancer Research.
The BRC-supported trial will be delivered in partnership with the NHS through the NIHR, which has committed £16m, with the remaining £26m funded by Prostate Cancer UK through its supporters and other founding partners.
Among the six research leads are Professors Mark Emberton and Caroline Moore from the UCL Division of Surgery & Interventional Science. TRANSFORM builds on 20 years of UCL research in prostate cancer diagnosis and screening.
Professor Emberton, a Professor of Interventional Oncology at UCL and Consultant Oncologist at UCLH, said: “We learned from our previous attempts at prostate cancer early detection that the tools we had available to us were very blunt. Though they were the only tools we had at the time and better than nothing.
“Now we have a different set of tools, including the ability to ‘see’ the cancer by virtue of MRI scans. This puts us in a position to determine what combination of tests work best to identify which men are at risk of cancers and which, if left alone, would impact on their quantity and quality of life.”
Professor Caroline Moore, Head of Urology at UCL and an Honorary Consultant Urological Surgeon at UCLH, said: “We know that PSA screening reduces prostate cancer deaths, but we believe that new tools, such as MRI and polygenic risk scores, could reduce deaths much more quickly, and with much less harm than traditional PSA based screening. I am delighted that we are launching TRANSFORM to find the best way to find the cancers that kill, and to invite those at most risk to take up the offer of screening.”
Polygenic scoring combs through a person's DNA and calculates how likely they may be to develop a disease. It can be useful to detect an individual's predisposition to conditions like common cancers.
Today the first men will begin receiving letters from their GPs, inviting them to join the landmark trial designed to make diagnosis earlier, safer and more effective. It aims to revolutionise diagnosis by testing the most promising screening techniques available, including PSA blood tests, genetic spit tests and fast MRI scans, combined in ways that have never before been tested in a large-scale screening trial.
The opening of TRANSFORM comes as the UK National Screening Committee (NSC) is soon to announce its decision on whether current evidence supports the introduction of screening for prostate cancer in the UK.
TRANSFORM goes far beyond this existing evidence, testing new ways to diagnose the disease that could find the cancers that today’s methods miss. However, the trial will also quickly produce robust new information about the tests we currently use. If the NSC decides there is insufficient evidence to recommend screening now, these early results could help shift the evidence in favour of screening in as little as two years.
TRANSFORM has also been specifically designed to help tackle inequalities in prostate cancer research and care. Black men are twice as likely to get prostate cancer and twice as likely to die from it. Yet historically too few Black men have been recruited into trials to generate reliable evidence of how effective screening would be for them. To help address this, at least one in ten men invited to the trial will be Black, and the charity and trial team will work with Black community leaders and organisations to ensure good representation of Black men in the trial, to ensure that future evidence is informed by, and reliable for, the men who stand to get the most benefit from screening.
The trial will recruit men aged 50-74 (or 45-74 for some groups known to have poorer outcomes, such as Black men). The first testing site to open is the InHealth Community Diagnostic Centre in Ealing, with more opening soon across the UK. Men will be invited directly by their GPs, so the trial mirrors how a future screening programme would operate.
It is not possible to volunteer for the trial, but anyone who receives a letter is encouraged to take part.
Image credit: Science RF / Adobe Stock
