Principal Investigators: 
Nick James, MBBS, PhD (Institute of Cancer Research)
Gerhardt Attard, MD, PhD (University College London)
Bissan Al-Lazikani, PhD (Institute of Cancer Research)

Co-Investigators: Julia Murray, PhD (The Royal Marsden; The Institute of Cancer Research), Katharina Von Loga, PhD (The Royal Marsden; The Institute of Cancer Research), Ros Eeles, PhD (Institute of Cancer Research), Noel Clarke, PhD (Salford Royal NHS Foundation Trust and The Christie NHS Foundation), Emily Grist, PhD (University College London), Felix Feng, MD (University of California at San Francisco), Elai Davicioni, PhD (Decipher Biosciences), Nasir Rajpoot, PhD (University of Warwick), Christopher Brawley, MSc (University College London MRC), Vincent Gnanapragasam, PhD, MBBS (University of Cambridge), Shan Ahmed Raza, PhD (The University of Warwick), Daniel Spratt, MD (Case Western University), Marina Parry, PhD (University College London), Mahesh Parmar, PhD (University College London), Daniel Berney, MBBS (Barts and the London NHS Trust/Barts Cancer Institute Queen Mary University of London), Paolo Cremaschi, PhD (University College London), Syed Adnan Ali, MBBS (The University of Manchester), Áine Haran, MBBS (The Christie NHS Foundation Trust)

Description:

• The STAMPEDE trial, led by Dr. Nick James, is a large multi-center multi-arm multi-stage trial studying a variety of new treatment approaches for men with both locally advanced and metastatic cancer commencing long term androgen deprivation therapy (ADT).
• Thus far, STAMPEDE has evaluated 10 different treatment approaches, and has identified three treatment regimens that prolong overall survival compared to ADT alone. These are now established standards of care in patients with metastatic prostate cancer who are initiating ADT: the addition of docetaxel, abiraterone, or prostate radiotherapy to ADT.
• However, it remains unclear how to select amongst these approaches for each patient. For instance, prostate radiotherapy + ADT was only found to be of benefit in patients with low-burden (oligo) metastatic prostate cancer.
• Dr. James and colleagues are now using samples and data from patients on STAMPEDE in order to identify biomarkers that better identify patients who will benefit from each treatment.
• In this project, Dr. James and colleagues will develop artificial intelligence algorithms to analyze tumor samples, imaging scans, and patient and tumor genomic alterations, from patients with newly diagnosed oligo-metastatic prostate cancer enrolled on the prostate radiotherapy + ADT treatment arm of the STAMPEDE trial, in order to identify biomarkers that predict benefit from this treatment option.
• These biomarkers will also be compared with biomarkers that predict benefit with the addition of abiraterone, enzalutamide, or docetaxel to ADT.
• Finally, this information will be used to develop an online tool for physicians and patients to aid in selecting treatments most likely to be of benefit.

What this means to patients: Several new treatment approaches have recently been shown to prolong survival in patients with newly diagnosed metastatic prostate cancer. However, it is unclear which treatment option will be best for each individual patient. Dr. James and team will use an AI-based approach to identify biomarkers that predict which patients will benefit from the addition of prostate radiotherapy to ADT. The team will then develop an online tool that physicians and patients can use to aid in optimizing personalized treatment decisions.