TRANSFORM trial looks to fine tune prostate cancer screening
Prostate Cancer UK is set to invest £42 million in the TRANSFORM trial, to test innovative approaches to prostate cancer screening with the hope of advancing early diagnosis.
The screening trial, funded by Prostate Cancer UK, the National Institute for Health and Care Research (NIHR) and Movember, will be the biggest of its kind for the past 20 years and could allow for the determination of the most effective prostate cancer screening methodology. Allowing clinicians to combat the disease in its initial stages where treatments are the most effective. As it stands, the trial is currently being configured, with recruitment of men set to begin later in the year.
Recent trials have shown that PSA and biopsies are able to mitigate 8–20% of deaths with the dependent variable being how frequently the tests are performed. With the TRANSFORM trial, the impact is projected to be a staggering 40% death mitigation.
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The trial consists of two stages with a 10-year follow up. In stage 1, approximately 12,500 men will be screened for prostate cancer using fast MRI scans, PSA blood testing, genetic screening or the current NHS screening method of requesting screening, which will act as a control group.
Stage 2 will follow-up to 300,000 men with the best screening method identified from stage 1. This part of the study will carefully further investigate and evaluate the harms of the screening method in addition to the benefits. There will be a decade long follow-up after stage 2 to see how prostate cancer mitigates the lives of the men.
GPs in the UK are set to send out invites to men aged 50–75 (45 for black men) to contribute to the TRANSFORM trial, no volunteers will be allowed to ensure that the study is reflective of the UK population and is highly controlled. As the prostate cancer risk posed to black men are double that of any other ethnic group, 1 in 10 of the recruited men for trial will be black.
“TRANSFORM is a game changer because it will allow us to rigorously test genetic markers on a large scale in men from diverse ancestries. This could give us the information we need to use genetic risk scores to identify men at risk of aggressive cancer who will need regular tests, while sparing men at low-risk from having unnecessary biopsies and treatments,” explained Ros Eeles from The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust (both London, UK).
This trial will be on a mammoth scale compared to previous similar studies and will identify crucial screening methodologies that not only positively impact the UK but will have a ripple effect across the world.
“Prostate cancer is the most common cancer without a screening program and it’s about time we changed that,” Matthew Hobbs (Prostate Cancer UK) commented.