Using next-generation imaging to improve treatment of prostate cancer in the bone

Grant information

Institution - The Royal Marsden Hospital
Researcher - Dr Nina Tunariu and Professor Dow-Mu Koh
Grant award - £340,868
Duration of funding - 2020-2025
Reference - RIA18-ST2-023

Why did we fund this project?

• Advanced prostate cancer is cancer that has spread from the prostate to other parts of the body. It develops when prostate cancer cells move throw the bloody stream or the lymphatic system.

• The most common site of prostate cancer spread, referred to as metastasis, is to the bones near the prostate. From there, the cancer can spread throughout the whole body.

• Currently, standard scans such as CT and targeted MRI do not provide clear information on whether such metastases are responding to treatment.

• Whole-body MRI can give doctors a more detailed picture of prostate cancer throughout the body, including cancer in the bones, and could help them spot earlier whether a treatment is working or whether the cancer is progressing.

• We funded Dr Nina Tunariu, Professor Dow-Mu Koh and their team to investigate whether whole-body MRI could provide a better way to monitor advanced prostate cancer and help guide treatment decisions for men.

What did the team do?

• The team analysed whole-body MRI scans from men with advanced prostate cancer to investigate whether information from the scans could help predict how their cancer might progress and how they would respond to treatment.

• They compared whole-body MRI with standard CT and bone scans to understand how well each approach could detect whether prostate cancer in the bones was responding to treatment or progressing.

• The team also investigated whether whole-body MRI could help doctors choose the best areas of bone to biopsy, increasing the chances of collecting enough cancer cells for further analysis.

What did the team achieve?

• The team found that measuring the amount of cancer in the bones using whole-body MRI could provide important information about a man's prognosis. Men with a greater volume of cancer detected in their bones had, on average, poorer survival.

• They also showed that whole-body MRI could find prostate cancer that has spread to the bones earlier and more often than standard imaging, while also distinguishing between cancer that was responding to treatment, remaining stable, or progressing.

• The team developed a standardised approach for using whole-body MRI and showed that it could help find suitable areas of bone to biopsy. Their work is now being used to support further prostate cancer research and clinical trials.

What does this mean for men?

• This research provides further evidence that whole-body MRI could give doctors a clearer picture of how advanced prostate cancer is behaving and help them identify sooner when a treatment is no longer working.

• In the future, this could help men avoid staying on ineffective treatments for longer than necessary and allow them to move on to another treatment sooner. Whole-body MRI can also help identify serious complications from cancer in the bones, such as spinal cord compression.

• More work is needed before this approach could be widely adopted. The team's optimised whole-body MRI approach is already being used in further research, including the STAMPEDE2 trial, helping to build the evidence needed to understand how it could best be used to guide treatment for men.