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World-first clinical trial shows improved survival for prostate cancer which has spread to bones

A world-first clinical trial led by Queen’s University Belfast has shown how a new combination of radiotherapies has improved the treatment of very advanced prostate cancer in men.

The ADRRAD clinical team pictured in 2016 left to right: Prof Joe O'Sullivan, Ms Donna Rowley, Dr Christos Chatzigiannis, Mrs Sharon Hynds and Dr Phil Turner

It has demonstrated excellent tolerability in patients in slowing the progression of prostate cancer which has spread to the bones, potentially improving overall survival. 

This is the first time that this combination of therapies has been tested in a clinical trial and has been proven to be safe and tolerable in this population of men with advanced prostate cancer, which accounts for around 10 per cent of all prostate cancer patients at diagnosis. 

The ADRRAD trial results have been published today (Wednesday 30 June) in leading cancer journal Clinical Cancer Research. 

Prostate cancer is the most common cancer in men in the UK. More than 47,500 men are diagnosed with prostate cancer every year – 129 men every day. In Northern Ireland, approximately 276 men die from the disease every year. 

Men with advanced prostate cancer are normally treated with hormone therapy, which aims to shrink a tumour by limiting the amount of testosterone reaching the cancer cells. This new approach was the first to combine two existing forms of radiotherapy - Radium 223, an intravenous, bone-seeking radioactive drug which targets the prostate cancer in the bones, and Volumetric Modulated Arc Therapy (VMAT) (very high-tech Radiotherapy) to target prostate cancer cells in the prostate gland and pelvic lymph nodes.  

To conduct the trial, 30 patients aged between 40 and 80 received this new combined therapy over the past four years. 

Lead researcher, Professor Joe O’Sullivan, Professor of Radiation Oncology from the Patrick G Johnston Centre for Cancer Research (PGJCCR) at Queen’s University, said: “This is the first trial of its kind anywhere in the world. We have found that combining these two forms of radiotherapy is safe and we have seen some indications that the approach may prove more effective than existing hormone treatment in targeting prostate cancer cells at multiple sites. We will proceed to a large, randomized trial to test the treatment against the current gold standard. 

“Conducting this trial has been a huge team effort involving research doctors, radiographers, nurses, physicists, and clinical trial professionals at the Northern Ireland Cancer Trials Centre. We are so grateful to the patients and their families for taking part in this trial. 

“This trial is a huge global success in the fight against prostate cancer, which is the most common type of cancer among men in the UK and is life-changing and life-saving research.” 

Simon Grieveson, Head of Research at Prostate Cancer UK, commented: “Radiation treatments like Radium-233 can provide significant benefit to men with advanced prostate cancer, but unfortunately after a while they stop working. These exciting results show that using a combination of two forms of radiotherapy, alongside hormone therapy, is safe for men with advanced disease, with many of the patients responding well to this treatment approach.  

“We are delighted to have supported this research through the Movember Centre of Excellence. Funding provided through this partnership will enable this group to shape a larger-scale clinical trial which is the crucial next step for this treatment combination. We very much look forward to seeing this research progress over the coming years.” 

David Livingstone, a patient who took part in the clinical trial, said: “In 2016, I was diagnosed with aggressive prostate cancer which had spread to my bones and my lymph nodes. My PSA level was 3495, one of the highest ever seen. I was given six months to a year to live so the future looked pretty grim. 

“I was invited to join the research programme led by Professor Joe O’Sullivan. It involved 37 sessions of radiotherapy and six months of Radium injections. After the first few sessions I started to feel weak, and my energy levels dropped considerably. I have a hormone implant every twelve weeks, and a calcium infusion to help strengthen my bones. Over five years on, with other medication which I take every day, I can now enjoy a pretty normal life. Although I’ve low energy and am limited to what I can do; without this breakthrough, I simply would not be here today. 


“I have seen my two daughters get married and have been able to spend quality time with my grandchildren. To put my faith in the hands of Professor O’Sullivan and his team was the only way forward for me. There’s no doubt that without this vital research, I wouldn’t have had the extended life beyond what was originally diagnosed.”

The research was conducted by the Academic Prostate Cancer Team at the Northern Ireland Cancer Centre, Belfast as part of the Prostate Cancer UK Movember Centre of Excellence (FASTMAN CoE) in the PGJCCR. The FASTMAN CoE is an ongoing partnership between Queen’s and the University of Manchester.  

The research was designed and conducted in partnership with the Belfast Health and Social Care Trust and the Northern Ireland Cancer Centre and was funded by Movember, Prostate Cancer UK and Friends of the Cancer Centre. 

The research will now be taken forward in a large, randomized trial with a greater number of patients with the aim of testing this treatment schedule against the current standard of care. 

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