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Clinical Research Programme

Prostate Cancer Clinical Research Unit

Head of Unit:  David Olmos
Research highlights

PROREPAIR study. PROREPAIR-B (Castro et al., Abstract LBA32, ESMO 2017) is the first prospective study to address the prevalence of germline DNA damage response genes, deleterious mutations and their impact on clinical outcomes following conventional treatments for metastatic prostate cancer. The study included 419 mCRPC patients. BRCA2 (3.3%), ATM (1.9%) and BRCA1 (0.9%) were the most commonly mutated genes. Pathogenic variants in all of the 107 analysed genes were identified in 15% of patients. Carriers and non-carriers presented similar characteristics at baseline, but carriers, particularly BRCA2 carriers, progressed earlier and lived shorter lives than noncarriers despite the administered treatments. This is a prospective multicentre cohort study involving 38 Spanish centres within the PROCURE network (see below).

SWITCH Phase II study. In 2017, we also presented the final results of the SWITCH study; a multicentre, single arm, open label, single-stage, phase II study. Clinically stable mCRPC patients who had PSA and/or limited radiographic progression after at least 12-weeks on Abiraterone plus prednisone, switched to Abiraterone plus dexamethasone. PSA50 response rate was 34.6%, Median time to biochemical and radiological progression were 5.3 and 11.8 months, respectively. Patients with AR gain detected in plasma ctDNA did not respond to the switch, while patients with AR normal status benefitted the most. The change of prednisone to dexamethasone in clinically stable patients progressing to Abiraterone plus prednisone could revert some resistances and induce durable responses in advanced prostate cancer.

PROCURE biomarkers platform. This network, started by our Group in 2013, involves 63 participating oncology departments across Spain. Over 900 patients have been enrolled in the 5 currently active prospective studies (PROREPAIR, PROSTAC, PROSABI, PROSENZA, PRORADIUM). This network has attracted international attention and partners from Italy (MEETURO group) and Australia (Peter McCallum Cancer Centre) have joined us this year.