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Wales plays leading role in one of the world’s biggest cancer trials

The STAMPEDE cancer trial has been responsible for improving the lives of hundreds of prostate cancer patients in Wales.

The trial’s 10,000th patient was recently recruited, making it one of the world’s biggest cancer trials. This is an incredible achievement for prostate cancer research as a whole, especially here in Wales. In 2005, the very first patient was recruited to the study at Velindre Cancer Centre in Cardiff. Today, STAMPEDE is the largest ever prostate cancer treatment trial, and Velindre remains the largest recruiting centre. Many patients have also been treated on the trial in Singleton, Glangwili General and Bronglais General Hospitals.

Tim Driscoll, 57, from Pontprennau was diagnosed with prostate cancer in 2015. As part of his treatment, he enrolled on the STAMPEDE trial. The electrician and father of triplets said, “Cancer doesn’t run in my family and so when the first signs began to appear it never crossed my mind that it could be cancer. I first went to the GP when I developed pain in my joints and my back. Little did I know then, but the cancer had spread to the lymph nodes around my kidney and bladder and was putting pressure on them. After six months of GP visits my cancer was finally diagnosed by a blood test. If they hadn’t caught it when they did, I’m told it would’ve only been four months until it became terminal.”

Rugby is Tim’s big passion and in his spare time he draws caricatures of Welsh players – as well as other celebrities – and these have been sold to raise thousands for cancer charities. To date, Tim has raised over £30,000.

He said, “I’m ever so grateful for the treatment I’ve received at Velindre Cancer Centre. I’ve put a lot of time into trying to give something back. Enrolling on the STAMPEDE trial has also helped me feel like I’m giving back. Knowing my experience on the trial will help inform treatments for future patients gives me a real sense of satisfaction. It also means that I have more regular check ups than I would do if I was having standard treatment – it feels like a bit of a safety net, knowing that someone is keeping a close eye on me.”

Clinical trials don’t guarantee a positive outcome for patients, but fortunately for Tim, STAMPEDE has kept his cancer under control. He has returned to work full-time and is planning to cycle over 100 miles from Cardiff to Oxford to raise money for charity. “I may have cancer,” he says, “but cancer hasn’t got me!”

The study, which is taking place across the UK and Switzerland, has already demonstrated improved survival with the addition of drugs (both docetaxel and abiraterone) to standard-of-care treatment for men starting long-term hormone therapy. The clinical results from STAMPEDE on docetaxel were published in The Lancet in 2015 and have changed the treatment for men with prostate cancer worldwide. The data showing the survival benefits of abiraterone were published in the New England Journal of Medicine in 2017, and NICE are in the process of reviewing whether men with cancer that has spread beyond the prostate, starting long-term hormone therapy, should have routine access to this drug in the NHS.

STAMPEDE implements an innovative trial method, developed by the Medical Research Council Clinical Trials Unit at UCL, which allows assessment of several treatments against a base line. Recruitment of patients to some parts of the trial can be stopped early and allows new treatments to be added as it progresses. Assessing several treatment options simultaneously like this speeds the rate of results, and means better treatments will reach patients sooner.

Dr Jason Lester, who is Principal Investigator on the trial and consultant Clinical Oncologist at Velindre Cancer Centre said:

 “STAMPEDE is a truly innovative trial that aims to improve the outcome of men with advanced prostate cancer. It is a unique trial in my career as men who took part in the early stages of the trial have had their management changed several years later as the results have matured.”

Professor Malcolm Mason, Professor of Clinical Oncology at Cardiff University was instrumental in setting up the trial.

He added:

“Back in 2005, the design of this trial was so novel that many people doubted that it would succeed. Now, 10,000 patients later, not only has the trial succeeded in recruiting patients, it has also delivered two major advances in the treatment of advanced prostate cancer, that have changed the way it is treated worldwide. The NHS in Wales should be proud of this achievement in which it played such a prominent role.”

Professor John Staffurth, Consultant Clinical Oncologist in Velindre Cancer Centre and Clinical Lead at the Wales Cancer Research Centre, said:

“STAMPEDE has been a great success story for cancer research within Wales; the high recruitment rate within Velindre owes much to our colleagues in the urology teams across South East Wales, where men are first diagnosed. The research teams within Velindre and Swansea have supported the patients within STAMPEDE for over a decade and we are all delighted that men being diagnosed with this devastating disease now live on average two years longer than they did just ten years ago.”

Ruth Amies, Cancer Research UK’s spokesperson for Wales, said:

“Trials like STAMPEDE are vital for working out the most effective treatments to tackle cancer. Passing the 10, 000th patient milestone shows the reach this Cancer Research UK funded trial has had. The study has already found that combining a chemotherapy drug with hormone treatment extended the lives of men with advanced prostate cancer, giving men more time with their family and friends. As the trial continues, we are looking forward to finding out which treatments are the most effective, and the kindest, for different men with prostate cancer.”