|1st November 2018
Prostate cancer impacts hundreds of thousands of men globally, however, it's not a disease men like to talk about.
During the last fifteen years, The Movember Foundation has worked hard to breakdown taboos around mens health issues – from prostate and testicular cancer to suicide prevention. It has helped men across the globe to gain acess to tools, resources and cutting edge developments in this field, and funded 1200 projects in 20 countries across the world.
As part of our efforts to raise awareness this Movember, Blue Latitude Health spoke to Nadine Brew, Senior Manager, Biomedical Research at the Foundation to find out how the organisation is staying at the forefront of innovation.
What are you working on at the moment?
My role involves understanding the portfolio of programs that the Movember Foundation funds globally. These projects span across the entire breadth of prostate cancer R&D, including biomarker discovery and validation, clinical trials, imaging studies, tissue repository consortia and active surveillance monitoring.
The goal is to determine how the Movember Foundation can best support the research that is most promising for improving outcomes for men with prostate cancer.
Which initiatives are you most excited about?
There are some interesting advancements in precision medicine and innovative trial designs in the oncology field. I’m looking at best practice in the sector and what can be learnt from others.
The Michael J Fox Foundation, Cystic Fibrosis Foundation and Multiple Myeloma Research Foundation are key examples that have all managed to bring together patients, industry and academic researchers to deliver improved outcomes for patients
. The Movember Foundation recently revealed the new Australian Prostate Cancer Research Alliance, which I’m really excited about. This is a partnership with the Australian Government and Cancer Australia to invest $12M in translational research programs from 2019.
The idea of men retaining their masculinity runs strongly throughout the Movember brand – from language such as “know thy nuts” to the ‘Ironman’ registries. Why is this so important? What makes it effective?
An important part of the Movember ethos is fun. Humour starts important health conversations men may not initially be comfortable with. On top of that, a prostate cancer diagnosis can be a threat to a man’s sense of masculinity and self-identity, as they face potential side effects in continence and sexual health. We wanted to make the campaign accessible and remove the taboos as this is integral to ensuring men get the best treatment quickly.
What are the major challenges faced by prostate cancer patients today?
A prostate cancer diagnosis is one of the most complex diagnoses in oncology, and one that hundreds of thousands of men globally receive each year. Treatment decisions, including opting for active surveillance for low risk prostate cancer, are fraught with many considerations around cost and benefit, which are all unique to each man’s particular circumstances.
While there are many options for treating prostate cancer, due to the gland’s location they can cause side effects that disrupt urinary, bowel and sexual function. Additionally, patients often consult different health practitioners who may recommend the particular treatment that they specialise in as the ideal option for them. To address this, collecting and understanding patient reported outcomes measures (PROMs) is critical to understanding treatment outcomes and patient satisfaction.
One of the biggest challenges is identifying prostate cancer patients that will best respond to more aggressive treatments, how does the Foundation hope to solve this?
This is a significant area of intense research. 90% of prostate cancer patients are diagnosed with localised carcinoma, which have a highly variable course of disease progression. Having a tool to distinguish aggressive tumour types would enable those difficult treatment decisions to be made with a greater degree of confidence for men and their partners.
To achieve this the Movember Foundation has funded a number of ground-breaking programs in this area. One of the most successful and high profile has been the Canadian Prostate Cancer Genome Network (CPC GENE). By genome sequencing five hundred tumours, the team was able to develop a novel prognostic signature to differentiate aggressive from slow growing tumours. This information can be used to determine what type and how much treatment should be given to each patient, or if any is needed at all.
Another approach we’ve invested in is the Biomarker Global Action Plan. Rather than using tissue alone, this project also evaluated other biomarker sources such as circulating tumour cells, blood, urine and exosomes. It also involves the development of critical resources in biomarker testing including biobanks of rare patient samples and new animal models that grow patient-derived cancers. The project has resulted in new tests that are progressing through clinical validation.
Has working in precision medicines given you a new perspective of this disease area and how it impacts patients?
Precision medicine is and will continue to change the journey of prostate cancer patients, and their families. We now know so much more about the range of genetic drivers of prostate cancer. This knowledge is being applied to both localised and advanced stages of disease – from diagnosis, to systemic therapy to new treatments for castrate resistant metastatic disease.
We are seeing PARP inhibitors, initially indicated for ovarian and breast cancers, generating responses in prostate cancer. The AR-V7 blood test enables men to ascertain ahead of time if hormone therapy will be effective for them. Family counselling is also more commonly considered, particularly for daughters, possibly affected by their fathers’ genetic status. With prostate cancer now having very high rates of 5- and 10-year survival in most countries, it really shows the different and distinct impacts that precision medicine can have within so many elements of one highly complex disease area.
Do you think the move from diagnosing a disease based on the organ of origin to diagnosing on a molecular level will be challenging for healthcare professionals and their patients to understand? How can that be improved?
The advent of new molecular based biomarkers and companion diagnostics is a revolution in healthcare. The integration of various -omics testing and information sharing between patients, healthcare providers, pathologists, insurers and the whole ecosystem will be immensely challenging. However, I don’t think that implementation barriers necessarily come down to the disease originating within a certain organ. There are studies showing that clinical trials with accompanying biomarkers have triple the likelihood of success in progressing from phase 1 to approval and this effect is even stronger in oncology clinical trials.
Many health-focussed foundations are collaborating with industry and patient organisations to accelerate the delivery of precision medicine and to actively educate patients about targeted therapy options and acting as their own health advocate. The most important aspect is to ensure that there is adequate implementation of promising research in to molecular stratification in a way that changes clinical practice in a meaningful way.
Blue Latitude Health has significant experience in the field of prostate cancer, developing end-to-end campaigns for products and services. To find out how we can help you reach your product, brand or portfolio goals, contact email@example.com
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