The incredible trajectory of Professor Ros Eeles' research over the last two decades encapsulates the necessity of funding discovery research and allowing scientists to explore their bright ideas for transforming the future of cancer.
Prostate cancer is the most common cancer among men in Europe. Treatment has come a long way and most will now survive their diagnosis for 10 years or more, but not all prostate cancers are equal. Better ways to identify aggressive prostate cancer could prevent thousands of lives being cut short.
Back in 1999, Professor Ros Eeles came to us with an idea for a project to find out more about inherited prostate cancers. It's estimated that around 10% of prostate cancers are inherited, and these are often the most aggressive types.
Because prostate cancer can be inherited, Professor Eeles knew that there must be combinations of genes responsible that, if known, could be used as markers to find the people most at risk.
But finding those genes had proven difficult. This project kick-started over two decades of additional research, as Professor Eeles dedicated her career to uncovering these genetic markers.
Eventually, Professor Eeles and her team were able to identify over 130 genes that play a role in inherited prostate cancer, allowing them to design a quick and easy test that combined these markers to give a risk score based on a patient's DNA.
Professor Eeles investigated whether this new test could be effective in a study called BARCODE1.
Over 6000 men took part, sending their DNA to the lab to be tested by spitting in a small plastic tube. The study was an incredible success as the new genetic marker test discovered cancer in 187 participants - 70% of which would not have been detected by the existing NHS diagnosis pathway.
Almost 6 in 10 of these patients were discovered to have prostate cancer that was classified as intermediate or high risk, and could begin treatment. We don't currently have reliable enough tests to distinguish aggressive prostate cancer that needs treatment, from slow-growing prostate cancer that would never impact a patient in their lifetime, but this new test could change this picture.
Funding early stage research enables discoveries that can completely change the way we look at cancer. Professor Eeles' work is an incredible example of this, and we're seeing the real consequences it could have for early detection and monitoring of one of the most common cancers in the UK. We're proud to have funded the early work that led to this trial that could see fewer lives cut short by prostate cancer.
Professor Eeles' timeline of discovery:
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The Worldwide Cancer Research project:
In 1999, our funding allowed Professor Eeles to explore the molecular mechanisms underpinning progression in prostate cancer, focusing on identifying genetic markers that could predict disease prognosis and improve diagnosis and treatment planning.
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A career dedicated to understanding prostate cancer:
Since then, Professor Eeles has spent decades co-leading international efforts to identify over 160 genes associated with prostate cancer risk - dramatically expanding our understanding of inherited prostate cancer risk. -
Launching the BARCODE1 screening test:
The BARCODE1 study aimed to determine whether a new spit test could find men in the general population who are at higher risk of prostate cancer. The results from study overwhelmingly indicated that this new saliva test is more accurate than the existing NHS pathway (measuring the amount of prostate-specific antigen (PSA) in the blood).
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Improving and targeting prostate cancer treatment with BARCODE2:
Following the success of the BARCODE1 study, Professor Eeles is now leading a clinical trial called BARCODE2 exploring how effective treatment is for people with specific gene mutations, which could lead to better targeted cancer treatments in the future. Men with advanced prostate cancer are undergoing rapid genetic testing to identify whether they have a mutation in a DNA repair gene, and the study aims to discover whether these genetic markers could indicate response to a specific chemotherapy drug called Carboplatin.
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The biggest prostate cancer screening trial in 20 years:
Professor Eeles is part of the team running the £42m research programme TRANSFORM, which will be the biggest trial in prostate cancer screening, comparing the saliva test to other potential screening options to find the best way to screen for prostate cancer, so that one day anyone at risk will be invited for regular tests to detect aggressive cancers early.
We know that if you find prostate cancer earlier, it's much easier to cure it. Now, for the first time, we can use a saliva test that looks at many genetic variants that can actually assess prostate cancer risk in the general population. It could alter the way we offer prostate cancer screening. With this test it could be possible to turn the tide on prostate cancer, and it wouldn't have been possible without years of research.
What is next for this discovery?
One of the biggest challenges in early cancer screening is the risk of overdiagnosis - patients who are either diagnosed incorrectly, or at a stage where the disease is growing so slowly that it wouldn't pose a risk to their health in the long term. These patients then undergo unnecessary medical procedures that can have serious side effects.
This is a particularly prevalent challenge for prostate cancer, which is why this new test is so exciting. It could be completely transformative for patients in the future.
There is still more work to do – for example, the BARCODE1 study was looking at a particular set of genes that are specific to white men of European descent - and since prostate cancer is more common among Black men, there’s an urgent need for further studies like this to support all patients.
But none of this would be possible if it weren’t for the curiosity and perseverance of researchers like Professor Eeles – and we’re proud to have taken a chance on her incredible research idea. By becoming a Curestarter, you can help us continue to support more bright ideas like Professor Eeles’ - allowing us to fund discoveries that could lead to livesaving new ways to prevent, diagnose and treat cancer.
With thanks to Professor Ros Eeles, the Institute of Cancer Research for their collaboration on this article and for providing the photography of Professor Eeles in the lab, and the Curestarters who choose to turn their compassion into action to support crucial research like this.
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