Generating good evidence for new cancer treatments is seriously tough.

By Professor Liam Bourke, Sheffield Hallam University

There are lots of reasons for this. The subject matter is complex. Capturing and recording prospective data in clinical populations is relentlessly challenging. Co-ordinating and harmonising the delivery of trial protocols across multiple sites can bring its own problems. Sometimes, making sure participants attend scheduled study assessments can be like herding cats: people tend to have other priorities than your study (fair enough). Those are the good days. And all this after you work for years to build a team of experts and write a competitive grant application. Best case scenario – your grant gets approved and you don’t have to spend any time face down and crying at the bottom of the academic well of despair. This is not something that is widely appreciated outside of academia, but the impact of this job on your mental health can be brutal: and not everyone recovers. All academics have been in the well, at one time or another: the trick is not to stay there. Never dwell…in the well. In my quieter moments, I do sometimes wonder why on earth I or anyone else would want to work in research.

With that being said, if something is worth doing, it’s worth doing well (not that type of well – I meant ‘right’). In our recent phase II CRUK PANTERA trial our study team and trial participants undertook what we think is a world first attempt to see if people diagnosed with cancer would take part in a study to evaluate the use of exercise training as a primary therapy. In short we found they would. Our intervention participants did lots of exercise and we found important changes in health-related measures such as cardiovascular health, weight management and improvements in quality of life. Given that men with localised prostate cancer are much more likely to die of cardiovascular disease (CVD) than men without, this is a real plus. And not something any other standard treatments can boast. We think we have a pretty good basis for exploring our central research question of “could this be offered to men with prostate cancer as standard therapy in the health service?” in a much larger and definitive trial.

There are many challenges ahead. A definitive trial will need to provide robust evidence of clinical effectiveness and cost effectiveness. We certainly know what methods to use to test this, but the challenges of a phase II trial just rise exponentially for a definitive trial. Further, nobody really knows how exercise training exerts any direct anti-cancer impacts. However, assessing samples from a large, prospective multi-centre randomised control trial (RCT) would be a fabulous way to generate valuable data to work out what might be going on. It is not an opportunity our team will miss.

You may be interested in the following related content: from CRUK and Fred Hutch

The views expressed are those of the author. Posting of the blog does not signify that the Cancer Prevention Group endorse those views or opinions.

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