Renal and prostate malignancies in particular are key contributors of cancer-related death and morbidity, presenting considerable opportunities for improved patient outcomes. Renal cell carcinoma (RCC) is the most aggressive urological malignancy and is the eighth most common adult cancer in the UK. More than 10,000 people are diagnosed each year but long-term survival rates remain poor, with only 50% patients surviving the disease for ten years or more. The clinical challenges are considerable; early biological mechanisms are not well understood, and almost half of kidney tumours have no symptoms and are picked up by chance alone, often at an advanced stage. While ultrasounds and CT scans are used for diagnosis, they offer only limited specificity for differentiating benign and malignant kidney masses. Even with an accurate diagnosis, no adjuvant therapy has yet been proven to be effective; the current global standard-of-care after nephrectomy for localised RCC remains active monitoring by clinical and radiological means, but 30-40% of patients with initially localised RCC go on to develop metastatic disease following surgery. To overcome these challenges, our research focuses on novel strategies for screening those at high risk of RCC, improved risk-stratification of kidney tumours via non-invasive methods, facilitation of more informed treatment choices and biopsy approaches, and identification and development of new targets for pre- and post-surgery adjuvant therapies.

 

Prostate cancer ranks as the most common male cancer in the UK, with over 40,000 new diagnoses every year. Although outcomes are comparatively better than for RCC patients, earlier detection of more aggressive cases will save lives and minimise the suffering caused by advanced incurable disease. Diagnostic success remains limited however. Early-stage prostate cancer is largely symptomless, and the Protein-Specific Antigen (PSA) blood test used for diagnosis is not accurate enough for general-screening  – some cancers are missed entirely, and approximately three-quarters of men with a raised PSA-level don’t have cancer at all. In addition, prostate biopsies carry significant risk of infection and often need to be repeated. To overcome this, our research aims to support improvements in diagnostic and therapeutic pathways, early disease modelling, and personalised prognostic and risk stratification tools to ensure treatment-types are optimally tailored.

 

Drawing these strands together, our clinicians and scientists continue to develop closely-integrated basic, translational and clinical research themes to tackle these overlapping areas of need. These include multi-platform genomic analysis and next-generation sequencing methods (underpinned by clinically-relevant biological studies in cell lines, animal models and human tissues), better modelling of early disease biology, identification of novel predictive biomarkers markers, development of novel biopsy and imaging methods, improved methods of risk stratification, novel translational window trials of new drugs and therapies, and clinical trials to test optimal therapy in different patient groups - including biological and imaging endpoints as potential early surrogates of therapeutic efficacy.

 

This work is supported and augmented by our large, well-annotated and steadily growing bio-repository, as well as the high-volume and clinical excellence of urological cancer practice at Addenbrookes Hospital. We also work in close collaboration with other scientists and academics locally, nationally and internationally to optimally utilise skills and knowledge across different disciplines maximise the advancement of global knowledge and expertise.

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