Dr Joe O'Sullivan: Numerous Prostate Cancer Therapies Is a Challenge for Clinical Trials

Having numerous therapies to treat prostate cancer can actually be a bad thing—it makes it difficult to design clinical trials for new therapies coming into the space, explained Joe O'Sullivan, MD, FRCR, clinical professor, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast.

What are the challenges you see with translating new scientific discoveries into clinical practice?

The biggest challenge in prostate cancer right now is a problem we didn’t have 10 years ago, which is we have too many drug therapies. Well, not that we have too many drug therapies, but it’s hard for new drug therapies to come in and compete for space. So, in fact, if we’re designing a clinical trial, especially a randomized clinical trial, it’s now very difficult to think: what would be the control arm? Both in hormone-sensitive and castration-resistant prostate cancer.

I guess we’re a victim of our own success. We have too many therapies, so a very big challenge now, especially for a new therapy, is [that] to prove overall survival benefit is very, very difficult. And this is why we have to depend on genetic understanding of the patient’s tumors to direct our therapy better. Because the one-size-fits-all therapy, that era is hopefully gone. And a more personalized approach based on the patient’s tumor characteristics and their own mutations will help us, I think, direct treatment more appropriately to the right patients. And that will, in turn, help us to design better and smarter clinical trials.