Research and development in the department of urology in Cambridge
The urology department in Cambridge is involved in a wide range of academic activity. The clinical department is involved in regular audit of practice and in commercial and NCRN portfolio studies. In addition to this there are programmes in academic, undergraduate and postgraduate teaching.
Research and development committee
The departmental urology research and development committee meet quarterly chaired by Mr VJ Gnanapragasam and is the point of contact for potential new studies. The committee reviews the department’s trials and studies portfolio and any issues on recruitment and resources. Trials work is supported by a dedicated urology research nurse. Enquiries about potential trial and studies can be sent to Mr VJ Gnanapragasam or Mrs S Taylor (insert email addresses). A list of current trials is listed below. In addition to uro-oncology (see below) there are research programmes in benign urological conditions with specific departmental interests in benign bladder conditions (Mr N Thiruchelvam), stone disease metabolism and clinical therapy (Mr OJ Wiseman/Mr N Shah), benign prostatic hyperplasia and HOLEP (Mr T Aho), and urology service configuration and delivery (Mr C Kastner).
List of current commercial and NCRN portfolio studies in the department
- Prostate cancer – REACT
- Bladder cancer – OXN, Symphony and SUSPEND
- Renal cancer – SORCE, NEOSUN
- Bladder dysfunction – Symphony
- Benign prostate hyperplasia (BPH) – EAU audit of treatment outcome for BPH
- Stone disease
Academic teaching programme
The urology department has an active academic programme with a monthly afternoon meeting following the audit and business meeting. This is led by the consultants and covers a range of urological topics in a rolling rota. These sessions are designed to provide updates and new developments in providing state of the art urological care. Sessions include presentations by consultants, registrars and invited speakers. There is also an annual, session where departmental audits and studies are presented. This is co-ordinated by Mr VJ Gnanapragasam and a copy of the current academic programme can be found here (link to programme)
Academic uro-oncology group
The focus of the academic unit is in prostate and renal cancer research. The group is led by Professor DE Neal, Chair of Surgical Oncology and Senior Group leader at the Cambridge Research Institute (CRI). Other members include Vincent Gnanapragasam (University Lecturer in Uro-oncology and Group Leader Hutchison MRC Research centre), Stephen Connolly as well as 2 clinical lecturers. The unit is an accredited training centre for academic clinical fellows with regular intakes every year. At the current time there are 6 ACF in the department.
Prostate cancer research
The prostate cancer programme in Cambridge covers basic, translation and clinical research. A principle focus is on castrate refractory prostate cancer and improving primary therapy for high risk disease. Professor Neal is the PI for a number of national prostate cancer studies including the PROTECT and PROMPT programmes. He also leads a translational science group in the Cambridge Research Institute with a focus on androgen receptor signalling, metabolism and novel diagnostic biomarkers. Vincent Gnanapragasam is the PI for a number of investigator led window trials in prostate cancer including the CHIRRP and DMAPS study and conducts laboratory research in growth factor signal regulation and translational research in treatment specific predictive biomarkers.
The prostate cancer research programme in Addenbrookes includes the collection of pre and post therapy biological samples (tissue, blood and urine) from men having different treatments for prostate cancer with further samples collected in follow up. These samples are used in multi-platform genomic analysis using high throughout and next generating sequencing methods to identify novel biomarkers. This work is underpinned by focused clinically relevant biological studies in cell lines, animal models and human tissue samples. A key aspect is close collaboration with other scientists and academics in Cambridge as well as nationally and internationally to optimally exploit skills and knowledge across different disciplines.
Working closely with urology colleagues we are also developing and assessing optimal pathways for clinical diagnosis and management including active surveillance protocols. A further important area is in seeking to improve the therapy pathways of patients by using novel biopsy and imaging methods to better diagnosis and monitor treatment outcomes. To achieve this we have established key clinical collaborations with a multi-disciplinary team including pathology, radiology and oncology. This is allowing us to develop novel translational window trials of new drugs and therapies in prostate cancer as well as clinical trials to test optimal therapy in different patient groups. These studies include biological and imaging endpoints as potential early surrogates of therapeutic efficacy.
List of current active academic prostate cancer studies
- PROTECT – National study of early detection and randomised trial of treatment in men with prostate cancer
- PROMPT – Collection of tissue and biological samples from men diagnosed and treated for prostate cancer (multi-centre)
- DMAPS – Study investigating the clinical value of diffusion weighted MRI in prostate cancer
- CHIRRP – Study investigating the use of MRI in monitoring treatment efficacy following androgen deprivation therapy
- DEGARELIX – Study of the biological and metabolic changes following androgen deprivation therapy
- PROSPUR – Study of the use of ultrasound to define pelvic tone before and after prostatectomy
- Da Vinci – Prospective collection of surgical and oncological outcomes following robot prostatectomy
Renal cancer research
Working with Professor Tim Eisen, we are seeking to develop a robust tissue and clinical database which can be used for biological and biomarker studies in renal cancer. We are also collaborating and recruiting into a number of trials of novel tyrosine kinase inhibitors currently open in the UK. A recent project is undertaking to construct a large tissue microarray of renal cancers linked to clinical outcomes for. This will be supplemented by a matched frozen tissue sample resource for transcript and genomic profiling.
List of current active academic renal and bladder cancer studies
- Tissue surplus to diagnostic requirements is being banked for molecular & genetic studies of urological malignancy
- Renal tissue microarray for biomarker detection and profiling
- NEOSUN and SORCE