Investigating new surgical treatments to improve aggressive prostate cancer survival

ATLANTA is the first ever randomised control trial looking at using focal therapy alongisde traditional surgery and radiotherapy to improve survival in men with metastatic prostate cancer.

ATLANTA will be the largest cytoreductive local treatment trial in the world.

A team of experts led by Professor Hashim Ahmed, based at Imperial College London, will be conducting this novel study.

This trial is funded by the Wellcome Trust charity and is managed by Imperial Clinical Trials Unit (ICTU).

47,000

Men in the UK are diagnosed with prostate cancer each year

30%

3 in 10 prostate cancer diagnoses are already advanced

New Research

Suggests treating the prostate tumour even in already advanced disease may significantly improve survival

ATLANTA

Will test this new research with standard and new cutting edge prostate therapies not yet available in the NHS

Overview

918 patients with biopsy and imaging proven metastatic prostate cancer, that are fit to undergo a treatment available in the trial, will be randomised to either: focal therapy (Intervention Arm 1), Prostatectomy or Radiotherapy (Intervention Arm 2), Standard of Care alone (Control Arm)

Focal Therapy &
Standard of Care

Using highly focused ultrasound energy or targeted freezing techniques, focal therapy destroys the prostate tumour without damaging adjacent tissue.

This single day case procedure has minimal risk. It has reported improved post-operative erectile dysfunction and urinary incontinence rates. Approved by NICE for other forms of prostate cancer treatment.

Patients in this arm will also be offered highly focused radiotherapy (Stereotactic ablative radiotherapy or SABR) treatment directed at metastatic deposits

Prostatectomy &
Standard of Care

Prostatectomy uses the latest keyhole and robotic assisted surgery to remove the whole prostate gland and surrounding affected tissue directly.

This longstanding surgical techniques has been improved significantly to reduce this to an average 3 hour procedure with an overnight stay in hospital. Approved by NICE in other forms of prostate cancer treatment

Patients in this arm will also be offered highly focused radiotherapy (Stereotactic ablative radiotherapy or SABR) treatment directed at metastatic deposits

Radiotherapy &
Standard of Care

A long standing approach to treating aggressive prostate cancer

Radiotherapy at curative high dose will be offered to men with advanced disease for the first time

Approved by NICE in other forms of prostate cancer treatment

Patients in this arm will also be offered highly focused radiotherapy (Stereotactic ablative radiotherapy or SABR) treatment directed at metastatic deposits

Standard of Care

This is the current gold standard NICE approved for all patients with advanced disease. All patients will receive this in additional trial treatments.

Treatment involves traditional hormone therapy (ADT) combined with new chemotherapy agents that have been proven to improve overall survival. Low dose radiotherapy may also been given to improve symptoms