DEDUCER

Development of Diagnostics and Treatment of Urological Cancers

Treatments for urological cancers have improved dramatically in recent decades. However, some urological cancers do not yet have effective treatment. It is sometimes challenging to do early-stage diagnostics and to predict how the disease is going to develop in the case of an individual patient. For example, the majority of prostate cancers are clinically irrelevant, which means that they do not need to be treated at all. However, some of these cancers require more effective treatment than what is currently given.

The aim is to find more effective pharmacotherapy for urological cancers and to assess the patient’s response to new and promising medicines. The assessment of prognoses and treatments for urological cancers can only develop through basic and clinical research.

In recent years, significant additional information on the birth of cancers has been obtained when mapping the genome of benign and malignant cells in humans. Our goal is to improve the diagnosis and treatment of cancer through the use of new research methods, which would allow an increasing number of patients to receive more efficient and harmless, individually tailored precision treatment.

The aim of this study is to apply new methods that are already routinely used in research activities to the diagnosis and treatment of cancer. Samples are collected from patients who have given their consent without compromising standard diagnostics e.g. urine, blood, and tissue sampling at different stages of the disease where applicable.

The collected samples will be subjected to the studies described below to further determine the nature of the potential cancer. The samples and their data are stored and data from patient documents and other registers are attached to them. The goal is to develop new methods for the diagnostics, treatment, and prognosis of urological cancers and to improve the prognosis of patients with these diseases.

Study measures and methods

We are asking for consent from patients in the Helsinki University Hospital specific catchment area (HUS, South Karelia, Kymenlaakso, and Päijät-Häme health care districts) who are suspected to have or have been diagnosed with urological cancer and who are sent for further examination or treatment or who are already in treatment or under monitoring. Patients without cancer are also recruited for the study. Patients without cancer are also recruited for the study.

In the diagnosis phase, during possible treatments and/or during cancer monitoring, some of the following are collected from patients who have given their consent, as appropriate:

• Urine, blood, and tissue samples
• Ascites and/or pleural fluid sample
• Microbiological saliva and/or faecal samples

The total volume of blood samples shall not exceed 100 ml of blood (vein blood sample) per sampling. Tissue samples include tissue removed during cancer surgery or taken during biopsy without compromising primary diagnostics.

Examples of key research methods are:

1. Storing the samples mentioned above in the sample storage unit for future studies.
2. Isolation of (cancer) cells in the sample (tumour or normal tissue), cell and tissue culture, and determining drug susceptibility.
3. Further culturing of cultured cells as “permanent” cell and/or tissue models for the study.
4. Determining the alkaline order of the whole genome or all genes in the sample (so-called thorough sequencing and bioinformative identification), other identification of the molecular profile of the sample as well as clinical chemistry analyses.
5. Analysis of the patient’s normal tissue (e.g. tissue sample, blood sample) for reference and examination use.
6. Analysis of a previously taken (e.g. during the diagnosis phase) and archived cell or tissue sample taken from the patient or analysis of cell or tissue samples taken during treatments and monitoring.
7. Analysis of clinical imaging (e.g. MRI, computer images, isotope imaging), analysis of cell and tissue samples and their digital recordings and clinical data (patient record systems, patient register and national registers (Cancer Register, THL registers, Statistics Finland registers, Findata, Digital and Population Data Services Agency) together with other data, using traditional statistical analysis or using deep learning and artificial intelligence.

In other words, the aim is to examine the samples you give and determine, within the limits of available resources and using all available techniques, whether there is a change in your cancer that would contribute to the development of diagnostics, prediction of cancer behaviour and/or therapeutic action.

Based on the results of the sequencing and drug susceptibility analysis, it is possible, for example, to make the necessary additional determinations of the blood and/or urine sample taken if, for example, there is a measurable marker for the changed signal route in question

Processing and use of samples

Samples are collected in HUS units and processed in HUS laboratories or hospitals and in the facilities of the University of Helsinki.

Samples are stored at HUS and/or the University of Helsinki in a modern and reliable sample storage unit.

The storage of samples is carried out by trained personnel. The molecular diagnostic examinations of the samples are carried out at HUS or the University of Helsinki, in cooperation with other research groups or by companies offering analytics as outsourced services.

Body conducting the study and the sponsor

This study is carried out by HUS (Urology Clinic) and the University of Helsinki, and they also act as joint controllers of the personal data processed in the study. The study is carried out on the premises of the above-mentioned organisations.

The research group is responsible for the research funds. The research is funded by i.a. HUS (State Research Funding), Jane and Aatos Erkko Foundation, Academy of Finland, and Cancer Society of Finland.

No compensation will be paid to the Research Centre for carrying out the study. Research physicians and other personnel are not paid any separate compensation for carrying out the study.

Person responsible for the study: Professor Antti Rannikko

Study nurse: Minna Malmstedt, minna.malmstedt@hus.fi

Unit/clinic: HUS Urology Clinic and the Research Program in Systems Oncology (ONCOSYS) at the University of Helsinki