Imperial Prostate 9 - ATLAS (Approaches To Long-Term Active Surveillance) 

A randomised controlled trial of regular MRI scans compared to standard care in patients with prostate cancer managed using active surveillance. 

Primary objective 

In patients on active surveillance for prostate cancer, to demonstrate that use of regular Magnetic resonance imaging (MRI) scans is better able to detect cancer progression over five years compared to the current National Institute for Health and Care Excellence (NICE) defined strategy.

Secondary objectives

• To carry out an economic evaluation to determine the cost-effectiveness of revising the prostate cancer active surveillance protocol to incorporate regular surveillance MRI.

In each randomised group to measure:

• Compliance to allocated surveillance strategy
• Patient reported outcome measures on urinary, sexual and bowel function; cancer-related anxiety; and overall health-related quality of life
• Proportion undergoing biopsy
• MRI and biopsy-related side-effects and complications
• Proportion treated, and types of treatment (surgery, radiotherapy, focal therapy) in patients with or without progression.