University Lecturer in Uro-oncology and Consultant Urologist
Biography/Research interests
Vincent Gnanapragasam graduated with BMedSci and MBBS degrees from Newcastle University. Following basic surgical training, he was one of the first trainees to be funded through a Cancer Research UK PhD for Clinicians. Whilst undertaking Higher Specialist Training in Urology in the North East, Vincent was appointed as Urology First Assistant (Clinical Lecturer) at Newcastle University in 2003.
In 2004, supported by the first CRUK Clinician Scientist Fellowship given to a surgeon, Vincent established his own research laboratory group. This work revealed novel insights into the role of negative signalling regulators in cancer metastasis and progression. He moved to Cambridge following the award of a HEFCE Senior Lectureship in 2007.
He is currently a University Lecturer at the University of Cambridge, and Honorary Consultant Urologist at Addenbrooke’s Hospital, Cambridge. Vincent’s research covers the full spectrum of basic science, translational, clinical and epidemiological disciplines in prostate cancer. He is CI of 3 multi-centre trials: the NIHR i4i funded CAMPROBE study, Predict Prostate RCT and PRIM bio-marker/imaging study. As well as this, he leads investigator initiated translational studies including the TAPS01 (Janssen) and ICON (CRUK) studies.
He is also Chief Investigator of the Cambridge Urological Biorepository which holds a unique collection of >6000 samples, biofluids and data on urological cancers and benign disease currently being used in over 50 research studies in Cambridge and internationally. He has developed the concept of precision medicine in primary aggressive prostate cancer through pilot work in a virtual molecular MDT. He is a member of the UK ICGC prostate group and on the clinical working group of the International Pan Prostate Cancer Collaborative and GAP 3 Active Surveillance consortium. He has developed novel more accurate prognostic prediction models for both group stratified cohorts Cambridge Prognotics Groups and for individualised prediction Prostate Predict and pioneered risk stratified pathways for active surveillance follow up.
To date he has raised over £9M in research grant funding and published over 120 peer reviewed papers, many in very high impact papers e.g. Nature, Nature Genetics, Plos Med, BMC Med and European Urology. His work has been cited and endorsed in prostate cancer guidelines by NICE and the European Association of Urology.
Prognostic tools he has developed are now recommended for use by CRUK and MacMillan Cancer Support amongst others, and have entered routine clinical practice. In the University of Cambridge he (i) leads the University Academic Urology Group, (ii) co-leads the CRUK Cambridge Cancer Centre Urological Malignancies Programme and (iii) established and directs the Cambridge Urology Translational Research and Clinical Trials (CUTRACT) office. He holds patents and has won numerous prizes for research including the CE Alken prize, Urological Research Society Medical and a Hunterian Professorship. His students have been awarded many prizes including the EAU residents prize and Urology Foundation medal. He is also a Visiting Professor at Anglia Ruskin University.
Key impact papers:
Thurtle DR, Jenkins VL, Pharoah PD, Gnanapragasam VJ. Understanding of prognosis in non-metastatic prostate cancer: A randomised comparative study 2 of clinician estimates measured against the PREDICT prostate prognostic model. Br J Cancer (2019) IF 5.9 (In Press) (Impact statement -conceived and led this work across nearly 200 clinicians and nurses which revealed how poor health professionals were in estimating risk of dying from a new prostate cancer diagnosis. We also showed that using a standardised tool significantly reduced the variance in likelihood in recommending treatment across clinicians by as much as 30% thus helping to standardise the information and guidance patients may receive).
Thurtle DR, Greenberg DC, Lee LS, Huang HH, Pharoah PD, Gnanapragasam VJ. Individual prognosis at diagnosis in non-metastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model. PLoS Med (2019) IF 11.7 Mar 12;16(3):e1002758. doi: 10.1371/journal.pmed.1002758. (Impact statement -conceived and led this seminal work to produce the first individualised prognostic model for new prostate cancer which estimates overall and cancer survival with and without treatment- powers the Public Health England Predict Prostate webtool: Prostate.predict.nhs.uk endorsed by NICE as the only recommended decision aid in postate cancer. Also endorsed by CRUK and MacMillan cancer Support.
Gnanapragasam VJ, Barrett T, Thankapannair V, Thurtle D, Rubio-Briones J, Domínguez-Escrig J, Bratt O, Statin P, Muir K, Lophatananon A. Using prognosis to guide inclusion criteria, define standardised endpoints and stratify follow-up in active surveillance for prostate cancer. BJU Int. (2019) IF 4.5 May 7. doi:10.1111/bju.14800. (Impact statement -conceived and led this first study to establish a safe start and endpoint for surveillance in prostate cancer. This work led to the East of England Cancer Alliance recommendation to use prognosis to guide and standardise Active Surveillance practice in the region)
Thurtle D, Starling L, Leonard K, Stone T, Gnanapragasam VJ. Improving the safety and tolerability of local anaesthetic outpatient transperineal prostate biopsies: A pilot study of the CAMbridge PROstate Biopsy (CAMPROBE) method. J Clin Urol. (2018) IF pending May;11(3):192-199. (Impact statement -conceived and invented a new safer way to do biopsies using a cheap device to eliminate infection and sepsis risk from prostate biopsies. Here the pilot trial on outcomes is reported and the data supported our NIHR i4i grant in 2017 of a new low cost disposibal device).
Wedge DC et al.Sequencing of prostate cancers identifies new cancer genes, routes of progression and drug targets. Nat Genet. (2018) May;50(5):682-692. doi: 10.1038/s41588-018-0086-z. IF 29.6 Mar 2. doi: 10.1038/ng.3221. ICGC Prostate Group. (Impact statement – ICGC Cambridge lead urologist contributing more than half of the index cases, key paper proving new pathways for molecular directed therapy in early prostate cancer for precision medicine approaches).
Gnanapragasam VJ, Bratt O, Muir K, Lee LS, Huang HH, Stattin P, Lophatananon A. The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study. BMC Med (2018) IF 9 Feb 28;16(1):31. doi: 10.1186/s12916-018-1019-5. PubMed PMID: 29490658 (Impact statement – designed and led this international study of>70,000 men validating the Cambridge Prognostic Groups as a much more accurate tool to stratify men by prognosis with an accuracy >80%. cambridgeprognosticgroups.com)
Thurtle D, Barrett T, Thankappan-Nair V, Koo B, Warren A, Kastner C, Saeb-Parsy K, Kimberley-Duffell J, Gnanapragasam VJ. Progression and treatment rates using an active surveillance protocol incorporating image-guided baseline biopsies and multiparametric magnetic resonance imaging monitoring for men with favourable-risk prostate cancer. BJU Int. (2018) Feb 13. doi: 10.1111/bju.14166. (Impact statement – first paper to show the true progression rates in well characterized men on active surveillance). Cited in the 2019 NICE prostate cancer guidelines.
Hori S, Wadhwa K, Pisupati V, Zecchini V, Ramos-Montoya A, Warren AY, Neal DE, Gnanapragasam VJ. Loss of hSef promotes metastasis through upregulation of EMT in prostate cancer. Int J Cancer (2017) IF 7.3 Jan 10. doi: 10.1002/ijc.30604.. (Impact statement – designed, supervised and led this study which proved the first mechanistic link between loss of the tumour suppressor hSef and the process of metastasis in prostate cancer)
Gnanapragasam VJ, Lophatananon A, Wright KA, Muir KR, Gavin A, Greenberg DC. Improving Clinical Risk Stratification at Diagnosis in Primary Prostate Cancer: A Prognostic Modelling Study. PLoS Medicine (2016) IF 14.4 http://dx.doi.org/10.1371/journal.pmed.1002063 (Impact statement – designed and led the first study demonstrating a new prognostic model that outperforms the current national standard in predicting prostate cancer death-webtool launched and embedded into hospital practice)
Gnanapragasam VJ, Burling K, George A, Stearn S, Warren A, Barrett T, Koo B, Gallagher FA, Doble A, Kastner C, Parker RA. The Prostate Health Index adds predictive value to multi-parametric MRI in detecting significant prostate cancers in a repeat biopsy population. Sci Rep (2016) IF 5.2 Oct 17;6:35364. doi:10.1038/srep35364. (Impact statement – led the first study to report combining a serum marker and imaging to detect aggressive prostate cancer) Cited in the 2019 NICE prostate cancer guidelines
