University Lecturer in Uro-oncology and Consultant Urologist
Biography/Research interests
Vincent Gnanapragasam graduated 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 and one of the first recipients of a CRUK Clinician Scientist Fellowship given to a surgeon. His early laboratory work led to novel discoveries into the role of endogenous signalling regulators (SEF/SPRED) in prostate cancer development and mechanistic insights into treatment resistance from growth factor inhibitors.
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 has developed novel, more accurate, prognostic prediction models for both group stratified cohorts Cambridge Prognostic Groups and for individualised prediction Predict Prostate and pioneered risk stratified pathways for active surveillance follow up. These models have been shown to outperform current guideline endorsed risk models and have been adopted into local and regional guidelines Predict prostate is the only decision aid endorsed by the UK NICE National Guidelines on prostate cancer. He is CI of the TAPS01 study, NIHRi4i funded CAMPROBE study (based on his invention of a new simple device for infection free prostate biopsies), national Predict Prostate patient RCT and multi-centre PRIM biomarker-imaging cancer detection study. His work has been cited in prostate cancer guidelines by NICE and the European Association of Urology. To further interdisciplinary research in prostate cancer he established the Translational Prostate Cancer Group (TPCG) in Cambridge with colleagues from urology, oncology, radiology, pathology and basic science. The TPCG have so far collaborated on >50 peer reviewed papers with a combined grant income of >£3M. He has also established links with STEM scientists to develop biosensors for cancer detection across different platforms.
He is a member of the UK ICGC prostate group and on the clinical steering committee of the International Pan Prostate Cancer Collaborative. He is a founder member of the International GAP3 Active Surveillance consortium. To date he has raised over £4M in personal research funding covering basic, translational and clinical trials research, over £5M as co-investigator and published over 130 peer reviewed papers. He is also joint applicant on research collaboratives that have secured over £70M in funding.
His current clinical practice is in precision prostate cancer diagnostics and personalised medicine. He has introduced practice changing innovations including risk-based stratification and tailored surveillance which has standardised patient care and significantly reduced over-treatment. More recently, with colleagues from the TPCG, he has established a platform for Integrated Genomics and Clinical Profiling to explore the potential for targeted adjuvant therapies to improve primary cure rates in poor prognosis prostate cancer.
In the University of Cambridge, he leads the University Academic Urology Group and established the Cambridge Urology Translational Research and Clinical Trials office which has recruited>1600 patients to various NIHR and portfolio urology trials. He is also directorate lead for urology research. He holds patents and has won numerous prizes for research, including the CE Alken prize, Urological Research Society Medial, Hunterian Professorship and is a recipient of a University of Cambridge Vice Chancellors Award for Research Impact. He is also 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
