Plasma AR Alterations and Timing of Intensified Hormone Treatment for Prostate Cancer

Rákkutatás · Prostate cancer

Stereotactic ablative radiotherapy (SABR) improves progression‑free survival and reduces progression at 6 months compared with observation in men with oligometastatic hormone‑sensitive prostate cancer.

This phase‑2, randomized clinical trial evaluated whether stereotactic ablative radiotherapy (SABR) improves oncologic outcomes versus observation in men with recurrent hormone‑sensitive oligometastatic prostate cancer. Fifty‑four men were randomized (36 to SABR, 18 to observation); progression at 6 months occurred in 7 of 36 (19%) in the SABR arm and 11 of 18 (61%) in the observation arm (P = 0.005). SABR improved median progression‑free survival (not reached vs 5.8 months; hazard ratio 0.30; 95% CI 0.11–0.81; P = 0.002). No grade ≥ 3 toxicities were observed. SABR was associated with a systemic immune response, and baseline immune phenotype and tumour mutation status may predict benefit. These results support SABR as a promising local consolidative strategy that may delay initiation of androgen‑deprivation therapy (ADT) and improve outcomes in oligometastatic hormone‑sensitive prostate cancer.

SABR offers a potential way to postpone systemic ADT—often fraught with adverse effects—while improving disease control in men with oligometastatic prostate cancer. Demonstrating a meaningful benefit for a targeted, non‑systemic modality could shift the treatment paradigm toward trials of local consolidation before early systemic therapy.

Bizonyítékszint: Megerősített klinikai bizonyíték. Több vagy erősebb humán vizsgálat támogatja.

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