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Latest Research in Prostate Cancer

Across the world, radiation oncologists are actively researching safe and effective radiation treatments, including more personalized approaches and studies of lower doses for a variety of cancers. The following research studies were presented during the ASTRO Annual Meeting in October 2020. Annually, ASTRO hosts the largest gathering of radiation oncology professionals in the world to share the latest science and research, all designed to improve patient care, support clinical practice and advance science and research in the field of radiation oncology.  

The information provided below highlights the research provided in the studies included in the Best of ASTRO onDemand course. This information is not intended as medical advice. It is important to review and discuss all treatment options, including radiation therapy with your primary care physician before determining which option or combination of options is best for you and your lifestyle. 

Studies in Prostate Cancer

Discussant: Gerard Morton, MD
Patient Takeaways prepared by Michael Corradetti, MD, PhD

Prostate cancer patients with intermediate- and high-risk disease may benefit from a higher, boosted dose of radiation therapy (RT). Multiple trials have shown promise investigating a variety of boost techniques:

  • The ASCENDE RT trial employed a brachytherapy (“internal” RT) boost.
  • The HYPOPROST trial employed an ultrahypofractionated (i.e., a higher dose per treatment) boost.
  • The FLAME trial demonstrated that a focal lesion within the prostate could be identified by MRI and “microboosted” to a high dose.

Short-term androgen deprivation therapy (ADT) works synergistically with RT in prostate cancer patients to enhance its efficacy and may reduce the toxicity of treatment by reducing the size of the prostate.

  • It remains controversial whether patients benefit from a period of ADT prior to the initiation of RT, or whether ADT can start concurrently with RT.
  • The HERO trial demonstrated that Relugolix is a promising oral ADT option which may become preferable to injectable options, especially in patients with pre-existing heart disease.

Patients with locally recurrent prostate cancer after RT may benefit from salvage brachytherapy.

  • Local recurrence or persistence of disease occurs in 10-30% of patients following definitive RT. In many instances, these patients are managed with palliative intent.
  • The NRG/RTOG 0526 trial demonstrated that brachytherapy is a promising alternative curative option which compares favorably to salvage prostatectomy.

Accurate imaging is essential to guide treatment in patients with recurrent prostate cancer after prostatectomy.

  • The EMPIRE-1 trial utilized Fluciclovine PET/CT to better define patients who are more likely to benefit from salvage RT and helped the radiation oncologist delineate the radiation plan. There were improved outcomes in patients who received this type of “molecular imaging.”
Download the PDF of the Best of ASTRO Patient Takeaways