- Adding prostate radiotherapy (RT) to androgen deprivation therapy (ADT) improves survival in men with metastatic hormone-sensitive prostate cancer (mHSPC) who have
- RT improves 3-year biochemical progression and failure-free survival (FFS) in unselected patients.
Why this matters
- Framework for adaptive meta-analysis (FAME) helps anticipate emerging trial results and identify the earliest opportunity for reliable meta-analysis.
- Future research should focus on timing and optimal dose of radiotherapy.
- STOPCAP FAME meta-analysis of 3 randomized trials (ongoing PEACE-1, completed HORRAD and STAMPEDE) involving 2126 men with mHSPC.
- Patients were randomly assigned to RT+ADT or ADT alone.
- Funding: UK Medical Research Council.
- No significant overall difference between groups in OS (2 studies; HR, 0.92; P=.195) or PFS (HR, 0.94; P=.238).
- Add-on RT yielded a significant reduction in biochemical progression (HR, 0.74; P=.94×10−8; absolute improvement in 3-year survival, 11%).
- FFS improved significantly with radiotherapy (HR, 0.76; P=.64×10−7).
- 4% of men who received prostate radiotherapy experienced severe acute bladder toxicity, and 1% reported severe acute bowel toxicity.
- Effect of radiotherapy varied with bone metastases: men with
- Meta-analysis included 1 ongoing trial.