STAMPEDE: RT boosts survival in low-burden metastatic PCa

  • Parker CC & et al.
  • Lancet
  • 21 Oct 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • The addition of prostate radiotherapy (RT) to standard care improves survival in patients with newly diagnosed prostate cancer (PCa) who have low metastatic burden, but not in unselected patients.

Why this matters

  • Prostate radiotherapy can be a treatment option for newly diagnosed men with low metastatic burden.

Study design

  • STAMPEDE: randomized controlled phase 3 study of 2061 patients with newly diagnosed metastatic PCa, randomly assigned 1:1 to receive standard care with or without radiotherapy to the prostate.
  • All patients received androgen deprivation therapy; docetaxel was added to standard care in 18% of patients.
  • Funding: Cancer Research UK; UK Medical Research Council; others.

Key results

  • Median follow-up was 37 months.
  • Add-on radiotherapy did not improve OS vs standard treatment alone (HR, 0.92; P=.266).
  • Failure-free survival was significantly improved in patients who received radiotherapy (HR, 0.76; P<.0001>
  • In patients with low metastatic burden, compared with standard treatment alone, add-on radiotherapy improved:
    • OS: HR, 0.68 (P=.007; 3-year survival, 81% vs 73%); and
    • failure-free survival: HR, 0.59 (P<.0001>
  • Radiotherapy showed no survival benefit in patients with high metastatic burden.
  • Grade ≥3 adverse event rate was 22% with add-on radiotherapy and 21% with standard treatment alone.

Limitations

  • Open-label study.

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