🧵Glad to share our 10y results at #ASTRO23.
🔎looking for the biological benefit of ultrahypofractionation, safety and confort of the patient and cost-effectiveness of the process, this prospective study was initiated in 2010.
Super paper by @elenmol2 et al from @ucl + @TheChristieNHS on #MRLinac guided central lung #SABR
📢Check out the amazing cine movies of adaption to target on the journal website (screenshot below)
➡️No grade ≥ 3 toxicities
➡️Median FU of 28 months, 66.7% of patients alive
➡️Median PFS = 5.8 months, OS = 20 months
🔗 https://t.co/b9s3kWi0dJ
STOPCAP at #ESMO26
Benefit of #radiotherapy in de novo M1 #prostatecancer on OS & PFS.
Restricted to <5 bone or low volume mets on conventional imaging.
No interaction with other patient/tumor characteristics.
As expected people resist letting go of dogma. Lets review the common examples people grasp at:
1. Nodal field size: cited as why GETUG01 was negative (S1/S2), then cited why RTOG 9413 was negative (L5/S1), then POP-RT positive (L4/L5), but definitive trial of RTOG 0924 (L4/L5) negative
#astro25@NRGonc Rtog 0924 trial on 2500 patients testing whole pelvic RT.
Negative trial
-OS no difference
-PCSM no difference
-DM no difference
-BCR was not SS different with only 4% difference at 10 years.
-toxicity increased
3 cooperative group trials now negative: getug01, Rtog 9413, Rtog 0924.
Goodbye WPRT
Critically important. We have 2 RCTs addressing this question: @GiulioFrancoli1#ARTO (MDT + abi > abi) and T Niazi #PCS IX (MDT + Enza > Enza)
Also have #EXTEND and #RADIOSA showing MDT + ADT > ADT or MDT in mHSCP.
In my mind leading question is doublet ARPI + MDT in mHSPC
Continuous Androgen Deprivation Therapy with or Without Metastasis-directed Therapy for Oligometastatic Prostate Cancer: The Multicenter Phase 2 Randomized EXTEND Trial
https://t.co/oADg5v1pEf
The phase 2 EXTEND trial showed that in patients with oligometastatic #ProstateCancer adding metastasis-directed therapy (MDT) to androgen deprivation therapy (ADT)💊 significantly improved progression-free survival compared with ADT alone (36 vs 17 months in combined analysis), with consistent benefits in radiologic and castration resistance–free survival; translational analyses revealed that MDT + ADT enhanced systemic immune activation, particularly T-cell receptor dynamics, suggesting both a durable clinical benefit and potential synergy with future immunotherapy strategies.
@AlexSherryMD@BSiddiquiMD@cara_haymaker@ASeoMDPhD@kieko_hara@StephenChunMD@ChapinMD@matthewdeek@woodlandscancer@aaparicioMD@DrLCohen@AReubenPhD@sumit_subudhi@ChadTangMD@silkegillessen@AOmlin@nataliagandur@bavilima@yekeduz_emre
High-risk prostate cancer patients had a significantly lower incidence of distant metastasis with a radiotherapy-based treatment strategy than with a prostatectomy-based treatment #radonc#pcsm
https://t.co/MAaCYKkfXU
📢 New in European Urology @AmarUKishan et al:
🎯 MRI-guided SBRT for prostate cancer significantly reduces late GU and GI toxicity vs CT-guided SBRT at 2 years!
🔬 In the MIRAGE RCT, MRI guidance with tighter margins (2 mm) halved GU toxicity (27% vs 51%) and markedly reduced GI toxicity (1.4% vs 9.5%).
💡 Also linked to better bowel & sexual function scores. Proof-of-principle for aggressive margin reduction using advanced imaging.
📄 Read more: https://t.co/ShEUaJCD4p
#ProstateCancer #Radiotherapy #MRI #SBRT #UroRadOnc #EurUrol
📢 New in European Urology @AmarUKishan et al:
🎯 MRI-guided SBRT for prostate cancer significantly reduces late GU and GI toxicity vs CT-guided SBRT at 2 years!
🔬 In the MIRAGE RCT, MRI guidance with tighter margins (2 mm) halved GU toxicity (27% vs 51%) and markedly reduced GI toxicity (1.4% vs 9.5%).
💡 Also linked to better bowel & sexual function scores. Proof-of-principle for aggressive margin reduction using advanced imaging.
📄 Read more: https://t.co/ShEUaJCD4p
#ProstateCancer #Radiotherapy #MRI #SBRT #UroRadOnc #EurUrol
📢The experience from @RadioterapiaHM is just out!!
🎯Clinician- And Patient-Reported Outcomes Of Stereotactic Ablative Radiotherapy For High-Risk Prostate Cancer
#radonc#pcsm#SABR
https://t.co/e0vflOqcPC
🧾 New Cheat Sheet on Prostate Cancer Treatment by Stage
🔹 Low-risk: Active surveillance; avoid ADT
🔹 Intermediate-risk: Surgery or RT; ADT case-based
🔹 High-risk: Surgery/RT + long-term ADT
#EAUguidelines#ProstateCancer
Download Cheat Sheet here:
https://t.co/IvTGHuFWt6
📢This might just be THE DEFINITIVE meta-analysis of PSMA PET for #prostatecancer recurrence.
🚨Meta-analysis of 43 studies (n=8,119)
⬆️Sensitivity from 48% at PSA 0.2–0.5 ng/ml to >90% at PSA >2. Congrats @declangmurphy@drMPerera + team @Uroweb!
➡️link https://t.co/VYvAn6kli1
Proud to see EMERALD Trial findings presented at #ESTRO2025 by Dr. Somnath Mukherjee! Watch this short video from @drjamesgood to discover how MR-guided SABR is transforming pancreatic cancer treatment 🎥
Click to download ESTRO presentation 👉🏽 https://t.co/nU6gPp3eE5
That’s a wrap #ESTRO25! @ESTRO_RT Proud to see the hard work&commitement of the @GenesisCare to providing experience-based evidence in the pursuit of clinical improvement! Here our contribution to #SMART using MRIdian on #upperGI https://t.co/5p10Kk0lxy
💎 EMERALD trial in #ESTRO25
Congratulations Dr. Mukherjee for excellent presentation! Honored to have worked w/you.
🎯 3-arm safety trial investigating #SMART in localised #PancreaticCancer (50 Gy/5, 39 Gy/3, 25 Gy/1)
👏🏽Big shout-out to all authors
@GenesisCare@UniofOxford
🚨10y results of HYPO RT PC at #ESTRO25
Hypofractionated #prostatecancer RT (42,7/7) vs conv fractionated RT
1. Non inferior for FFS (even better?)
2. Similar bPFS, DMFS, ADT use, OS
3. Similar GU/GI tox (except transient flare at 1y for UHF)