Re: Radiotherapy to the Primary Tumour for Newly Diagnosed, Metastatic Prostate Cancer (STAMPEDE): A Randomised Controlled Phase 3 Trial.

Abstract

Experts’ summary: In this randomised trial, Parker et al. [1] studied the effect of radiotherapy to the prostate on overall survival (OS) in 2061 men with metastatic prostate cancer (PCa), of whom 1029 were randomised to standard of care (SOC; androgen deprivation therapy [ADT] docetaxel) and 1032 were randomised to SOC plus prostate radiotherapy between 2013 and 2016. In unselected newly diagnosed metastatic patients, radiotherapy to the prostate did not improve OS (0.92, 0.80–1.06; p = 0.266). In the prespecified subgroup analysis by baseline metastatic burden (a high metastatic burden was defined as four or more bone metastases with one or more outside the vertebral bodies or pelvis, or visceral metastases, or both), OS was improved in patients with a low metastatic burden who were randomised to radiotherapy (hazard ratio 0.68, 95% confidence interval 0.52–0.90; p = 0.007). The authors conclude that prostate radiotherapy should be a standard treatment option for men with a low metastatic burden.