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EAU 2017

EAU 2017: 4th ESO Prostate Cancer Observatory: The Radiation Oncologist’s Perspective

London, England (UroToday.com) The esteemed Dr. Bolla provided the radiation oncologist’s perspective at this morning’s EAU 2017’s 4th ESO Prostate Cancer Observatory: Innovation and Care in the Next 12 Months. Dr. Bolla started by highlighting that there are now three randomized phase III trials showing that moderate hypofractionation (2.5-3.4 Gy per fraction) delivered with 3D conformal radiotherapy (3D-CRT) with or without intensity modulation is equivalent to low conventional fractionation (2 Gy/fraction) for men with low and intermediate risk prostate cancer with regard to treatment efficacy. Additionally, this treatment regimen is associated with decreased toxicity, cost and treatment duration.

Dr. Bolla also reviewed the results of the CETUG-AFU 16 trial of which 743 patients with undetectable PSA for >6 months after radical prostatectomy who then experienced a biochemical recurrence (PSA 0.2-2 ng/mL) received 3D-CRT or intensity-modulated radiation therapy (IMRT) (66 Gy to the prostate +/- 46 Gy to the pelvis) and were randomized to +/- 6 months of LHRH agonist therapy. Although there was no difference in 5-year overall survival between the two groups (RT 95% vs RT+LHRH agonist 96%; HR 0.66, 95%CI 0.36-1.22), patients receiving a short course of LHRH agonist therapy had a significant reduction in 5-year progression free survival (RT 62% vs RT+LHRH agonist 80%; HR 0.50, 95%CI 0.38-0.66).

Finally, Dr. Bolla highlighted a number of exciting points for the next 12 months in the radiation oncology arena including (i) prospective clinical trials assessing stereotactic radiotherapy for patients with low and intermediate risk prostate cancer, (ii) three trials assessing salvage radiotherapy with androgen suppression, (iii) ongoing phase III randomized trials assessing radiotherapy in the setting of complete androgen blockade (LHRH agonist + abiraterone + enzalutamide, (iv) two trials assessing prophylactic lymph node irradiation in clinically N0 patients, (v) two trials assessing radiotherapy + ADT +/- docetaxel in high-risk patients, and (vi) three prospective trials assessing the optimal treatment of patients with oligometastatic disease. 2017 will be exciting indeed!

Presented by: Michel Bolla, Grenoble University Hospital, Grenoble, France

Written by: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto
Twitter: @zklaassen_md

at the #EAU17 -March 24-28, 2017- London, England