Dr. Parker on the Rationale for Radiotherapy in Metastatic Prostate Cancer

Chris Parker, MD, consultant clinical oncologist, The Royal Marsden NHS Foundation Trust, discusses the rationale for radiotherapy in the treatment of newly-diagnosed metastatic prostate cancer.

This subgroup of patients has always been managed with drug treatment, says Parker. They do not have specific treatment to the prostate, such as radiotherapy, unless they show symptoms. In some animal models, treating the primary cancer showed a slowing of metastasis, which improved survival. This hypothesis was then tested in a subgroup analysis from the STAMPEDE trial, where patients with newly-diagnosed metastatic prostate cancer with a low metastatic disease burden were given radiotherapy in addition to standard of care therapy.

Findings showed that men with low metastatic disease burden demonstrated a 32% improvement in overall survival (OS) when given radiotherapy plus standard of care therapy compared with men who received standard of care treatment alone. The absolute improvement in OS in this group at 3 years was 81%. However, OS was not improved with radiotherapy in the 1120 men with a higher metastatic burden.