OBR Daily Commentary

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Researchers Develop New Approach To Radiation For Prostate Cancer

(Feinstein Institute) Feb 26, 2019 - Louis Potters, MD, deputy physician-in-chief and chairman of radiation medicine at the Northwell Health Cancer Institute, and professor at the Feinstein Institute for Medical Research, has demonstrated the safety and improved efficacy of increased dosage of radiation when treating prostate cancer, according to a new study.

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Howard Sandler, MD, MS, FASTRO (Posted: February 27, 2019)

quotesLouis Potters and colleagues report out a phase I study of dose escalation for low/intermediate risk prostate cancer using 5 fraction SBRT of 40, 45, and 50 Gy. They didn't detect any increased toxicity with the higher doses although other centers have seen higher doses with 50 Gy in 5 treatments. So far so good, but a small study doesn't have the power to detect a small but meaningful risk of serious late toxicities. I don't expect to see a bunch of relatively rare events with 40 or even 45 Gy but before offering men a more convenient (but so far not more efficacious) treatment, one should be pretty confident about safety.quotes

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Phase 3 Randomized Trial Data Shows SBRT has Similar Acute Safety Profile to Conventional Radiation Therapy in Patients with Localized Prostate Cancer

(MarketWatch) Feb 22, 2019 - Accuray Incorporated announced today that data from an international, randomized, 38-center trial (PACE - Prostate Advances in Comparative Evidence) show that treatment with stereotactic body radiation therapy (SBRT) results in a similar safety profile to conventional radiation in men with low- or intermediate-risk prostate cancer.

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Howard Sandler, MD, MS, FASTRO (Posted: February 22, 2019)

quotesThe PACE (Prostate Advances in Comparative Evidence) trial with two subcomponents: PACE-A and PACE-B is important in prostate cancer radiation and surgical oncology. PACE-B, recently reported some data comparing 'standard, 4-9 week' RT to 'SBRT, 5-fraction' RT, and is showing no difference in acute toxicity. If the tumor control is ultimately shown to be equivalent, then the shorter 5-fraction approach will be widely adopted (adoption is appropriately selective at this point). Results from the highly interesting PACE-A component, comparing surgery to SBRT, (not reported at ASCO GU Cancer Symposium) is eagerly awaited.quotes

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NRG Oncology Trial Affirms Hypofractionated Radiotherapy Should Be Considered New Practice Standard for Men with Low Risk Prostate Cancer

(NRG Oncology) Feb 15, 2019 - NRG Oncology trial affirms hypofractionated radiotherapy should be considered new practice standard for men with low risk prostate cancer.

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Howard Sandler, MD, MS, FASTRO (Posted: February 19, 2019)

quotesNew guidelines from ASTRO-ASCO recommend moderately hypofractionated radiotherapy for many men with prostate cancer based on multiple high quality randomized trials including an NRG trial: RTOG 0415. Patient reported outcomes from RTOG 0415 further support the safety of the shorter, hypofractionated regimen. The 3 largest, multicenter randomized trials (CHHiP, PROFIT, and 0415) have been practice changing and are providing men with a shorter, more convenient radiotherapy option.quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Associate Clinical Professor, Medical Oncology Executi...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics Professo...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Steven Spielberg Family Chair in Hematology Oncology P...

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Stephen M. Schleicher, M.D., MBA

Community Oncology, Medical Oncologist, OneOncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Health Policy
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William McGivney, PhD

National Health Policy Expert...