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Updated: Jun 8, 2025

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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The impact of progression-directed therapy on survival in metastatic castration-refractory prostate cancer: MEDCARE

Kato Rans1, Karolien Goffin2,3, Steven Joniau4,5

  • 1Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.

BJU International
|November 7, 2024
PubMed
Abstract

Insights

Progression-directed therapy (PDT) may delay the need for next-line systemic treatment (NEST) in patients with oligoprogressive metastatic castration-refractory prostate cancer (mCRPC). This phase 3 trial investigates PDT

Area of Science:

  • Oncology
  • Prostate Cancer Research
  • Clinical Trials

Background:

  • Metastatic castration-refractory prostate cancer (mCRPC) poses significant therapeutic challenges with limited survival options.
  • Next-line systemic treatment (NEST) is standard for progressive mCRPC but involves toxicity and cost.
  • Progression-directed therapy (PDT) may delay NEST initiation in oligoprogressive mCRPC.

Purpose of the Study:

  • To evaluate the impact of progression-directed therapy (PDT) on overall survival (OS) in patients with oligoprogressive metastatic castration-refractory prostate cancer (mCRPC).
  • To compare PDT against standard-of-care therapy (surveillance or NEST) in this patient population.

Main Methods:

  • The MEDCARE phase III trial is a multicentric, randomized, prospective study.
  • 246 patients with oligoprogressive mCRPC will be randomized 1:1 to receive either standard-of-care or PDT while continuing current systemic treatment.
  • Stratification will be based on lesion number/location and prior therapies; primary endpoint is OS.

Main Results:

  • This section is not yet available as the trial is ongoing.
  • Secondary endpoints include quality of life, progression-free survival, and treatment toxicity.

Conclusions:

  • This is the first randomized phase 3 trial to investigate progression-directed therapy (PDT) in patients with oligoprogressive metastatic castration-refractory prostate cancer (mCRPC), using overall survival (OS) as the primary endpoint.
Keywords:
metastasectomymetastasis‐directed therapymetastatic castration‐refractory prostate cancermetastatic prostate canceroligoprogressive prostate cancerstereotactic body radiotherapy

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