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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Pelvis Or Involved Node Treatment: Eradicating Recurrence in Prostate Cancer (POINTER-PC) - study protocol paper for

Finbar Slevin1,2, Sophie Alexander3,4, Sarah R Brown5

  • 1Leeds Institute of Medical Research, University of Leeds, Leeds, UK finbarslevin@nhs.net.

BMJ Open
|December 26, 2024
PubMed
Summary

This study compares extended nodal irradiation (ENI) with stereotactic body radiotherapy (SBRT) for prostate cancer recurrence. ENI shows promise for improving metastasis-free survival and reducing toxicity in patients with pelvic nodal recurrence.

Keywords:
Prostatic NeoplasmsRADIOTHERAPYToxicity

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Area of Science:

  • Oncology
  • Radiotherapy
  • Clinical Trials

Background:

  • Prostate cancer (PCa) recurrence is common after initial treatment for high-risk disease.
  • Pelvic nodal recurrence lacks a standard treatment, with options including SBRT and ENI.
  • Observational data suggest ENI may improve metastasis-free survival (MFS) with low toxicity compared to SBRT.

Purpose of the Study:

  • To compare the efficacy of ENI versus SBRT in patients with PCa pelvic nodal recurrence.
  • To evaluate the impact of ENI and SBRT on metastatic progression.
  • To assess the long-term toxicity of different ENI fractionation schedules.

Main Methods:

  • A UK multicentre, open-label, phase III randomised controlled trial (POINTER).
  • Randomisation of 480 participants to SBRT, 5-fraction ENI, or 20-fraction ENI.
  • Coprimary endpoints: MFS at 3 years and participant-reported late bowel toxicity at 3 years.

Main Results:

  • This section is not yet available as the trial is ongoing.

Conclusions:

  • This trial will provide high-quality evidence on the optimal radiotherapy strategy for PCa pelvic nodal recurrence.
  • Findings will inform treatment decisions and potentially establish ENI as a preferred approach.
  • Biomarker analysis will support personalized treatment strategies.