ARTO trial was a phase II randomized trial suggesting the benefit of a concomitant treatment strategy including Abiraterone acetate plus predisone (AAP) and stereotactic body radiotherapy (SBRT) in oligometastatic castrate resistant prostate cancer (omCRPC). The object of the current analysis is to explore whether the benefit provided by SBRT to AAP is maintained at later stages of disease after oligoprogression METHODS: Patients enrolled in ARTO trial in whom a first progression event was reported were divided in two groups according to the treatment approach received, regardless of the initial randomization. After first progression event, Patients in Group A received SBRT on oligoprogressive disease, while patients in group B received second line systemic treatment. Palliative RT was not considered for the purpose of this analysis. Progression-Free survival (PFS) 1 and 2 were defined as time between AAP start and first progression event and time between first and second progression event, death or last follow up, (whichever came first), respectively. Cox regression analysis was performed to compare PFS1 + PFS2 in patients in group A vs Group B. Kaplan-Meier analysis was performed to compare overall survival between the two groups RESULTS: Median PFS1 + PFS2 was 45.9 months vs. not reached in group A (n = 43) vs Group B (n = 20), respectively (HR 0.63, 95% CI 0.17-2.33, p value 0.489), no significant difference was detected. Median OS was not reached in neither of the two arms of treatment, with a non-significant trend in favour of the experimental arm (HR 0.50, 95% CI 0.14-1.78, p = 0.284) CONCLUSIONS: Results from the present analysis show that SBRT after progression may be a viable and feasible option for omCRPC after progression if compared to second line systemic therapy.
Prostate cancer and prostatic diseases. 2025 Feb 19 [Epub ahead of print]
Giulio Francolini, Niccolò Bertini, Vanessa Di Cataldo, Pietro Garlatti, Michele Aquilano, Saverio Caini, Alessio Bruni, Gianluca Ingrosso, Rolando Maria D'angelillo, Luca Tagliaferri, Matteo Augugliaro, Luca Triggiani, Silvana Parisi, Giorgia Timon, Fabio Arcidiacono, Giulia Marvaso, Barbara Alicja Jereczek-Fossa, Andrea Lancia, Ciro Franzese, Filippo Alongi, Gabriele Simontacchi, Daniela Greto, Pierluigi Bonomo, Mauro Loi, Giulio Frosini, Luca Burchini, Isacco Desideri, Icro Meattini, Richard K Valicenti, Lorenzo Livi
Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy. ., Department of Biomedical, Experimental and Clinical sciences "Mario Serio", University of Florence, Florence, Italy., Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, University of Florence, Florence, Italy., Cyberknife Unit, Istituto Fiorentino di Cura ed Assistenza, IFCA, Florence, Italy., Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy., Radiation Oncology Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Radiation Oncology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy., UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Rome, Italy., Unit of Radiotherapy, Azienda USL-IRCCS di Reggio Emilia, Reggio emilia, Italy., Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, Brescia, Italy., Radiation Oncology Unit, Department of Biomedical, Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy., Radiation Oncology Centre, S.Maria Hospital, Terni, Italy., Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy., Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy., Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy., Department of Radiation Oncology, UC Davis, Sacramento, CA, USA.