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Is SBRT replacing systemic therapy?
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Or should they be combined?
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TOAD trial
(Duchesne et al, ASCO 2015): immediate versus delayed ADT
at PSA relapse after definitive therapy
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HR=0.55 (CI: 0.30-1.00)
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CHAARTED-
(Sweeney et al NEJM 2015): ADT+docetaxel versus ADT alone
in advanced stage hormone sensitive PCa
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HR=0.61 (CI: 0.47-0.80)
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m-OS: 58 and 44 months, respectively
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STAMPEDE
(James et al Lancet 2016): SOC+docetaxel versus SOC in
advanced stage hormone sensitive PCa
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HR=0·78 (CI: 0·66–0·93)
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Combination with immune stimulating agents
SBRT of prostate cancer and systemic therapies