Single-center randomized phase 2 trial of addition of ADT to SBRT for hormone-sensitive oligorecurrent prostate cancer

Metastasis-directed therapy by stereotactic body radiotherapy (SBRT) improves clinical outcomes in the oligometastatic prostate cancer setting. The randomized phase 2 RADIOSA trial at the European Institute of Oncology (Milan, Italy) evaluated addition of androgen deprivation therapy (ADT) to SBRT for hormone-sensitive oligorecurrent prostate cancer. Patients were randomized to SBRT alone or SBRT plus six months of ADT. With a median follow-up of 31 months (IQR 16-36) for both groups, the median clinical progression-free survival was 15.1 months in de SBRT alone group versus 32.2 months in the SBRT plus ADT group (HR 0.43; p<0.0010). Addition of ADT to SBRT was tolerated well. The authors conclude that RADIOSA is the first randomized trial in the metachronous oligometastatic hormone-sensitive prostate cancer setting to report improved clinical progression-free survival with the combination of SBRT and a short course of ADT.