Dr. Sean McBride | Best of GU Radiation Oncology

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Join Dr. Sean McBride, Vice Chair of Radiation Oncology and Chief of External Beam Radiation at Memorial Sloan Kettering, as he presents the Best of GU Radiation Oncology 2026. This session reviews landmark trials shaping radiation therapy for prostate cancer, including oligometastatic, definitive, and salvage settings.

Key highlights include:

1️⃣ Oligometastatic Prostate Cancer:

• PCS9 Trial: SBRT added to ADT + Enzalutamide improves radiographic and biochemical progression-free survival in castrate-resistant patients.
• LUNAR Trial: Neoadjuvant Lutetium (Pluvicto) before SBRT significantly prolongs progression-free survival in hormone-sensitive oligometastatic disease.

2️⃣ Definitive Prostate Cancer:

• RTOG-0924: Whole pelvic elective radiation shows no OS benefit in unfavorable intermediate/favorable high-risk patients; minimal toxicity differences.
• ENZARAD: Enzalutamide plus prostate-directed RT shows no benefit in N0 patients; clear benefit for N1 disease.

3️⃣ Biochemical Recurrence:

• GU006 / PAM50: Luminal B tumors benefit from short-course ARPI with salvage RT; non-luminal B tumors show no significant improvement.

4️⃣ Practice-changing takeaways:

• SBRT is a standard for selected oligometastatic CRPC patients.
• Neoadjuvant Lutetium may become a preferred option for oligometastatic HSPC.
• Elective pelvic radiation is largely unnecessary in high-risk definitive cases.
• PAM50 subtype can guide short-course ARPI in salvage therapy.
Categoria
Oncology
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