Prostate Cancer
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Oct 12 – Oct 19, 2026
Dose-Escalated Focal Salvage High-Dose-Rate Brachytherapy and Genomic Classifier Risk Stratification in Radiorecurrent Prostate Cancer: The F-SHARP Phase I/II Clinical Trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
F-SHARP is a multi-institutional phase I/II prospective clinical trial evaluating dose-escalated focal salvage high-dose-rate brachytherapy (DE-fsHDR) in 62 patients with intraprostatic radiorecurrence after definitive radiotherapy for localized prostate cancer. Patients received up to 30 Gy in one or two fractions, with the primary endpoint of acute grade ≥3 genitourinary and gastrointestinal toxicity and secondary endpoints including quality of life, disease control, and genomic classifier (GC) risk stratification via a clinical-grade transcriptome assay. No acute grade 3 toxicities occurred and two patients (3.2%) had late grade 3 toxicity; three-year survival rates were 62.7% (bPFS), 67.5% (rPFS), 73.0% (LRFS), and 85.9% (MFS), with no differences between fractionation groups. Among 31 patients with GC results, higher scores were associated with worse bPFS, rPFS, LRFS, and MFS, and all four patients with GC score >0.85 experienced recurrence. The authors conclude that DE-fsHDR is a safe and effective salvage treatment for intraprostatic radiorecurrence and that GC score is a promising prognostic tool warranting further study to guide treatment intensification.
10.1200/JCO-25-02730
Immune biomarkers of response and resistance to ipilimumab and nivolumab in metastatic castration-resistant prostate cancer.
SCI ADV · Q1 JOURNAL - RANK #12/135TOP-TIER
The AMADEUS prostate expansion cohort (NCT03651271) is a prospective clinical trial evaluating escalating ipilimumab doses combined with nivolumab in 32 patients with metastatic castration-resistant prostate cancer. Coprimary endpoints were 6-month disease control rate (DCR) and changes in tumoral CD8 percentage, with DCRs of 33% (4/12) for I1+N360, 20% (1/5) for I3+N1, and 20% (3/15) for I5+N1, and a median tumoral CD8 increase of 5.0%. Higher ipilimumab doses were tolerable, but I1+N360 achieved similar disease control and immune activation with a more favorable safety profile. Early progression correlated with a TREM2-associated myeloid gene signature, also enriched in two independent prostate cancer datasets.
10.1126/sciadv.aee8730
Talazoparib plus enzalutamide in high-volume metastatic hormone-naive prostate cancer: a randomized phase 2 trial.
NAT MED · Q1 JOURNAL - RANK #1/195TOP-TIER
This randomized phase 2 trial evaluated talazoparib plus enzalutamide versus enzalutamide alone in 54 men with high-volume metastatic hormone-naive prostate cancer, using a 1:2 randomization after two cycles of enzalutamide lead-in. The combination arm achieved a 73% PSA <0.2 ng/ml response rate at 12 months (95% CI 56-86%), exceeding the prespecified efficacy threshold (P<0.001), while the control arm showed 64.7% (95% CI 38-86%, P=0.54). Grade ≥3 adverse events occurred in 68% of combination patients versus 35% with enzalutamide alone, including two fatal myeloid neoplasms. The authors concluded that talazoparib plus enzalutamide demonstrated clinical activity but did not establish clear additional benefit over enzalutamide alone in this biomarker-unselected population, with increased toxicity.
10.1038/s41591-026-04671-5
Oct 05 – Oct 12, 2026
Phase I/II Study of Bavdegalutamide, a Proteolysis-Targeting Chimera Androgen Receptor Degrader, in Metastatic Castration-Resistant Prostate Cancer.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This phase I/II trial evaluated bavdegalutamide, a PROTAC androgen receptor degrader, in 239 patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with an AR pathway inhibitor. In phase I (N=95), the recommended phase II dose was 420 mg once daily; phase II administered this dose in 28-day cycles across AR molecular profile-defined subgroups. PSA50/PSA30 response rates reached 60.0%/70.0% in tumors with AR T878/H875 mutations (n=20), versus 4.3%/6.5% in wild-type/other AR alterations (n=46) and 3.1%/6.3% in AR L702H/splice variant 7 (n=32), with median rPFS of 11.1, 4.2, and 5.1 months, respectively. The authors conclude bavdegalutamide has a manageable safety profile and promising clinical activity, particularly in AR T878/H875-mutated mCRPC.
10.1200/JCO-25-02995
Exploration of tumor genomics associated with prolonged benefit from or resistance to talazoparib monotherapy in patients with metastatic castration-resistant prostate cancer.
EUR J CANCER · Q1 JOURNAL - RANK #45/326
This study explored tumor genomics associated with prolonged benefit or resistance to talazoparib monotherapy in patients with metastatic castration-resistant prostate cancer (mCRPC) using data from the phase II TALAPRO-1 trial. Tumor genetics were retrospectively assessed in 104 patients from the efficacy population, categorized by radiographic progression-free survival (rPFS: ≥12 months, ≥2 to <12 months, <2 months), and serial circulating tumor DNA samples were analyzed for emergent mutational changes using FoundationOne Liquid CDx. Among 16 patients with rPFS ≥12 months, 15 (94%) had tumor BRCA2 alterations versus 6/27 (22%) with rPFS <2 months (p<0.00001); HRR gene reversions were detected in 7/27 patients and emergent PARP1 variants in 5/27 evaluable patients. The authors conclude that prolonged benefit is associated with BRCA2 alterations, while reversion mutations and PARP1 variants likely reflect selective pressure to escape talazoparib synthetic lethality or PARP trapping.
10.1016/j.ejca.2026.117079
Efficacy and Safety of Olaparib plus Abiraterone Versus Placebo plus Abiraterone in the Non-BRCA Mutation Subgroup of Patients with Metastatic Castration-resistant Prostate Cancer in the PROpel Trial.
EUR UROL ONCOL · Q1 JOURNAL - RANK #7/133
This post hoc exploratory analysis of the phase 3 PROpel trial evaluated olaparib plus abiraterone versus placebo plus abiraterone in 693 patients with non-BRCA-mutated metastatic castration-resistant prostate cancer. Patients were randomized 1:1 to receive olaparib or placebo plus abiraterone with prednisone/prednisolone. Median investigator-assessed radiographic progression-free survival was 24.1 months for olaparib plus abiraterone versus 19.0 months for placebo plus abiraterone (HR 0.76, 95% CI 0.61-0.94), while median overall survival was 39.6 versus 38.0 months (HR 0.91, 95% CI 0.73-1.13). The authors concluded that olaparib plus abiraterone provided numerically longer rPFS with no new safety signals, supporting it as a treatment option for non-BRCA-mutated mCRPC.
10.1016/j.euo.2026.08.014
Sep 28 – Oct 05, 2026
PSMA-PET/CT-guided Intensification of Radiation Therapy for Prostate Cancer (PSMAgRT): 5-yr Analysis of a Phase 2 Randomized Controlled Trial.
EUR UROL · Q1 JOURNAL - RANK #3/133TOP-TIER
This phase 2, two-center, open-label randomized controlled trial evaluated whether PSMA-PET/CT-guided radiotherapy (PSMAgRT) intensification improves failure-free survival (FFS) in prostate cancer patients planned for standard-of-care radiotherapy. A total of 262 patients were randomized 1:1 across four strata (salvage post-radical prostatectomy, high-risk, oligometastatic, and salvage post-RT), with 253 treated/analyzed and a median follow-up of 66 months. The primary FFS endpoint was not met (5-year FFS 66% vs 62%; HR 0.80; one-sided 90% CI upper bound 1.04; p=0.14), but freedom from biochemical progression favored PSMAgRT overall (72% vs 65%; sHR 0.70; p=0.048), with greater benefit in high-risk (81% vs 66%; sHR 0.54; p=0.07) and post-RP (80% vs 68%; sHR 0.54; p=0.037) strata. The authors conclude that although the primary endpoint was not met overall, treatment-effect estimates support PSMAgRT in high-risk and post-RP populations, providing rationale for the phase 3 PATRON trial. Only one grade ≥3 event was possibly related to dose escalation, and limitations include the phase 2 design and heterogeneous population.
10.1016/j.eururo.2026.09.017
Immunometabolic effects of oral testosterone for castration-resistant prostate cancer in the ACROBAT trial.
MOL CANCER RES · Q1 JOURNAL - RANK #77/326
This prospective clinical trial evaluated the immunometabolic effects of high-dose oral testosterone undecanoate in 10 patients with castration-resistant prostate cancer (CRPC) enrolled in the ACROBAT trial. The study performed longitudinal plasma metabolomic profiling and high-dimensional immune cell phenotyping to assess treatment response and resistance mechanisms. Results showed that testosterone exposure increased circulating metabolites within the arginine-ornithine-polyamine axis, including guanidoacetic acid, creatine, homoarginine, and N1-acetylspermidine, with non-responders exhibiting elevated polyamines such as putrescine. The study concluded that high-dose testosterone therapy increases polyamine synthesis, which is associated with therapy resistance and abundance of immunosuppressive myeloid cells, providing clinical evidence for metabolic reprogramming as a resistance mechanism.
10.1158/1541-7786.MCR-26-0573
Differential Association of Post-Testosterone Recovery PSA Kinetics with Progression and Metastatic Outcomes in Non-metastatic Prostate Cancer.
INT J RADIAT ONCOL · Q1 JOURNAL - RANK #14/212
This study evaluated whether PSA kinetics after testosterone recovery predict progression and metastasis in non-metastatic prostate cancer patients treated with radiotherapy and androgen deprivation therapy. Individual patient data from two randomized trials were pooled, and Bayesian joint models linked longitudinal PSA measurements to progression-free and metastasis-free survival. Among 461 patients with median 115-month follow-up, shorter PSA doubling time showed directionally higher progression risk (PSADT 12 months: HR 1.10) but paradoxically lower metastasis risk (HR 0.80), with wide credible intervals. The authors conclude that PSA slope associations with metastatic outcomes were inconsistent and imprecise, warranting no definitive inference on metastatic risk.
10.1016/j.ijrobp.2026.08.050
Sep 21 – Sep 28, 2026
Steroidogenesis inhibitor ODM-209 for metastatic castration-resistant prostate cancer and advanced breast cancer: Results from the first-in-human STESIDES study.
EUR J CANCER · Q1 JOURNAL - RANK #45/326
The STESIDES phase 1 trial evaluated the oral CYP11A1 inhibitor ODM-209 in 38 heavily pretreated patients with metastatic castration-resistant prostate cancer (n=34) and advanced breast cancer (n=4), using a 3+3 dose-finding design with glucocorticoid and mineralocorticoid replacement. Primary endpoints were dose-limiting toxicities and adverse events, with secondary endpoints including pharmacodynamics and clinical response. All participants experienced adverse events, most commonly fatigue (53%) and peripheral edema (34%), with grade ≥3 events in 24% and serious adrenal insufficiency in 8%. ODM-209 showed activity in mCRPC, with a 29% PSA50 response rate overall and 47% in patients with AR-LBD mutations, but no responses in advanced breast cancer.
10.1016/j.ejca.2026.117041
Sep 14 – Sep 21, 2026
Two-year outcomes following PSMA PET and MRI guided prostate SABR with simultaneous focal boost: a brief report from the ARGOS-CLIMBER phase 1/2 trial.
RADIOTHER ONCOL · Q1 JOURNAL - RANK #22/212
ARGOS-CLIMBER is a phase 1/2 prospective clinical trial evaluating PSMA PET and MRI guided prostate stereotactic ablative radiotherapy (SABR) with simultaneous focal boost to intraprostatic and nodal disease in men with unfavourable intermediate and high-risk prostate cancer. The trial reports two-year outcomes, demonstrating acceptable safety and quality of life with high biochemical and imaging response rates. This single-arm, non-randomized interventional study represents an active treatment assignment involving radiation therapy. The updated results support the tolerability and early efficacy of this dose-escalated SABR approach.
10.1016/j.radonc.2026.111786
Effect of demographic characteristics on the outcome of prostate cancer salvage radiotherapy: Analysis from a randomized controlled trial.
CANCER-AM CANCER SOC · Q1 JOURNAL - RANK #68/326
This secondary analysis of a randomized controlled trial investigated how demographic and metabolic factors influence outcomes of salvage radiotherapy (sRT) for prostate cancer recurrence. Post-prostatectomy men with detectable PSA were randomized to sRT guided by conventional imaging (arm A) or 18F-fluciclovine PET/CT (arm B) and followed for up to 48 months to assess failure-free survival (FFS). Across both arms, African American men (AAM) showed significantly higher FFS than men of other races (MOR) (72.8% vs. 58.7%, p=.002), with similar trends in each arm. The authors conclude that despite lower socioeconomic status and higher metabolic dysregulation, AAM have more favorable sRT outcomes than MOR when healthcare access disparities are controlled.
10.1002/cncr.70602
Patient-clinician symptom agreement before and after radiotherapy for prostate cancer: results from the randomized HYPO-RT-PC study.
RADIOTHER ONCOL · Q1 JOURNAL - RANK #22/212
This sub-study of the randomized HYPO-RT-PC trial evaluated agreement between patient- and clinician-reported symptoms before and after radiotherapy in 1,180 men with prostate cancer randomized to conventional (2.0 Gy × 39 fx) or ultra-hypofractionated (6.1 Gy × 7 fx) radiotherapy between 2005 and 2015. Urinary, bowel, and sexual symptoms were assessed using the Prostate Cancer Symptom Scale and clinician-rated Radiation Therapy Oncology Group scale at baseline, end of radiotherapy, and 1, 2, and 4 years post-treatment, with 580-910 paired assessments analyzed per follow-up. Spearman correlations ranged from -0.091 to 0.750, with clinicians consistently underrating urinary and bowel symptoms and overrating sexual activity, while erectile dysfunction results were inconsistent. The authors concluded that patient-clinician symptom agreement was generally poor, highlighting limitations of clinician-only assessment and the need to integrate patient-reported outcome measures into clinical practice and research.
10.1016/j.radonc.2026.111780
Sep 07 – Sep 14, 2026
Association Between Castration-resistant Prostate Cancer Progression Patterns and Survival Outcomes in Metastatic Castration-sensitive Prostate Cancer: A Post Hoc Analysis of the TITAN Trial.
EUR UROL FOCUS · Q1 JOURNAL - RANK #13/133
This post hoc analysis of the TITAN trial evaluated how castration-resistant prostate cancer (CRPC) progression patterns influence survival in metastatic castration-sensitive prostate cancer patients treated with apalutamide versus placebo. Among 1,052 intention-to-treat patients, 499 who developed CRPC were classified as having PSA-CRPC or radiographic-CRPC, with 24-month cumulative incidence compared using the Gray test and overall survival assessed via inverse probability of treatment weighting-adjusted restricted mean survival time. Apalutamide significantly reduced PSA-CRPC incidence (19% vs 52%; p<0.001) but not radiographic-CRPC (13% vs 14%; p=0.6). Radiographic-CRPC was associated with shorter survival than PSA-CRPC in the placebo group, but this difference was attenuated with apalutamide, and baseline visceral metastasis predicted radiographic-CRPC in both arms.
10.1016/j.euf.2026.07.003
Impact of Treatment Intensification with Abiraterone on Fracture-related Hospitalisation in Newly Diagnosed Prostate Cancer: A Secondary Analysis of Two Randomised Phase 3 Trials Within the STAMPEDE Trial Platform.
EUR UROL · Q1 JOURNAL - RANK #3/133TOP-TIER
This secondary analysis of two randomised phase 3 trials within the STAMPEDE platform evaluated the impact of abiraterone-based treatment intensification on fracture-related hospitalisation (FRH) in newly diagnosed prostate cancer patients. The study linked Hospital Episode Statistics data for 3102 patients in England randomised to standard of care (SOC) with or without abiraterone plus prednisolone (AAP) and/or enzalutamide. In metastatic (M1) disease, 5-year FRH incidence was significantly lower with SOC+AAP (22% vs 30%; SDHR 0.77, p=0.04) and SOC+AAP+Enza (28% vs 38%; SDHR 0.69, p=0.002) compared with SOC alone; no significant difference was seen in M0 disease. The authors concluded that abiraterone intensification did not increase fracture risk and reduced FRH in M1 disease, likely reflecting improved metastatic bone disease control, but noted limitations including exclusion of non-hospitalised fractures and lack of baseline bone mineral density data.
10.1016/j.eururo.2026.08.012
Aug 31 – Sep 07, 2026
Long-term Oncological Outcomes of Retzius-sparing Versus Anterior Robot-assisted Radical Prostatectomy: Post Hoc Analysis of a Randomized Cohort.
EUR UROL ONCOL · Q1 JOURNAL - RANK #7/133
This study is a post hoc analysis of a randomized controlled trial comparing Retzius-sparing (RS) versus anterior robot-assisted radical prostatectomy (RARP) in 120 men with low-to-intermediate-risk prostate cancer. The primary endpoint was progression-free survival (PFS), defined as biochemical recurrence or additional treatment, analyzed using Kaplan-Meier and Cox regression adjusted for CAPRA-S. At a median follow-up of 77 months, 5-year PFS was 80.2% in the RS group versus 91.1% in the anterior group (p=0.01), with a 2.64-fold higher risk of progression for RS (p=0.049). The authors conclude that although RS RARP improves early continence, it is associated with less favorable long-term oncological control, possibly due to technical demands.
10.1016/j.euo.2026.07.012
Aug 24 – Aug 31, 2026
Alkaline Phosphatase and Prostate-specific Antigen Response in Metastatic Castration-resistant Prostate Cancer Treated with Enzalutamide Alone or in Combination with Radium-223: Ad Hoc Analysis of the PEACE-3 Consortium Trial.
EUR UROL ONCOL · Q1 JOURNAL - RANK #7/133
This exploratory post hoc analysis of the international, randomized, open-label phase 3 PEACE-3 trial evaluated alkaline phosphatase (ALP) and prostate-specific antigen (PSA) responses in 446 patients with metastatic castration-resistant prostate cancer and bone metastases. Patients received enzalutamide 160 mg daily alone or with six monthly injections of radium-223 (55 kBq/kg). At 6 months, confirmed ALP-30 response was 56.5% with combination versus 50.8% with enzalutamide alone, and median time to confirmed ALP-30 response was 2.4 versus 3.7 months (HR 1.41; p=0.003). Confirmed PSA-90 response at 6 months was 50.5% versus 34.1% (p=0.001), with median time to response of 5.6 versus 22.1 months (HR 1.48; p=0.004). The authors concluded that adding radium-223 to enzalutamide was associated with faster and more frequent biomarker responses, supporting additional antitumour activity.
10.1016/j.euo.2026.08.001
Salvage Hypofractionated Accelerated Versus Standard Radiotherapy for Biochemical Recurrence After Radical Prostatectomy: A Phase III Randomized Clinical Trial.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This phase III randomized clinical trial compared hypofractionated (65 Gy in 26 fractions) versus conventional (66 Gy in 33 fractions) salvage radiotherapy for biochemical recurrence after radical prostatectomy. A total of 316 patients were enrolled and followed for a median of 52.6 months. The 4-year biochemical progression-free survival rates were 80.1% for hypofractionation and 78.1% for conventional fractionation, with no significant differences in distant metastasis-free survival (91.7% vs 91.0%) or prostate cancer-specific survival (100% vs 100%). Grade ≥2 gastrointestinal toxicity was higher with hypofractionation (7.9% vs 0.7%, resolved by last follow-up), but quality-of-life was comparable. The authors concluded hypofractionated radiotherapy is a viable alternative in the salvage setting.
10.1200/JCO-25-02234
High-dose radiotherapy in patients with high-risk prostate cancers treated with long-term androgen deprivation therapy (GETUG AFU 18): a randomised, phase 3 trial.
LANCET ONCOL · Q1 JOURNAL - RANK #8/326TOP-TIER
This multicenter, open-label, randomized phase 3 trial (GETUG AFU 18) evaluated the effect of dose-escalated radiotherapy (80 Gy) versus standard-dose (70 Gy) combined with long-term androgen deprivation therapy on progression-free survival (PFS) in 505 men with high-risk prostate cancer. Patients were randomized 1:1 and followed for a median of 9.5 years. The 10-year PFS was significantly improved in the 80 Gy group (83.6% vs 72.2%; stratified HR 0.56, 95% CI 0.40-0.78, p<0.0001), while 5-year PFS was 91.4% vs 88.1% (not significant). Grade 3 or worse acute and late toxicities were similar between groups, with no treatment-related deaths. The authors conclude that 80 Gy radiotherapy improved PFS and may be a treatment option, but longer follow-up is needed to confirm survival benefits.
10.1016/S1470-2045(26)00277-9
Aug 17 – Aug 24, 2026
APUC-6 Genes as a Potential Prognostic and Predictive Biomarker in the CHAARTED Prostate Cancer Trial.
JCO PRECIS ONCOL · Q1 JOURNAL - RANK #57/326
This study evaluated the prognostic and predictive value of a six-gene APUC-6 panel in metastatic castration-sensitive prostate cancer (mCSPC) using transcriptomic data from 160 patients in the phase III CHAARTED trial, a prospective interventional clinical trial. Patients were stratified by APUC-6 and AR expression, and outcomes (time to clinical progression, time to castration resistance, overall survival) were compared between ADT and ADT plus docetaxel arms. APUC-6-high/AR-low patients showed improved outcomes (OS HR 0.31, p=0.0003) but no docetaxel benefit, while APUC-6-low/AR-low patients significantly benefited from adding docetaxel (OS HR 0.39, p=0.0019), with interaction testing supporting this predictive effect (HR 0.36, p=0.001). The authors conclude that APUC-6 and AR expression define clinically relevant subgroups that may enhance precision treatment approaches in mCSPC.
10.1200/PO-25-01012
Prevention of lymphedema after extended pelvic lymphadenectomy using diosmin, bromelain, melilotus, and hesperidin: results from a prospective randomized study (PRELYNE trial).
J ROBOT SURG · Q1 JOURNAL - RANK #48/312
This prospective randomized trial assessed whether an oral formulation of diosmin, bromelain, melilotus, and hesperidin (Meliven Top) could reduce lymphatic morbidity after robot-assisted radical prostatectomy with extended pelvic lymph node dissection for prostate cancer. One hundred patients were randomized 1:1 to standard care or standard care plus the oral supplement for one month, with 98 completing follow-up. No significant differences were observed in lower-limb volumetric changes at 1 or 3 months; however, genital pain at 1 month (2% vs. 18%, p=0.008) and persistent genital swelling at 3 months (0% vs. 8%, p=0.041) were significantly lower in the treatment group. The study concluded that the supplement did not reduce limb volume changes but improved genital symptom recovery, warranting larger studies with longer follow-up.
10.1007/s11701-026-03816-5
Eight-year outcomes of testosterone suppression plus enzalutamide or a non-steroidal anti-androgen for metastatic, hormone-sensitive prostate cancer (ENZAMET; ANZUP 1304).
ANN ONCOL · Q1 JOURNAL - RANK #4/326TOP-TIER
This randomized controlled trial (ENZAMET) compared enzalutamide plus testosterone suppression to a non-steroidal anti-androgen (NSAA) plus testosterone suppression in men with metastatic hormone-sensitive prostate cancer, with optional early docetaxel. At a median follow-up of 8.1 years, overall survival was significantly longer with enzalutamide (median 7.9 vs 5.8 years; 8-year OS 50% vs 40%; HR 0.73, 95% CI 0.63-0.86; p=0.0001). Progression-free survival also favored enzalutamide (8-year 43% vs 20%; HR 0.49, p<0.0001), and prostate cancer deaths were fewer (207 vs 261). Adverse events were similar between groups, with more falls in the enzalutamide group, but treatment was sustained with no increase in non-prostate cancer mortality.
10.1016/j.annonc.2026.07.412