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MRI-Guided Focused Ultrasound Focal Therapy Safe, Effective for Intermediate-Risk Prostate Cancer
A phase 2b trial found that MRI-guided focused ultrasound focal therapy is a safe and effective treatment for patients with localized grade group 2 or 3 intermediate-risk prostate cancer. As many patients with grade group 2 or 3 prostate cancer are either ineligible for active surveillance, or experience early disease progression which requires radical therapy while being managed on active surveillance, MRI-guided focused ultrasound focal therapy could safely reduce the treatment burden in this population.
In this single-arm, multicenter phase 2b study, 101 patients with previously-untreated prostate adenocarcinoma from 8 centers in the United States were enrolled between May 4, 2017 and December 21, 2018. For all patients, prostate lesions were locally treated with MRI-guided, endorectally-applied, focused ultrasound energy.
The co-primary outcomes of this study were oncological outcomes, as determined by the absence of grade group ≥2 cancer in treated area at 6-month and 24-month combined biopsy, and safety.
At 24 months, 88% of the patients had no evidence of grade group ≥2 prostate cancer in the treated area. There were no grade ≥4 treatment-related adverse events, and a single incidence of a grade 3 adverse event, which was a urinary tract infection. No treatment-related deaths occurred.
The study authors concluded that focal therapy is supported for select patients and suggest further “comparative trials to determine if a tissue-preserving approach is effective in delaying or eliminating the need for radical whole-gland treatment in the long-term.”
Source:
Ehdaie B, Tempany CM, Holland F, et al. MRI-guided focused ultrasound focal therapy for patients with intermediate-risk prostate cancer: a phase 2b, multicentre study. Lancet Oncol. Published online June 14, 2022. doi:10.1016/S1470-2045(22)00251-0
