Trial Outcomes & Findings for Targeted Radiotherapy in Androgen-suppressed Prostate Cancer Patients. (NCT NCT03644303)

NCT ID: NCT03644303

Last Updated: 2026-05-14

Results Overview

Median progression free survival following SBRT to progression, starting new treatment or death from any cause. Progression is defined as one of the following; (i) PSA progression: PSA rise by at least 25% over post-SBRT baseline (set at 4 weeks), confirmed by a second reading at least 4 weeks later, (ii) Radiological progression: at least 2 new lesions on bone scan or unequivocal progression of soft tissue on CT, or evidence on other local imaging of disease progression (e.g. PET or MRI progression) as per Response Evaluation Criteria In Solid Tumours Criteria (RECIST v1.1) (iii) Symptomatic progression: new or progressing symptoms at the site of a metastasis, or (iv) Date at which the clinician decides to stop Abiraterone/Enzalutamide or starts new line of therapy, whichever occurs sooner.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

86 participants

Primary outcome timeframe

Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Results posted on

2026-05-14

Participant Flow

Of the 86 patients registered for screening, 85 patients met eligibility criteria and passed screening. Of the 85 patients that passed screening, 81 patients were eligible to receive trial treatment. The trial aimed to treat 84 patients but only 81 patients received trial treatment - once 85 patients has been registered and passed screening, patient drop out exceeded the number expected, and patients were not replaced.

Participant milestones

Participant milestones
Measure
SBRT + ADT
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
Eligibility for trial treatment
STARTED
86
Eligibility for trial treatment
COMPLETED
81
Eligibility for trial treatment
NOT COMPLETED
5
Completion of trial treatment (SBRT)
STARTED
81
Completion of trial treatment (SBRT)
COMPLETED
81
Completion of trial treatment (SBRT)
NOT COMPLETED
0
24 month survival
STARTED
81
24 month survival
COMPLETED
38
24 month survival
NOT COMPLETED
43

Reasons for withdrawal

Reasons for withdrawal
Measure
SBRT + ADT
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
Eligibility for trial treatment
Baseline eligibility not met
1
Eligibility for trial treatment
Lymph node too large for SBRT
1
Eligibility for trial treatment
Two unsuccessful 4D scans
1
Eligibility for trial treatment
Area too long for SBRT treatment
1
Eligibility for trial treatment
Area has been previously treated
1
24 month survival
Death
18
24 month survival
Withdrawal by Subject
6
24 month survival
Censored: Last known alive before 24months
19

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
Disease Burden sites
Lung
3 Participants
n=81 Participants
Age, Continuous
74 years
n=81 Participants
Sex: Female, Male
Female
0 Participants
n=81 Participants
Sex: Female, Male
Male
81 Participants
n=81 Participants
PSA value at diagnosis
41.5 ug/l
n=79 Participants • 2 patients did not have PSA data available at diagnosis.
Gleason sum score at diagnosis
5
1 Participants
n=81 Participants
Gleason sum score at diagnosis
6
5 Participants
n=81 Participants
Gleason sum score at diagnosis
7
36 Participants
n=81 Participants
Gleason sum score at diagnosis
8
6 Participants
n=81 Participants
Gleason sum score at diagnosis
9
22 Participants
n=81 Participants
Gleason sum score at diagnosis
10
4 Participants
n=81 Participants
Gleason sum score at diagnosis
Not available
7 Participants
n=81 Participants
ECOG Performance Status
0
29 Participants
n=81 Participants
ECOG Performance Status
1
52 Participants
n=81 Participants
Number of oligo-progressing lesions
1
52 Participants
n=81 Participants
Number of oligo-progressing lesions
2
29 Participants
n=81 Participants
Disease Burden
High (≥4 Lesions)
37 Participants
n=81 Participants
Disease Burden
Low (<4 Lesions)
43 Participants
n=81 Participants
Disease Burden
Not available
1 Participants
n=81 Participants
Disease Burden sites
Prostate
47 Participants
n=81 Participants
Disease Burden sites
Lymph nodes
37 Participants
n=81 Participants
Disease Burden sites
Adrenal
1 Participants
n=81 Participants
Disease Burden sites
Bone
56 Participants
n=81 Participants
Disease Burden sites
Other (Right ureteric lesion, Uretic lesions, Peritoneal, Right testicle)
4 Participants
n=81 Participants
Treatment History
Previous chemotherapy
26 Participants
n=81 Participants
Treatment History
Previous radiotherapy
55 Participants
n=81 Participants
Treatment History
Previous prostatectomy/pelvic surgery
14 Participants
n=81 Participants
Androgen Deprivation Therapy
Abiraterone
47 Participants
n=81 Participants
Androgen Deprivation Therapy
Enzalutamide
34 Participants
n=81 Participants

PRIMARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT and were evaluable for the primary endpoint.

Median progression free survival following SBRT to progression, starting new treatment or death from any cause. Progression is defined as one of the following; (i) PSA progression: PSA rise by at least 25% over post-SBRT baseline (set at 4 weeks), confirmed by a second reading at least 4 weeks later, (ii) Radiological progression: at least 2 new lesions on bone scan or unequivocal progression of soft tissue on CT, or evidence on other local imaging of disease progression (e.g. PET or MRI progression) as per Response Evaluation Criteria In Solid Tumours Criteria (RECIST v1.1) (iii) Symptomatic progression: new or progressing symptoms at the site of a metastasis, or (iv) Date at which the clinician decides to stop Abiraterone/Enzalutamide or starts new line of therapy, whichever occurs sooner.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Median Progression-Free Survival (PFS)
6.0 months
Interval 5.5 to 7.8

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Number of patients that had a PFS event following SBRT in the duration of the study. Progression free survival definition is time from SBRT to progression, starting new treatment or death from any cause. Progression is defined as one of the following; (i) PSA progression: PSA rise by at least 25% over post-SBRT baseline (set at 4 weeks), confirmed by a second reading at least 4 weeks later, (ii) Radiological progression: at least 2 new lesions on bone scan or unequivocal progression of soft tissue on CT, or evidence on other local imaging of disease progression (e.g. PET or MRI progression) as per Response Evaluation Criteria In Solid Tumours Criteria (RECIST v1.1) (iii) Symptomatic progression: new or progressing symptoms at the site of a metastasis, or (iv) Date at which the clinician decides to stop Abiraterone/Enzalutamide or starts new line of therapy, whichever occurs sooner.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Progression-Free Survival (PFS) Events
PFS event experienced during study follow up
67 Participants
Progression-Free Survival (PFS) Events
No PFS event experienced during study follow up
14 Participants

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Progression free survival estimates following SBRT to progression, starting new treatment or death from any cause. Progression is defined as one of the following; (i) PSA progression: PSA rise by at least 25% over post-SBRT baseline (set at 4 weeks), confirmed by a second reading at least 4 weeks later, (ii) Radiological progression: at least 2 new lesions on bone scan or unequivocal progression of soft tissue on CT, or evidence on other local imaging of disease progression (e.g. PET or MRI progression) as per Response Evaluation Criteria In Solid Tumours Criteria (RECIST v1.1) (iii) Symptomatic progression: new or progressing symptoms at the site of a metastasis, or (iv) Date at which the clinician decides to stop Abiraterone/Enzalutamide or starts new line of therapy, whichever occurs sooner.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Progression-Free Survival (PFS) Estimates
Estimated percentage of patients event-free at 6 months (%)
46.6 Percentage of patients
Interval 35.4 to 57.0
Progression-Free Survival (PFS) Estimates
Estimated percentage of patients event-free at 12 months (%)
30.2 Percentage of patients
Interval 20.6 to 40.4
Progression-Free Survival (PFS) Estimates
Estimated percentage of patients event-free at 24 months (%)
17.5 Percentage of patients
Interval 10.1 to 26.6

SECONDARY outcome

Timeframe: At the 6 month timepoint from end of SBRT

Population: Of the 81 patients who received SBRT treatment, the oligo-progressive disease lesion form was completed for 76 (93.8%) patients. There were 72 patients with available data entered on the CRF; of these, 67 (93.1%) patients achieved overall local control (PR/SD) according to oligo-progressive disease status at 6 months after SBRT (+/- 2 months).

Overall control defined as stable disease or partial response of irradiated metastases assessed using the RECIST (v 1.1) criteria on imaging such as computed Tomography (CT), magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET) scan or control on bone scan

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=72 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Local Control Rate Following SBRT
Irradiated OPD lesion progressed
5 Participants
Local Control Rate Following SBRT
Irradiated OPD lesion not progressed
67 Participants

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Median OS following SBRT until death from any cause.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Median Overall Survival (OS)
29.5 months
Interval 27.2 to 37.6

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Number of patients who had an OS event following SBRT in the duration of the study. Overall survival definition is time from SBRT to death from any cause.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Overall Survival (OS) Events
OS event experienced during study follow up
33 Participants
Overall Survival (OS) Events
No OS event experienced during study follow up
48 Participants

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

OS estimates following SBRT to death from any cause.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Overall Survival (OS) Estimates
Estimated percentage of patients event-free at 6 months (%)
95.0 Percentage of patients
Interval 87.3 to 98.1
Overall Survival (OS) Estimates
Estimated percentage of patients event-free at 12 months (%)
92.4 Percentage of patients
Interval 83.8 to 96.5
Overall Survival (OS) Estimates
Estimated percentage of patients event-free at 24 months (%)
75.1 Percentage of patients
Interval 63.1 to 83.6

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Median time following SBRT to alternative therapy administration or death.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Median Time to Administration of Next Line of Therapy or Death
21.4 months
Interval 15.3 to 29.6

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Number of patients that started new treatment or died following SBRT in the duration of the study.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Administration of Next Line of Therapy or Death Events
Did not start new treatment and did not die during study follow up
31 Participants
Administration of Next Line of Therapy or Death Events
Started new treatment or died during study follow up
50 Participants

SECONDARY outcome

Timeframe: Time on study (up to 24 months from the end of SBRT, with further follow-up after 24 months if patient data were available).

Population: 81 patients received SBRT treatment and were evaluable for this endpoint.

Time estimates from SBRT to alternative therapy administration or death.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Time to Administration of Next Line of Therapy or Death
Estimated percentage of patients event-free at 6 months (%)
83.8 Percentage of patients
Interval 73.8 to 90.3
Time to Administration of Next Line of Therapy or Death
Estimated percentage of patients event-free at 12 months (%)
65.8 Percentage of patients
Interval 54.3 to 75.2
Time to Administration of Next Line of Therapy or Death
Estimated percentage of patients event-free at 24 months (%)
49.7 Percentage of patients
Interval 38.1 to 60.3

SECONDARY outcome

Timeframe: Up to 12 months from the end of SBRT

Population: 81 patients who received SBRT treatment. Number analysed at each timepoint is the number of patients out of the 81 patients who were treated with SBRT, who had an available EQ-5D score at the respective timepoint. The left column reports results across all completed assessments for the patient population. The right column reports results only from assessments conducted prior to the occurrence of disease progression for all patients in the patient population.

Patient Reported Quality of Life assessed using the EuroQol (EQ) EQ-5D-5L questionnaire. VAS scale is from 0-100. A higher VAS score indicates better quality-of-life. Outcome data has been reported for (i) all completed assessments and for (ii) assessments conducted up to the point of disease progression, in order to exclude the potential influence of progression on quality-of-life outcomes.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
n=81 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Health Related Quality of Life
EQ-5D VAS score at end of SBRT
76 EQ-5D VAS score
Interval 20.0 to 100.0
76 EQ-5D VAS score
Interval 20.0 to 100.0
Health Related Quality of Life
EQ-5D VAS score at screening
77 EQ-5D VAS score
Interval 20.0 to 100.0
77 EQ-5D VAS score
Interval 20.0 to 100.0
Health Related Quality of Life
EQ-5D VAS score at 4 weeks post SBRT
78 EQ-5D VAS score
Interval 35.0 to 100.0
78 EQ-5D VAS score
Interval 35.0 to 100.0
Health Related Quality of Life
EQ-5D VAS score at 3 months post SBRT
74 EQ-5D VAS score
Interval 15.0 to 98.0
77 EQ-5D VAS score
Interval 35.0 to 98.0
Health Related Quality of Life
EQ-5D VAS score at 6 months post SBRT
77 EQ-5D VAS score
Interval 25.0 to 97.0
79 EQ-5D VAS score
Interval 40.0 to 97.0
Health Related Quality of Life
EQ-5D VAS score at 12 months post SBRT
75 EQ-5D VAS score
Interval 35.0 to 100.0
79 EQ-5D VAS score
Interval 39.0 to 100.0

SECONDARY outcome

Timeframe: Up to 24 months from the end of SBRT

Population: Of the 81 patients which had SBRT, the number of patients with an RTOG assessment at each respective visit is recorded. Results are reported up to 12 months post-SBRT as no toxicity assessments were reported at 18 and 24 months post-SBRT.

Severity of acute and late side-effects resulting from SBRT assessed using the RTOG (Radiation Therapy Oncology Group) scoring criteria. A higher RTOG grade suggests higher severity of symptoms. Overall maximum grade for each patient at each timepoint is reported.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=79 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
n=79 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
n=77 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
n=71 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
n=2 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (RTOG)
Grade 1
32 Participants
31 Participants
25 Participants
13 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (RTOG)
Grade 2
9 Participants
4 Participants
7 Participants
2 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (RTOG)
Grade 3
0 Participants
0 Participants
0 Participants
1 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (RTOG)
Grade 4
0 Participants
0 Participants
1 Participants
0 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (RTOG)
No toxicity reported
38 Participants
44 Participants
44 Participants
55 Participants
2 Participants

SECONDARY outcome

Timeframe: Up to 24 months from the end of SBRT

Population: Of the 81 patients which had SBRT, the number of patients with an CTCAE assessment at each respective visit is recorded. Results are reported up to 12 months post-SBRT as no toxicity assessments were reported at 18 and 24 months post-SBRT.

Severity of acute and late side-effects resulting from SBRT assessed using the Common Terminology Criteria for Adverse Events (CTCAE). A higher CTCAE grade suggests higher severity of symptoms. Overall maximum grade for each patient at each timepoint is reported.

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=79 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
n=80 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
n=77 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
n=71 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
n=2 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
No toxicity reported
51 Participants
46 Participants
53 Participants
47 Participants
2 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
Grade 1
26 Participants
24 Participants
16 Participants
13 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
Grade 2
1 Participants
7 Participants
7 Participants
6 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
Grade 3
1 Participants
1 Participants
0 Participants
3 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
Grade 4
0 Participants
0 Participants
1 Participants
2 Participants
0 Participants
Number of Participants With Incidence and Severity of Treatment Induced Symptoms (CTCAE)
Grade 5
0 Participants
2 Participants
0 Participants
0 Participants
0 Participants

SECONDARY outcome

Timeframe: Up to 12 months from the end of SBRT

Population: Of the 81 patients who received SBRT treatment, 77 (95.1%) had both baseline and post-SBRT PSA results available, some of which were captured from PSA assessments following disease progression. Of the 77 patients with PSA results available, 40 (51.9%) patients either progressed or died within 6 months post-SBRT, whilst 37 (48.1%) patients did not progress or die within 6 months.

Prostate Specific Antigen (PSA) values recorded post-SBRT

Outcome measures

Outcome measures
Measure
SBRT + ADT
n=40 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
SBRT + ADT (Excluding Assessments After Disease Progression)
n=37 Participants
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide This group excludes VAS assessments completed after disease progression
SBRT + ADT (3 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 3 months post-SBRT visit.
SBRT + ADT (6 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 6 months post-SBRT visit.
SBRT + ADT (12 Months Post-SBRT)
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide Overall maximum RTOG grade reported at 12 months post-SBRT visit.
Prostate Specific Antigen (PSA) Values
PSA at baseline post-SBRT
7.0 ng/ml
Interval 2.3 to 13.0
5.0 ng/ml
Interval 1.8 to 20.9
Prostate Specific Antigen (PSA) Values
PSA at 1 month post-SBRT
4.5 ng/ml
Interval 2.2 to 17.8
3.4 ng/ml
Interval 1.3 to 14.3
Prostate Specific Antigen (PSA) Values
PSA at 3 months post-SBRT
6.3 ng/ml
Interval 1.8 to 25.9
1.8 ng/ml
Interval 0.5 to 6.6
Prostate Specific Antigen (PSA) Values
PSA at 6 months post-SBRT
11.0 ng/ml
Interval 2.9 to 46.1
1.1 ng/ml
Interval 0.2 to 4.5
Prostate Specific Antigen (PSA) Values
PSA at 12 months post-SBRT
60.0 ng/ml
Interval 12.0 to 210.4
0.9 ng/ml
Interval 0.3 to 4.0

Adverse Events

SBRT + ADT

Serious events: 1 serious events
Other events: 43 other events
Deaths: 33 deaths

Serious adverse events

Serious adverse events
Measure
SBRT + ADT
n=81 participants at risk
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
Cardiac disorders
Myocardial infarction
1.2%
1/81 • Number of events 1 • Up to 24 months from the end of SBRT
Infections and infestations
Bladder infection
1.2%
1/81 • Number of events 1 • Up to 24 months from the end of SBRT

Other adverse events

Other adverse events
Measure
SBRT + ADT
n=81 participants at risk
Enzalutamide OR Abiraterone at licensed doses in combination with stereotactic radiotherapy: 30 Gray in 5 fractions SBRT + ADT: Short course SBRT to 1 or 2 oligo-progressing metastases in addition to continued abiraterone or enzalutamide
Gastrointestinal disorders
Abdominal pain
6.2%
5/81 • Up to 24 months from the end of SBRT
Gastrointestinal disorders
Constipation
6.2%
5/81 • Up to 24 months from the end of SBRT
General disorders
Fatigue
45.7%
37/81 • Up to 24 months from the end of SBRT
Musculoskeletal and connective tissue disorders
Back pain
11.1%
9/81 • Up to 24 months from the end of SBRT
Musculoskeletal and connective tissue disorders
Bone pain
7.4%
6/81 • Up to 24 months from the end of SBRT
Respiratory, thoracic and mediastinal disorders
Dyspnea
7.4%
6/81 • Up to 24 months from the end of SBRT
Gastrointestinal disorders
Nausea
7.4%
6/81 • Up to 24 months from the end of SBRT

Additional Information

Clinical Trials Manager - Angelie Tirona

The Royal Marsden NHS Foundation Trust

Phone: 020 8642 6011

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place