onc brain

Investigator-initiated phase 2 nonrandomized single-arm trial, N=310 evaluable across 21 community, regional and academic centers, treated 2008-2010. Median follow-up 9 yr; 10-yr Kaplan-Meier estimates.

172 low-risk (T1b-T2a, Gleason 6, PSA ≤10) and 138 intermediate-risk (Gleason 7 with PSA ≤10, or Gleason 6 with PSA 10-20), central path review. Median age 68; prostate volume up to 100 cc; ADT not allowed.

40 Gy in 5 fractions (8 Gy×5) on a noncoplanar robotic platform with real-time motion management, dose escalated to ~100 Gy EQD2 (α/β=2).

10-yr OS 84% and overall RFS 90%; risk-group and favorable/unfavorable IR breakdown in the results table. Relapse defined as biochemical failure (nadir+2), clinical failure, or salvage/systemic therapy.

Late G3 GI/GU 1.4% LR, 1.5% IR; no grade 4-5. G2+ GI 2.1% vs GU 14%, the dominant late burden. Physician-reported CTCAE v3.

PACE-B showed SBRT noninferior to conventional EBRT at 5 yr; this extends single-arm SBRT durability to 10 yr, consistent with the cohort's prior 5-yr low-toxicity report.

Single-arm, no randomized comparator; toxicity is physician-reported (CTCAE v3), not patient-reported, so late GU burden may be understated; RFS folds salvage/systemic therapy into the relapse endpoint.

Single-arm nonrandomized phase 2; no comparator arm (PACE-B provides randomized evidence). Mature 10-yr data reassure but design caps the read below confirmatory.

Phase 2, open-label, randomised 1:1, N=157, 16 Italian academic/community centres; stratified by centre, ECOG PS, and number of metastases. Median follow-up 53 mo (IQR 43-60). This OS read is an unplanned long-term analysis.

Prostate adenocarcinoma with metastatic castrate-resistant disease, ≤3 metastatic sites, and no prior systemic therapy for mCRPC. Control n=82, experimental n=75.

Both arms received ADT plus oral abiraterone acetate 1000 mg daily. The experimental arm added SBRT.

SBRT to all sites of metastatic disease, 1-5 fractions, biologically effective dose ≥100 Gy (ablative).

Primary: 6-month biochemical response (PSA drop ≥50%), previously met and reported. This paper reports an unplanned overall survival analysis at long-term follow-up.

OS median NR (95% CI 55-NR) experimental vs 50 mo (36-NR) control, HR 0.55 (0.33-0.92), p=0.021.

G3-4 infectious complications 5 (control) vs 0 (experimental); cardiovascular disorders 3 vs 3. One treatment-related death (myocardial failure) in the control arm. No excess toxicity from MDT.

Prior oligomet-MDT RCTs (STOMP, ORIOLE) enrolled castration-sensitive disease; ARTO extends the metastasis-directed RT signal into the CRPC setting on an ARSI backbone.

Unplanned OS analysis with post-hoc power recalculation; the trial was powered for 6-month biochemical response, not survival. Open-label, small N (157), phase 2.

Unplanned OS analysis (trial powered for 6-mo biochemical response, not survival); phase 2, N=157, open-label. Positive but hypothesis-generating pending a survival-powered phase 3.

Single-arm bladder-preservation trial: induction dual checkpoint blockade followed by chemoradiation. N and site count not reported in source. Outcomes reported at 2 years.

Stage II/III MIBC, cT2-4aN0-2. Notably includes clinically node-positive (N1-2) disease, a group usually routed to radical cystectomy.

Induction ipilimumab + nivolumab (dual IO) before chemoradiation. Doses, cycles, and radiosensitizing chemotherapy not stated in source.

Chemoradiation is the definitive local component, but RT dose, fractionation, and target volume are not specified in source, gating whether the result transfers to a given practice.

Headline readout is 2yr bladder-intact event-free survival; overall survival reported alongside.

Single-arm, no comparator vs chemoRT alone or cystectomy; short 2yr follow-up; bladder-intact EFS is a composite surrogate; N and RT details absent from source.

Single-arm, no comparator vs chemoRT alone or cystectomy; 2yr follow-up; bladder-intact EFS a composite surrogate. Hypothesis-generating induction-IO-plus-CRT signal, not yet mature.

Phase 2 single-group nonrandomized trial, N=90, 9 tertiary sarcoma centers (Europe + US), enrolled 2010-2020. Median follow-up 66.4 mo (IQR 48.8-87.5).

Adults with biopsy-proven, translocation-confirmed localized MLS of trunk or extremity. Mean age 47, 56% male.

36 Gy in once-daily 2-Gy fractions (18 fx) preoperatively, against the standard 50 Gy/25 fx for soft-tissue sarcoma. Delivered per protocol in all 90 pts, then resection.

5yr LRFS 97.4% (95% CI 93.9-100) is the standout; PFS 81.0%, DSS 89.5%, OS 88.5% (full set in table). 3 pts (3%) progressed to metastasis before surgery.

Wound complications in 18 pts (21%), 14 (16%) needing intervention. Late toxicity: G2 in 13 (15%), G3 in only 3 (3%).

Standard preoperative dose for soft-tissue sarcoma is 50 Gy/25 fx. MLS is highly radiosensitive, which motivates cutting ~14 Gy to 36 Gy while preserving local control.

Single-arm, no randomized comparator vs 50 Gy; equivalence inferred, not proven. Rare cancer makes a phase 3 impractical (authors' argument).

Single-arm nonrandomized phase 2; no randomized comparator vs standard 50Gy. Long follow-up, but efficacy equivalence is inferred, not tested. Single-arm design caps the read.

Single-institution, open-label, parallel-cohort randomized trial (4 Emory-affiliated centers, Jun 2020-2024). ADT-eligible pts randomized 1:1 relugolix vs leuprolide, stratified by ASCVD 10-yr risk; a lower-risk radiotherapy-alone cohort ran in parallel as a no-ADT control. N=94.

Non-metastatic intermediate/high-risk prostate cancer, all receiving pelvic RT (± pelvic nodes). ADT arms received ≥6 months hormone therapy; the control cohort was lower-risk, RT-alone, with no planned ADT.

Relugolix 360mg load then 120mg daily vs leuprolide 3-month depot. Serial coronary CTA at baseline and 12mo, blinded to arm, quantified by the HeartFlow automated tool.

Primary: 12-month change in total plaque volume. Secondary: non-calcified, calcified, and low-attenuation plaque subtypes.

Adjusted mean total-plaque difference 68.9 mm³ favoring relugolix; crude 12-mo change 56 vs 25 mm³ (leuprolide vs relugolix). Excess driven by non-calcified plaque; calcified and low-attenuation subtypes showed no significant difference.

Offers a coronary-atherosclerosis mechanism for HERO (2020), where relugolix showed lower MACE than leuprolide despite similar testosterone suppression and metabolic effects.

Surrogate imaging endpoint (plaque volume), not clinical MACE; small single-institution N=94, 12-month follow-up. Open-label, with a non-randomized RT-alone control cohort.

Small single-institution randomized trial, surrogate coronary-plaque imaging endpoint (not clinical MACE), 12-mo f/u; mechanistically supports HERO but doesn't independently establish clinical benefit.

Phase 2 randomized trial, 2:1 SABR vs observation, N=54 at 3 US radiation centers. Primary: composite progression at 6 mo. Median follow-up 18.8 mo.

Recurrent hormone-sensitive prostate cancer, 1-3 asymptomatic mets ≤5 cm on conventional imaging, prior definitive treatment of the primary. No ADT within 6 mo. Median age 68.

SABR to all conventional-imaging metastases; PSMA-PET obtained but blinded to planning. Dose/fractionation not reported in source. Local control 98.9% at 6 mo.

Because PET was blinded, 16/36 SABR pts had untreated PET-avid lesions; any untreated lesion collapsed DMFS to 6.0 vs 29.0 mo (HR 0.19). Total consolidation, not SABR per se, drove the benefit.

Concordant with STOMP (phase 2 MDT in oligomet PC): both show metastasis-directed therapy delays progression and defers ADT. The pooled ORIOLE+STOMP analysis reinforced the signal.

Phase 2, N=54; composite surrogate primary read at 6 mo, not OS-powered. Open-label observation control. Conventional-imaging staging misses PET-avid disease.

Phase 2, N=54; composite progression primary read at only 6mo. Randomised but small, short f/u. Concordant with STOMP MDT signal; awaits phase 3.

Randomised phase 2, N=224 (111 asandeutertinib vs 113 osimertinib), 1L EGFR-mutant NSCLC with brain metastases. All efficacy endpoints BICR-assessed. Blinding not specified in source.

Treatment-naive (1L) EGFR-mutant NSCLC with brain metastases. Mutation subtype, symptomatic status, and prior brain RT not reported in source.

Asandeutertinib (next-generation EGFR TKI) vs osimertinib. Dose and schedule not reported in source.

Intracranial endpoints (response, icPFS) drove the result and cleared significance more decisively than the borderline overall PFS benefit. Full arm comparison in the table above.

Any TRAEs 99.1% vs 95.6%; serious TRAEs numerically higher with asandeutertinib (10.8% vs 7.1%). Fatal and discontinuation rates not reported in source.

Osimertinib is the established CNS-active 1L EGFR TKI (FLAURA). Asandeutertinib raises the intracranial bar in phase 2, but no OS or phase 3 head-to-head yet.

Phase 2 with immature time-to-event data (medians not reached); overall PFS benefit borderline (p=0.0473); no OS; blinding not specified.

Strong intracranial activity revives whether a CNS-active TKI can defer upfront brain-directed RT/SRS in EGFR-mutant NSCLC. Phase 3 confirmation vs osimertinib, plus OS and durability, is needed before displacing the standard.

Randomised phase 2; strong intracranial ORR but time-to-event immature (medians NR), overall PFS borderline (p=0.0473), no OS. Needs phase 3 before displacing osimertinib.

Non-randomised phase 2, eight hospitals in Australia and the Netherlands (TROG 15.03, with ANZUP). Accrual July 28 2016 to Feb 27 2020: 71 enrolled, one withdrew consent before treatment, 70 treated. This report is the pre-planned final long-term follow-up, median 62 months (IQR 60-72).

Histologically confirmed primary RCC in pts who were medically inoperable, high risk, or declined surgery; ECOG ≤2; tumour ≤10 cm; N0-N1. Median age 77 (70-82), 70% male. Median tumour size 46 mm (37-55): T1a 34%, T1b 56%, T2a 9%, T3a 1%, with one N1 pt.

Size-adapted prescription: 26 Gy in a single fraction for tumours ≤4 cm, and 42 Gy in 3 fractions delivered 48 h apart for tumours >4 cm. No systemic therapy component.

Primary: freedom from local progression by RECIST, assessed in the intention-to-treat population, with safety co-assessed in ITT.

100% local control at 36, 60, and 84 months, with no local recurrences and no cancer-related deaths reported over median 62-month follow-up.

Seven pts (10%) had at least one treatment-related grade 3 event within 9 months: pain (abdominal/flank/tumour) 4 (6%), nausea and vomiting 3 (4%), colonic obstruction 2 (3%), diarrhoea 1 (1%). No grade 4 events, no treatment-related deaths, and no new long-term safety signals.

Single-arm and non-randomised: no head-to-head against partial nephrectomy, cryoablation, or radiofrequency ablation, which is the live comparison in the surgery-declining subset. N=70 with one N1 pt leaves nodal disease essentially untested. Industry co-funding (Varian) alongside Cancer Australia.

The value here is durability rather than magnitude: a flat 100% at 84 months in a cohort with median 46 mm tumours argues the ablative dose is adequate for lesions well beyond the small-renal-mass range where thermal ablation is usually deployed. The bowel events, not renal function, define the practical constraint for central tumours on the 3-fraction schedule.

Single-arm phase 2; no randomised comparator vs nephrectomy or thermal ablation. Long f/u and 100% local control do not lift a non-randomised design.

Phase II randomized trial of metastasis-directed therapy added to standard of care vs standard of care alone in oligometastatic solid tumors. This report is the primary analysis of all tumor-histology baskets pooled.

No effect sizes are reported in the source, which is a tweet plus a JCO title-page image. Primary endpoint, medians, HRs, and follow-up all require the full text.

Pooling across histology baskets can obscure heterogeneity between them. MDT technique, dose, fractionation, and target volume are not stated in source, so transferability to a specific RT practice cannot be judged here.

Phase II randomized basket design caps the read at hypothesis-generating; source gives no primary endpoint, effect size, or follow-up to classify further.