Is There a Role for Prostate Radiotherapy in De Novo Metastatic Prostate Cancer?

Overwhelming level 1 evidence supports the addition of androgen receptor pathway inhibitors with or without docetaxel in patients with de novo metastatic castration-sensitive prostate cancer (mCSPC). A meta-analysis of two randomized trials showed evidence of survival benefit from the addition of prostate radiotherapy in men with low-volume metastatic disease (Eur Urol 2019; 76:115).

Now, investigators from the industry-funded, randomized, phase 3 PEACE-1 trial report the efficacy and safety associated with the addition of prostate radiotherapy to androgen deprivation therapy (ADT), docetaxel, and abiraterone in these patients. In the ongoing open-label trial, 1172 patients with de novo mCSPC were randomly assigned to receive standard of car…