The phase 3 multiarm, multistage STAMPEDE trial has been a tour de force in prostate cancer—its design has allowed efficient evaluation of pressing questions in the management of high-risk and metastatic prostate cancer resulting in practice change multiple times over. The publication by Parker et al1 in Lancet in 2018 was one of STAMPEDE’s landmark comparisons. While the hypothesis that prostate radiotherapy (RT) would improve overall survival (OS) was negative for the population as a whole, the study enrolled sufficient patients that a planned analysis of metastatic burden showed that RT did improve OS in men with a low metastatic burden.
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Koontz BF, Hope TA. More Answers and More Questions About Radiotherapy for Metastatic Prostate Cancer. JAMA Oncol. 2021;7(4):563–564. doi:10.1001/jamaoncol.2020.7708
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