A randomised trial of short- vs long-term androgen deprivation with salvage radiotherapy for biochemical failure following radical prostatectomy: URONCOR 06-24

BJU Int. 2024 Oct;134(4):568-577. doi: 10.1111/bju.16484. Epub 2024 Jul 23.

Abstract

Background: Salvage radiotherapy (SRT) and androgen-deprivation therapy (ADT) are widely used in routine clinical practice to treat patients with prostate cancer who develop biochemical recurrence (BCR) after radical prostatectomy (RP). However, there is no standard-of-care consensus on optimal duration ADT. Investigators propose three distinct risk groups in patients with prostate cancer treated with SRT in order to better define the indications and duration of ADT combined with SRT.

Study design: The URONCOR 06-24 trial (ClinicalTrials.gov identifier NCT05781217) is a prospective, multicentre, randomised, open-label, phase III, clinical trial. The aim of the trial is to determine the impact of short-term (6 months) vs long-term (24 months) ADT in combination with SRT on distant metastasis-free survival (MFS) in patients with prostate cancer with BCR after RP (intermediate and high risk).

Endpoints: The primary endpoint is 5-year MFS rates in patients with prostate cancer treated with long- vs short-term ADT in combination with SRT. Secondary objectives are biochemical-relapse free interval, pelvic progression-free survival, time to start of systemic treatment, time to castration resistance, cancer-specific survival, overall survival, acute and late toxicity, and quality of life.

Methods and analysis: Total of 534 patients will be randomised 1:1 to ADT 6 months or ADT 24 months with a luteinizing hormone-releasing hormone analogue in combination with SRT, stratified by risk group and pathological lymph node status.

Ethics and dissemination: The study is conducted under the guiding principles of the World Medical Association Declaration of Helsinki. The results will be disseminated at research conferences and in peer-reviewed journals.

Trial registration number: EudraCT number 2021-006975-41.

Keywords: androgen‐deprivation therapy; biochemical failure; prostate cancer; salvage radiotherapy; survival.

Publication types

  • Clinical Trial Protocol
  • Randomized Controlled Trial
  • Clinical Trial, Phase III
  • Multicenter Study

MeSH terms

  • Androgen Antagonists* / therapeutic use
  • Humans
  • Male
  • Multicenter Studies as Topic
  • Neoplasm Recurrence, Local
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatectomy*
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / radiotherapy
  • Prostatic Neoplasms* / surgery
  • Prostatic Neoplasms* / therapy
  • Randomized Controlled Trials as Topic
  • Salvage Therapy* / methods
  • Time Factors

Substances

  • Androgen Antagonists
  • Prostate-Specific Antigen

Associated data

  • ClinicalTrials.gov/NCT05781217