RAVES clarifies post-operative radiotherapy in prostate cancer

A big week for prostate cancer in the Lancet! No less than three much-anticipated randomised trials to investigate the role of adjuvant vs salvage radiotherapy in prostate cancer, were published in the Lancet and Lancet Oncology this week, plus a pre-planned meta-analysis of all three. RAVES, RADICALS-RT, and GETUG-AFU 17, each examined the issue of post-operative radiotherapy in men at risk of biochemical recurrence, and randomised those men to receive radiotherapy prior to PSA recurrence (adjuvant), or at the first sign of PSA recurrence (early salvage). There were some differences in patient population and trial design, but the overall message is that early salvage radiotherapy offers the same oncological benefit as adjuvant radiotherapy, with significantly less toxicity. An accompanying pre-planned meta-analayis (ARTISTIC), and Editorial reinforce the message.
GU Cast hosts Professor Declan Murphy and Dr Renu Eapen were delighted to speak today with RAVES lead author Professor Andrew Kneebone of Royal North Shore Hospital/University of Sydney, and co-author Professor Mark Frydenberg of Monash University, about the results of this trial and what it means for patients at risk of biochemical recurrence following radical prostatectomy. Truly practice-defining studies!

Links:
RAVES paper
RADICALS
GETUG-17
ARTISTIC meta-analysis
Lancet Editorial

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ANZUP