I am pleased to announce that the medical journal The Lancet Oncology has published 2-year results on MRI-guided focused ultrasound as a focal therapy for intermediate risk prostate cancer (PCa). This is a particular privilege for the Sperling Prostate Center, since we were one of eight sites participating in a national clinical trial of this noninvasive treatment.
This was not the first presentation of our data. In an earlier blog, I wrote that our results were posted as an abstract at the September, 2021 annual meeting of the American Urological Association. Now, acceptance by The Lancet is something in which we take special pride. The collective Lancet journals have earned the tag line, “The Best Science for Better Lives,” in part due to their credibility.
The Lancet Oncology, one of their 23 specialty journals, is ranked 5th among 242 oncology journals in the world. Only a third of submitted papers are accepted for publication, and ours was one of them. This is an honor and a privilege. It was good news for our clinical trial, but more importantly, our impressive clinical outcomes are excellent news about a beneficial noninvasive treatment for men that controls cancer with minimal-to-no side effects.
The story begins with the 101 enrolled patients whose intermediate-risk PCa met the criteria for a focal treatment. Our study participants were treated between May 4, 2017 and Dec. 21, 2018, and who would be followed for two years. Most of them had been diagnosed with grade group 2 disease, but some had grade group 3. The average age was 63, and the average PSA was 5.7 ng/mL. There were no severe side effects following treatment, and only one urinary tract infection was reported.
Treatment effectiveness was monitored by 6-month biopsy targeted to the area of treatment, and a combined targeted and systematic biopsy at 24 months. The primary outcome was defined as absence of grade group 2 and higher PCa in the treated area. Our results showed that 88% of participants achieved this outcome, with no evidence of PCa in the treated area as defined.
These are very encouraging numbers in terms of the safety and effectiveness of MRI-guided focused ultrasound as a focal treatment for grade group 2 or 3 PCa. As discussed in our Lancet Oncology paper, “These results support focal therapy for select patients and its use in comparative trials to determine if a tissue-preserving approach is effective in delaying or eliminating the need for radical whole-gland treatment in the long term.”[i] In other words, can carefully selected patients with intermediate-risk PCa avoid the side effects of whole gland treatment (surgery, radiation, ablation) in the short term, or even gain permanent cancer control and never need a radical therapy? Future clinical trials will help answer this question, as will the experience of patients themselves who live out the results of their treatment.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
[i] Ehdaie B, Tempany CM, Holland F, Sjoberg DD et al. MRI-guided focused ultrasound focal therapy for patients
with intermediate-risk prostate cancer: a phase 2b, multicentre study. Lancet Oncology. 2022 Jun 14.