Nicholas van As: Delighted to share the results of PACE B trial

Nicholas van As, Medical Director at The Royal Marsden NHS Foundation Trust, shared his recent article on X:

“Delighted to share the results of PACE B trial, published in The New England Journal of Medicine.

Today 5 fraction SBRT is non inferior to CRT.

Title:Phase 3 Trial of Stereotactic Body Radiotherapy in Localized Prostate Cancer

Authors: Nicholas van As, Clare Griffin, Alison Tree, Jaymini Patel, Peter Ostler, Hans van der Voet, Andrew Loblaw, William Chu, Daniel Ford, Shaun Tolan, Suneil Jain, Philip Camilleri, Kiran Kancherla, John Frew, Andrew Chan, Olivia Naismith, John Armstrong, John Staffurth, Alexander Martin, Ian Dayes, Paula Wells, Derek Price, Emily Williamson, Julia Pugh, Georgina Manning, Stephanie Brown, Stephanie Burnett and Emma Hall

“874 men with low or intermediate risk PCa (90% intermediate risk) randomised between SBRT (36.25Gy) vs CRT (62GY in 20 0r 78Gy in 39)”

“Freedom from biochemical or clinical failure at 5 years for SBRT was 95.8% CI (93.3 to 97.4) vs 94.6% CI (91.9 to 96.4) for CRT p=0.004 for non inferiority.”

“No difference in RTOG GU toxicity. Cumulative GU CTCAE tox was 26.9% for SBRT vs 18.3% for CRT (HR:1.59 p<0.001). Toxicity mostly in first 18 months, no difference at 5 years.”

“No difference in GI toxicity or sexual function.”

“Thanks to all the amazing PACE team that made this trial possible and to all the patients who agreed to enter.”

Drew Moghanaki shared his views on the article on X:

“The more data I see showing the incredible effectiveness of SBRT, the more I realize the key thing holding back patients from this treatment, who favor surgery, is an uninformed sense of radiophobia.

Our societies must step up and do a better job to address this equity issue.”

Andrew Loblaw shared his views on the article on X:

“I’m so pleasantly surprised that 76% of patients were unfavourable intermediate risk yet only had a 4.2% risk of biochemical or clinical failure with no hormones in a 3 country international RCT.

I think it speaks to the tight RTQA built into protocol. Thank you.”

Nicholas van As is the Medical Director at The Royal Marsden NHS Foundation Trust, an oncologist, and a Professor at The Institute of Cancer Research. His research focuses on stereotactic and image-guided radiotherapy, risk prediction in early prostate cancer, and functional MRI. He serves as the Chief Investigator for the PACE trial, an international randomized controlled trial comparing stereotactic body radiotherapy (SBRT) to image-guided radiotherapy (IGRT) and surgery for prostate cancer treatment.