Ian Davis (Bluesky @profiand)

Can treatment intensification improve outcomes in high-risk prostate cancer, or does the benefit depend on who we treat? ascopubs.org/doi/pdf/10.1200… ENZARAD (ANZUP 1303): Phase 3 Trial of Enzalutamide With Androgen Deprivation Therapy and Radiation Therapy in High-Risk Localized or Locally Advanced Prostate Cancer The phase 3 ENZARAD trial evaluated adding enzalutamide to ADT and definitive radiotherapy ☢️ in 802 patients with high-risk localized or locally advanced #ProstateCancer . ➡️At eight years, metastasis-free survival was 74% versus 72%, showing no statistically significant overall benefit. ➡️However, patients receiving pelvic nodal radiotherapy demonstrated a notable benefit (HR 0.47). Grade 3–5 adverse events were identical at 46%, highlighting important questions about patient selection and treatment intensification. @ChrisSweens1, @DocJarad, @RayMcDermott1, @MartinStockler, @Prof_IanD, @DrPaulNguyen @OncoAlert 🚨 #LPCCC27 @Silke_Gillessen @AOmlin @ProfKHerrmann @weoncologists

🔬 Can adding an androgen receptor inhibitor to ADT and radiotherapy improve metastasis-free survival in very high-risk localised prostate cancer? New Phase 3 interim results from DASL-HiCaP suggest a significant benefit. 📊 LBA4 – DASL-HiCaP (ANZUP1801): Darolutamide with ADT and definitive or salvage locoregional radiotherapy cslide.ctimeetingtech.com/es… Darolutamide added to ADT and locoregional radiotherapy significantly improved metastasis-free survival in patients with very high-risk localised or biochemically persistent/recurrent prostate cancer. At four years, metastasis-free survival was 95% versus 88% with placebo (HR 0.42; p=0.0001). ✅ These findings support treatment intensification, although longer follow-up is needed to establish whether this benefit translates into improved overall survival. #ProstateCancer @niazi_Dr7, @Prof_IanD, @ChrisSweens1, @AlisonZhangMBBS, @seanmmcbride, @DocJarad, @DavePryorRO, @MartinStockler @OncoAlert 🚨 #LPCCC27 @Silke_Gillessen @AOmlin @ProfKHerrmann @weoncologists

‼️ On 134 key questions in prostate cancer care, experts reached consensus on just 44. What does that tell us about the evidence guiding treatment — and where do we need better answers? 📄 Management of Patients with High-risk Localised, Locally Advanced, and Biochemically Recurrent Prostate Cancer: Report from the 2026 Advanced Prostate Cancer Consensus Conference 🔗 sciencedirect.com/science/ar… At #APCCC26, 144 international experts 🌐 tackled challenging clinical questions where high-level evidence remains limited. Using a modified Delphi process, 133 panellists voted on 134 questions covering high-risk localised, locally advanced and biochemically recurrent prostate cancer, including PSA persistence, PSA recurrence and treatment-related side effects. ✅ Consensus (≥75% agreement) was reached on just 44 questions (32.8%), with strong consensus (≥90%) on only seven. 👉 Where experts disagree, the need for better evidence is clear. Areas without consensus highlight important priorities for future clinical trials. @Silke_Gillessen, @AOmlin, @Prof_Nick_James, @LVM_Walz, @AOmlin, @AttardLab, @bjartell, @LoebStacy, @Tilki_De, @piet_ost, @Nicola_Fossati, @AnthonyMJoshua, @VedangMurthy, @neerajaiims, @Achard_Verane, @PBlanchardMD, @lisahorvath73, @BarbaraJereczek, @fontev1, @ChrisSweens1, @AarmstrongDuke, @CharlesRyanMD, @ProfKHerrmann, @KarimFizazi, @NealShore, @himishabeltran, @HeatherChengMD, @DrRanaMcKay, @AliciaMorgansMD, @declangmurphy, @DrSpratticus, @EvanYuMD, @NehaVapiwalaMD, @drjefstathiou, @BertrandTOMBAL @OncoAlert 🚨 #ProstateCancer #APCCC26