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Our Research

Our Research

Completed Trials

SABR Pooled Analysis PACE-B

Ongoing Trials

ASCENDE-SBRT

SABR: The emerging standard of care

Fewer treatments, better outcomes

A SABR radiotherapy session in real time

Stereotactic Ablative Body Radiotherapy (SABR) radiotherapy treatment promises better cure rates with fewer side effects.

The trial, which is taking place at nine Canadian cancer centres (and is part of a large-scale international trial called PACE), comes after early research indicated that SABR may deliver better cure rates with fewer side effects than the standard radiotherapy protocol.

With SABR, radiation sessions are reduced from 39 to just five.

The benefits of SABR

Reduced side effects in
sexual and urinary functioning. ​

96% of SABR patients retain normal sexual function compared to baseline.

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High rates of remission five
years after treatment.​

100% for low-risk patients and 95% for favourable intermediate-risk patients.

Lower treatment cost per
patient.

Cost for 5-session SABR is $1,470 vs. $6,987 for 39-session EBRT.

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Evolution of SABR

ENI using UHRT provides an oncological response with a demonstrated safety profile over 5 years of follow-up

With the increased use of SABR, novel adaptations to the approach are bound to emerge. Recently, a pooled analysis examined the clinical effect and safety profile of elective nodal irradiation (ENI) using ultra-hypofractionated radiation therapy (UHRT) in four separate prospective studies.

In this pooled analysis, ENI using UHRT was associated with low rates of Grade 3+ acute and late GU and GI toxicities and favourable oncologic and patient-reported outcomes.

Key observations from this pooled analysis

Low rates of Grade 3+ acute and late GI and GU toxicity.

0% and 2.7% incidence of acute GI and acute GU AEs, respectively.

1.5% and 0% incidence of late GI and GU AEs, respectively.

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Oncological outcomes across each of the 4 trials were high.

The 3-year metastases-free survival, CRPC-free survival and overall survival were 98%, 99% and 96.3%, respectively.

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Patient-reported urinary, bowel, and sexual QoL improved over time.

All domains were associated with improvement over time across the remainder of the follow-up period.
(p<0.0001, p=0.0018, and p<0.0001, respectively)

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CRPC=castrate-resistant prostate cancer; ENI=elective nodal irradiation; GI=gastrointestinal; GU=genitourinary; QoL=quality of life;
SABR=stereotactic ablative body radiotherapy; UHRT=ultra-hypofractionated radiation.

The impact of the PACE trial

PACE is setting the standard for favorable localized prostate cancer care – in Canada, and across the globe.

The PACE study includes PACE-A (which compared SABR to surgery) and PACE-B (which compared SABR to standard radiotherapy).

The PACE-B Trial

SABR can provide the effect you expect over 5 years of follow-up

The PACE-B trial was a large, international, multi-centre (38 sites), open-label, phase III randomized controlled trial comparing stereotactic ablative body radiotherapy (SABR) vs. standard radiotherapy among low- and intermediate-risk patients with localized PCa (N=874).

Key observations from the PACE-B trial

Lower treatment failure vs. standard radiotherapy over
5 years follow-up.

96% likelihood of remaining event-free for patients who received SABR vs. 94.6% with standard radiotherapy

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No unexpected safety signals or GI/GU adverse events were observed.

Cumulative incidence rates for late RTOG Grade ≥2 events up to 5 years was:

  • • similar for GI toxicity in SABR patients compared to standard radiotherapy patients (10.7% vs. 10.2%)
  • • higher for GU toxicity among those who received SABR compared to standard radiotherapy (27% vs. 18%)
  • • this is typically managed with a pill prescribed to help urination for a few months after treatment
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SABR can provide the results you expect within a fraction of the time and for a fraction of the cost.

In low- or intermediate-risk localized PCa, SABR was deemed equivalent to conventional radiotherapy for safety and achieving freedom from biochemical or clinical failure over 5 years of follow-up.

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The high chance of cancer control and acceptable safety profile observed in the PACE-B trial demonstrated that five-fraction SABR is a robust and viable alternative to conventional radiotherapy for prostate cancer, offering equivalent efficacy with enhanced convenience for patients.

AE=adverse event; GI=gastrointestinal; GU=genitourinary; PCa=prostate cancer; RTOG=Radiotherapy Oncology Group; SABR=stereotactic ablative body radiotherapy.

ongoing research

ASCENDE-SBRT: Comparing SABR to EBRT + brachytherapy boost

This recently launched, international, multicentre, open-label clinical trial will compare SABR to standard radiation therapy (EBRT) combined with a brachytherapy boost among patients with unfavourable risk PCa.

Trial Arm 1
EBRT + Brachy Boost
  • 46Gy / 23 fractions of EBRT to pelvis and prostate + LDR or HDR boost to prostate, plus
  • Adjuvant ADT for 6 months (unfavourable intermediate risk) or 24 months (high / very high risk)
Trial Arm 2
SABR
  • 25Gy / 5 fractions to pelvis + 40 Gy / 5 fractions to prostate
  • Adjuvant ADT for 6 months (unfavourable intermediate risk) or 24 months (high / very high risk)

Prospective participants

Key inclusion criteria
  • Histologically confirmed PCa, diagnosed within the last 9 months
  • Unfavourable or intermediate-risk PCa
Key exclusion criteria
  • Prior pelvic radiotherapy
  • Contraindication to radical prostate radiotherapy

Enrollment for the ASCENDE-SBRT clinical trial is ongoing and is estimated to be completed in Q4 of 2032.

Review the ASCENDE-SBRT trial design

EBRT=external body radiation therapy; PCa=prostate cancer; SABR=stereotactic body radiotherapy.

Have a message for us?
Email us at info@cureprostatecancer.ca



Charitable Registration #: 805140951 RR0001

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