2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7ec,Most patients with high-risk localized prostate cancer (HRLPC) do not undergo stereotactic body radiotherapy (SBRT) in part because of the limited evidence of long-term outcomes. We report long-term efficacy and toxicity outcomes for men treated with SBRT for HRLPC. Individual patient data from ten prospective clinical studies evaluating SBRT for HRLPC across nine institutions were pooled in the Stereotactic Body Radiotherapy for High-Risk Localized Carcinoma of the Prostate consortium. The Kaplan-Meier method was used to estimate 5-yr biochemical recurrence (BCR) and distant metastasis (DM), stratified by receipt of intensified treatment (≥12 mo of androgen deprivation therapy [ADT] with extremely dose-escalated [≥8 Gy/fraction] prostate-directed SBRT). The impact of intensified treatment on BCR-free survival and DM-free survival was evaluated using multivariable Cox proportional hazards models. Late Common Terminology Criteria for Adverse Events grade ≥2 gastrointestinal (GI) and genitourinary (GU) toxicity was analyzed using time-to-event models. In 440 patients with a median follow-up time of 60.4 mo, 5-yr BCR and DM rates were 22% (95% confidence interval [CI] = 17-26%] and 9.2% (95% CI = 6.2-12%), respectively. In the 93 patients (21%) who received intensified treatment, 5-yr BCR and DM rates were 7.4% (95% CI = 1.7-13%) and 3.7% (95% CI = 0-7.9%), respectively. Receipt of intensified therapy was associated with a significant reduction in both BCR (hazard ratio [HR] = 0.38 [95% CI = 0.20-0.74], p = 0.005) and DM (HR = 0.43 [95% CI = 0.18-0.99], p = 0.049). For the overall cohort, 5-yr rates of grade ≥2 GU and GI toxicity were 23% (95% CI = 19-27%) and 10% (95% CI = 7-13%), respectively. Limitations include heterogeneous treatment techniques and the nonrandomized nature of the study. The safety and efficacy profile of SBRT for HRLPC remains favorable at long-term follow-up, and SBRT should be integrated into shared decision-making for treatment of HRLPC.31:T747,Docetaxel improves survival in metastatic hormone-sensitive prostate cancer (mHSPC) and high-risk localized disease, but benefits vary substantially among patients. Without predictive biomarkers, clinicians cannot identify patients who will benefit, exposing many to unnecessary toxicity. We developed and validated an artificial intelligence-based pathology image classifier (APIC) to predict docetaxel benefit. We analyzed digitized H&E-stained biopsy specimens from two phase 3 trials: CHAARTED (286/790 patients with mHSPC) and NRG/RTOG 0521 (350/563 patients with high-risk localized disease). APIC used features capturing tumor-immune spatial interactions and nuclear heterogeneity. We evaluated the predictive value of APIC for docetaxel benefit on overall survival and castration-resistance using Cox proportional hazards with interaction terms. In CHAARTED, APIC-positive patients (56.7%) showed significant overall survival improvement with docetaxel (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.31-0.85; P = 0.008) and delayed castration-resistance (HR 0.48, 95% CI 0.33-0.71; P < 0.001), while APIC-negative patients (43.3%) showed no benefit (HR 1.31, 95% CI 0.71-2.44; P = 0.39). Treatment-APIC interactions were significant (P = 0.022 and P = 0.031). In NRG/RTOG 0521, APIC-positive patients (44.7%) demonstrated survival benefit (HR 0.49, 95% CI 0.26-0.92; P = 0.023), while APIC-negative patients (55.3%) showed no benefit. Treatment-APIC interaction was significant (P = 0.024). Predictive value remained significant after adjusting for clinical variables. Limitations include retrospective analysis and need for prospective validation. APIC predicts docetaxel benefit in both metastatic and localized prostate cancer, independent of clinical factors. Validation in triplet therapy with androgen receptor pathway inhibitors is needed.32:T9ef,Abstract Purpose: Docetaxel improves survival in metastatic hormone-sensitive prostate cancer (mHSPC) and high-risk localized disease, but benefits vary substantially among patients. Without predictive biomarkers, clinicians cannot identify patients who will benefit, exposing many to unnecessary toxicity. We developed and validated an artificial intelligence–based pathology image classifier (APIC) to predict docetaxel benefit. Experimental Design: We analyzed digitized hematoxylin and eosin–stained biopsy specimens from two phase 3 trials: CHAARTED (286/790 patients with mHSPC) and NRG/RTOG 0521 (350/563 patients with high-risk localized disease). APIC used features capturing tumor-immune spatial interactions and nuclear heterogeneity. We evaluated the predictive value of APIC for docetaxel benefit on overall survival (OS) and castration resistance using Cox proportional hazards with interaction terms. Results: In CHAARTED, APIC-positive patients (56.7%) showed significant OS improvement with docetaxel [HR, 0.52; 95% confidence interval (CI), 0.31–0.85; P = 0.008] and delayed castration resistance (HR, 0.48; 95% CI, 0.33–0.71; P < 0.001), whereas APIC-negative patients (43.3%) showed no benefit (HR, 1.31; 95% CI, 0.71–2.44; P = 0.39). Treatment–APIC interactions were significant (P = 0.022 and P = 0.031). In NRG/RTOG 0521, APIC-positive patients (44.7%) demonstrated survival benefit (HR, 0.49; 95% CI, 0.26–0.92; P = 0.023), whereas APIC-negative patients (55.3%) showed no benefit. Treatment–APIC interaction was significant (P = 0.024). Predictive value remained significant after adjusting for clinical variables. Limitations include retrospective analysis and need for prospective validation. Conclusions: APIC predicts docetaxel benefit in both metastatic and localized prostate cancers, independent of clinical factors. Validation in triplet therapy with androgen receptor pathway inhibitors is needed. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"High-Risk Localized Prostate Cancer: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on High-Risk Localized Prostate Cancer (condition). Clinician-written summaries and actionable practice insights. 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Clinicians should watch for upcoming trials with standardized endpoints before considering this approach outside a research setting."}},{"doi":"10.1016/j.euo.2026.03.019","pmid":"41966956","title":"Extended Follow-up from the Stereotactic Body Radiotherapy for High-risk Localized Carcinoma of the Prostate (SHARP) Consortium: Updated Analysis of 440 Patients","journal_title":"European Urology Oncology","journal_issn":"2588-9311","published_at":"2026-04-12T00:00:00.000Z","url":"https://doi.org/10.1016/j.euo.2026.03.019","source_score":38,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-04-14","doi":"10.1016/j.euo.2026.03.019","days":"30","issn":"2588-9311","rank":"7","field":"Clinical Medicine","score":"38","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1016/j.euo.2026.03.019","title":"Extended Follow-up from the Stereotactic Body Radiotherapy for High-risk Localized 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All rights are reserved, including those for text and data mining, AI training, and similar technologies."}],"deposited":{"date-time":"2026-04-23T19:55:08Z","timestamp":1776974108000,"date-parts":[[2026,4,23]]},"issn-type":[{"type":"print","value":"2588-9311"}],"published":{"date-parts":[[2026,4]]},"publisher":"Elsevier BV","reference":[{"DOI":"10.1056/NEJMoa2403365","key":"10.1016/j.euo.2026.03.019_b0005","year":"2024","issue":null,"author":"van As","volume":"391","first-page":"1413","unstructured":null,"article-title":"Phase 3 trial of stereotactic body radiotherapy in localized prostate cancer","journal-title":"N Engl J Med","doi-asserted-by":"crossref"},{"DOI":"10.1038/s41391-020-00300-5","key":"10.1016/j.euo.2026.03.019_b0010","year":"2021","issue":null,"author":"Patel","volume":"24","first-page":"578","unstructured":null,"article-title":"Stereotactic body radiation therapy use for high risk prostate cancer in the United States","journal-title":"Prostate Cancer Prostatic Dis","doi-asserted-by":"crossref"},{"DOI":"10.3390/cancers13040759","key":"10.1016/j.euo.2026.03.019_b0015","year":"2021","issue":null,"author":"Foerster","volume":"13","first-page":"759","unstructured":null,"article-title":"Stereotactic body radiotherapy for high-risk prostate cancer: a systematic review","journal-title":"Cancers (Basel)","doi-asserted-by":"crossref"},{"DOI":"10.1016/S0140-6736(19)31131-6","key":"10.1016/j.euo.2026.03.019_b0020","year":"2019","issue":null,"author":"Widmark","volume":"394","first-page":"385","unstructured":null,"article-title":"Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: five-yr outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial","journal-title":"Lancet","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.clon.2018.03.004","key":"10.1016/j.euo.2026.03.019_b0025","year":"2018","issue":null,"author":"Murthy","volume":"30","first-page":"442","unstructured":null,"article-title":"Early results of extreme hypofractionation using stereotactic body radiation therapy for high-risk, very high-risk and node-positive prostate cancer","journal-title":"Clin Oncol (R Coll Radiol)","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.ijrobp.2018.11.011","key":"10.1016/j.euo.2026.03.019_b0030","year":"2019","issue":null,"author":"Alayed","volume":"104","first-page":"36","unstructured":null,"article-title":"SABR in high-risk prostate cancer: outcomes from 2 prospective clinical trials with and without elective nodal irradiation","journal-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"crossref"},{"DOI":"10.3390/cancers14143484","key":"10.1016/j.euo.2026.03.019_b0035","year":"2022","issue":null,"author":"Poon","volume":"14","first-page":"3484","unstructured":null,"article-title":"A prospective study of stereotactic body radiotherapy (SBRT) with concomitant whole-pelvic radiotherapy (WPRT) for high-risk localized prostate cancer patients using 1.5 tesla magnetic resonance guidance: the preliminary clinical outcome","journal-title":"Cancers (Basel)","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.ejca.2016.02.014","key":"10.1016/j.euo.2026.03.019_b0040","year":"2016","issue":null,"author":"Hannan","volume":"59","first-page":"142","unstructured":null,"article-title":"Stereotactic body radiation therapy for low and intermediate risk prostate cancer-Results from a multi-institutional clinical trial","journal-title":"Eur J Cancer","doi-asserted-by":"crossref"},{"DOI":"10.1016/j.ijrobp.2021.01.016","key":"10.1016/j.euo.2026.03.019_b0045","year":"2021","issue":null,"author":"van Dams","volume":"110","first-page":"731","unstructured":null,"article-title":"Stereotactic body radiotherapy for high-risk localized carcinoma of the prostate (SHARP) consortium: analysis of 344 prospectively treated patients","journal-title":"Int J Radiat Oncol Biol Phys","doi-asserted-by":"crossref"},{"DOI":null,"key":"10.1016/j.euo.2026.03.019_b0050","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"National Comprehensive Cancer Network. 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Cancer","updated":"2025-12-04T15:52:58+00:00","published_date":"2025-12-01","best_oa_location":{"url":"https://doi.org/10.1158/1078-0432.ccr-25-3327","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1158/1078-0432.ccr-25-3327"}}},"created_at":"2026-01-15T20:51:27.064Z","updated_at":"2026-01-15T20:51:27.064Z","tags":[{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"condition","value":"High-Risk Localized Prostate Cancer","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"condition","value":"Metastatic Hormone-Sensitive Prostate Cancer","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"generic","value":"docetaxel","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"modality","value":"Taxane Chemotherapy","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"sample_size","value":"n=636","value_numeric":636},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"study_design","value":"Retrospective Cohort","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"warning","value":"Absolute survival rates and follow-up durations were not provided in the abstract.","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"warning","value":"Design classification is approximate: this is a retrospective biomarker analysis of subsets from two phase 3 trials, not a randomized test of the classifier.","value_numeric":null},{"paper_doi":"10.1158/1078-0432.ccr-25-3327","tag_type":"warning","value":"Only subsets with available digitized biopsies were included, which may limit generalizability.","value_numeric":null}],"summaries":{"what_studied":"Retrospective analyses of two phase 3 trials (CHAARTED: 286/790 with mHSPC; NRG/RTOG 0521: 350/563 with high‑risk localized disease) evaluated an AI pathology image classifier (APIC) on H&E biopsies to predict which patients gain survival benefit from docetaxel using Cox models with treatment-by-APIC interaction.","key_result":"In CHAARTED, APIC‑positive patients (56.7%) had improved overall survival with docetaxel (HR 0.52, 95% CI 0.31–0.85; P=0.008) and delayed castration‑resistance (HR 0.48, 95% CI 0.33–0.71; P<0.001), while APIC‑negative patients (43.3%) did not (OS HR 1.31, 95% CI 0.71–2.44; P=0.39); treatment‑APIC interactions were significant (P=0.022 and P=0.031). In NRG/RTOG 0521, APIC‑positive patients (44.7%) showed an OS benefit (HR 0.49, 95% CI 0.26–0.92; P=0.023), APIC‑negative patients did not, and the interaction was significant (P=0.024); effects persisted after adjustment for clinical variables.","limitations":"Retrospective analysis; findings require prospective validation. Only subsets of trial participants with available digitized biopsies were analyzed (CHAARTED 286/790; NRG/RTOG 0521 350/563).","practice_takeaway":"APIC appears to identify which patients with mHSPC or high‑risk localized prostate cancer benefit from docetaxel, while others may not. Until prospectively validated, use is exploratory and should not replace current selection criteria."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"High-Risk Localized Prostate Cancer"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"High-Risk Localized Prostate Cancer"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"High-Risk Localized Prostate Cancer"}}}]]

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