Palliative care 2016

• Is SBRT replacing systemic therapy? • Or should they be combined? • TOAD trial (Duchesne et al, ASCO 2015): immediate versus delayed ADT at PSA relapse aSer defini(ve therapy – HR=0.55 (CI: 0.30-­‐1.00) • CHAARTED-­‐ (Sweeney et al NEJM 2015): ADT+docetaxel versus ADT alone in advanced stage hormone sensi(ve PCa – HR=0.61 (CI: 0.47-­‐0.80) – m-­‐OS: 58 and 44 months, respec(vely • STAMPEDE (James et al Lancet 2016): SOC+docetaxel versus SOC in advanced stage hormone sensi(ve PCa – HR=0·∙78 (CI: 0·∙66–0·∙93) • Combina(on with immune s(mula(ng agents SBRT of prostate cancer and systemic therapies