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# PSMA-guided radiotherapy missed its primary endpoint but favoured biochemical control
- URL: https://www.coios.me/psma-guided-radiotherapy-missed-its-primary-endpoint-but/
- Published: 2026-10-05T07:24:17.000Z
- Updated: 2026-10-05T08:22:17.000Z
- Description: In a phase 2 randomised trial of 253 men, radiotherapy intensified to all PSMA-PET-detected lesions did not meet its primary endpoint of five-year failure-free survival (66% vs 62%), though freedom from biochemical progression was higher (72% vs 65%).
- Author: Daniel Ryan
- Tags: Healthcare today, Cancer, Innovation in treatment, Canada, #peer-reviewed, #new, #item, #source-2026-10

A two-centre phase 2 randomised trial assigned 253 men planned for standard radiotherapy to standard of care or to radiotherapy intensified to every site detected on PSMA-PET, across salvage post-prostatectomy, high-risk, oligometastatic and post-radiotherapy strata. At a median 66 months, five-year failure-free survival was 66% with PSMA-guided treatment versus 62% with standard care (HR 0.80), short of the prespecified threshold; freedom from biochemical progression was 72% versus 65% (sHR 0.70). Estimates favoured PSMA-guided treatment more in the high-risk and post-prostatectomy strata, where the combined analysis was post hoc, and one grade 3 or worse event was possibly related to dose escalation.

*Why it is interesting: Randomised outcome data on whether treatment guided by PSMA-PET lesion detection improves outcomes, ahead of the phase 3 PATRON trial.*

Source

[European Urology, 3 October 2026](https://doi.org/10.1016/j.eururo.2026.09.017?ref=coios.me)

DOI

10.1016/j.eururo.2026.09.017

Type

Peer-reviewed article

Design

Two-centre phase 2 open-label RCT, 262 randomised (253 analysed) 2018-2021, median follow-up 66 months

Verdict

New finding

Driver

[Cancer](https://www.coios.me/d-cancer/)

Driver

[Innovation in treatment](https://www.coios.me/d-treatment-innovation/)