Personalized Prostate Cancer Therapy Study Closes Early

by Shreeya
Prostate Cancer

A large national clinical trial for high-risk prostate cancer has completed enrollment nearly two years ahead of schedule, a milestone researchers attribute to the growing use of genomic testing. The NRG Oncology PREDICT-RT study aims to determine if treatment can be tailored based on a tumor’s genetic profile, potentially improving outcomes and reducing side effects for men.

The trial enrolled 2,478 patients, far exceeding initial projections for its accrual rate. This rapid enrollment reflects a significant shift in prostate cancer care, as more clinicians and patients embrace genomic tools to guide critical treatment decisions.

“Prostate cancer is not one-size-fits-all. This study was designed to improve quality of life and outcomes by matching the treatment intensity to the aggressiveness of each man’s cancer, as determined by a genomic test,” said Dr. Paul Nguyen, the study’s Principal Investigator from Mass General Brigham and Dana-Farber Cancer Institute.

How the PREDICT-RT Trial Works

The trial uses the Decipher Prostate Genomic Classifier, a test that analyzes the tumor’s RNA to generate a score predicting how aggressive the cancer is likely to be. Based on this score, patients were assigned to one of two study groups:

De-Intensification Group (Lower Genomic Risk): Men with a Decipher score ≤ 0.85 were randomized to receive either the current standard of care (radiation + 24 months of hormone therapy) or a less intensive regimen (radiation + 12 months of hormone therapy). The goal is to see if less therapy can achieve the same survival results while preserving quality of life.

Intensification Group (Higher Genomic Risk): Men with a higher Decipher score or disease that had spread to lymph nodes received the standard care (radiation + 24 months of hormone therapy) with or without an additional powerful drug, apalutamide, for two years. The objective is to see if intensifying treatment can improve metastasis-free survival for these higher-risk patients.

The primary goals are to see if de-intensified care is not worse than standard care for lower-risk men and if intensified care is better for higher-risk men.

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