SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic…

Randomized trialThe Lancet. Oncology· Jul 2026

SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer (ARTO): long-term, unplanned overall survival analysis of an open-label, randomised, phase 2 trial.

Giulio Francolini, Vanessa Di Cataldo, Saverio Caini … ARTO Working Group

Prostate CancerRandomized trialTreatmentQ1IF 9.4

Adding SBRT to systemic therapy improves overall survival in prostate cancer.

SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer (ARTO): long-term, unplanned overall survival analysis of an open-label, randomised, phase 2 trial.

Giulio Francolini … ARTO Working Group

The Lancet · Jul 2026

Background

The ARTO trial showed improved early clinical outcomes by adding metastasis-directed therapy (metastasis-directed therapy), through stereotactic body radiotherapy (stereotactic body radiotherapy), to abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer.

Purpose

The aim of this analysis is to explore the long-term impact of metastasis-directed therapy on overall survival.

Methods

Were randomly assigned (1:1, using random permuted blocks; stratified by treating centre, Eastern Cooperative Oncology Group performance status, and number of metastases) in an open-label design to androgen deprivation therapy plus oral abiraterone acetate 1000 mg daily with or without stereotactic body radiotherapy to all sites of metastatic disease (one to five fractions providing a biologically effective dose ≥100 Gy).

n = 157 patients

Results

HR 0·55

adding SBRT to systemic therapy lowered the risk of death

n = 157 patients

More results

Between Jan 2, 2019, and Sept 7, 2022, 157 patients were randomly assigned to the control (n=82) and experimental (n=75) groups.

More results

Most common grade 3-4 adverse events recorded were infectious complications (five in the control group vs zero in the experimental group) and cardiovascular disorders (three in the control group vs three in the experimental group).

One treatment-related death occurred in the control group due to myocardial failure.

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Conclusion

The ARTO trial showed significant benefit in overall survival with the addition of metastasis-directed therapy to systemic therapy versus systemic therapy alone.

SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer (ARTO): long-term, unplanned overall survival analysis of an open-label, randomised, phase 2 trial.

SBRT plus abiraterone acetate and ADT versus abiraterone acetate and ADT in oligometastatic castrate-resistant prostate cancer (ARTO): long-term, unplanned overall survival analysis of an open-label, randomised, phase 2 trial.

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